Out of School Registration Form

Name: HIA Year Round Camps – Spring Break
Start: 2023-03-27T08:00:00-06:00
End: 2023-03-31T17:00:00-06:00

I have a current funding agreement*

I have received services from AdaptAbilities before*

Parent/Guardian Name*

First Last

Phone Number*

Email Address*

Participant Name*

First Last

Participant Date of Birth*

(dd/mm/yyyy)

Age

(calculated automatically)

I am registering for:*

Select Days

Select a Location:*

Days Required:*

Select as many days as you need.

Pick-Up Time Requested:*

Please include hours requested for OS Care and full-day programming (if applicable).

AdaptAbilities Out of School Registration Form