SNAP Workshop Registration

Participant Application Form

Registration is for all nine (9) workshops

The program will run once a week on Wednesdays and is aimed at children between the ages of 7-15 who would benefit from the program. Please note that spaces are limited.

Criteria

Please fill out this application form if you believe your child meets the following criteria:

Must be a child with an intellectual disability between the ages of 7-15 years.
Must be physically comfortable moving up and down a basketball court.
Must have participated in group activities before and be comfortable with receiving instruction from multiple people.
Must be available to join all nine session dates.
The first three weeks, sessions will only run Wednesdays (February 1-15), and for the remaining weeks, sessions will run both Mondays and Wednesdays (February 20-March 8). Session dates are outlined below.
Children need to be transported to NYUAD’s Saadiyat Campus each session and parents or guardians are required to stay for the duration of each session.

Spring 2023 Dates

Wednesday, February 1, 2023
Wednesday, February 8, 2023
Wednesday, February 15, 2023
Monday, February 20, 2023
Wednesday, February 22, 2023
Monday, February 27, 2023
Wednesday, March 1, 2023
Monday, March 6, 2023
Wednesday, March 8, 2023

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.

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