Down Syndrome Advocates in Action Nebraska
Home
About Us
Programs
Myths and Facts
Buddy Walk
New Diagnosis
New Parents
>
Prenatal
Postnatal
New Grandparents
Medical Professionals
CONNECT
Events
Resources
Blog
Contact
Kearney
World Down Syndrome Day
New Parent Gift Bag Request
Next Chapter Book Club
Covid
IEP Support Request
IEP Support Request
Home
About Us
Programs
Myths and Facts
Buddy Walk
New Diagnosis
New Parents
>
Prenatal
Postnatal
New Grandparents
Medical Professionals
CONNECT
Events
Resources
Blog
Contact
Kearney
World Down Syndrome Day
New Parent Gift Bag Request
Next Chapter Book Club
Covid
IEP Support Request
IEP Support Request
Search by typing & pressing enter
YOUR CART
Participation Waiver
I hereby request that you accept this application to the Sibling Workshop for siblings ages 6-14 to be held at St. Luke United Methodist Church, 1621 Superior Street, Lincoln NE, on Saturday, .June 3, ,2017 from 1-4.
In consideration of your acceptance of the application, I hereby release the St. Luke United Methodist Church from all claims on account of any injuries which may be sustained while attending the Sibling Workshop Event; and I agree to indemnify St. Luke and the ARC, and Down Syndrome Advocates in Action groups and all their employees for any claim which may hereafter be presented by me as a result of any such injuries.
I also grant permission for the ARC and Down Syndrome Advocates in Action NE to use photos and videos taken at the Sibling Workshop Event for publicity, advertising or other purposes.
The Arc and Down Syndrome Advocates in Action admits all applicants without regard to gender, disability, ace, color, religion, national or ethnic origin, or sexual orientation.
*
Indicates required field
Parent or Guardian Electronic Signature, by entering your name below you agree to the terms of the waiver.
*
First
Last
[object Object]
Email
*
Phone Number
*
Name(s), age(s) and gender of siblings attending
*
What is the Name. Age and Gender of the individual with a disability
*
Nature of Disability
*
What School(s) do your children attend
*
Does your child have any food restrictions?
*
Submit