SNAP Workshop Registration

Please complete the following application form as accurately as possible so that we can understand how to best accommodate for the child's needs and preferences.

* Required Field

Participant and Parent/Guardian Information

Full Name of parent/guardian: *
(first name, last name)

Full Name of the child: *
(first name, last name)

Email of parent/guardian: *

Contact number of parent/guardian: *

Child's gender: * Female Male

Child's age (as of February 1, 2023): *

Child's primary nationality: *

Child's primary language of instruction, in which they prefer to be addressed and which they understand (not necessarily speak): *

If Other, please indicate the language:

Languages spoken by the child: *

If Other, please list the language:

Child's grade/year: *

Name of the child's school/center (if applicable): *

Does the child have a 1:1 shadow? * Yes No

Child's diagnosis: *

What type of group is the child most comfortable with? *

What is the best way to give instructions to the child? *

If Other, please list:

Has the child played ball games before? (ex: basketball, football, handball, etc.) * Yes No

Does the child have any of the following physical limitations? *

Does the child have any specific triggers that may cause upset? *

If Other, please list:

What are some ways to make the child feel more calmed down? (ex.: holding hands, sitting away from the big group, covering ears, etc.). Please be as specific as possible. *

What reward systems do you use for the child to be more motivated and engaged? *

Please list any recreational activities/hobbies in which the child is involved: *

Is there anything else that we should know to provide a better experience for your child?

Photo Upload (Required)

Please follow the instructions to upload an image of the child in the box below. Be sure to follow this file name structure "Last name_First name" (e.g., Smith_Jill.jpg).*

Please check the "I'm not a robot" box above and wait until the green check-mark appears before you click the submit button.

Having difficulty with this form? Please let us know.