Under 18 DSAW Connects: Statewide Summer Programs Registration
Thank you for registering for our summer edition of DSAW Connects! This form is for participants under age 18. Despite the circumstances, we are thrilled to be able to offer you programs and classes via the internet! Completing this form does NOT guarantee your spot in the class(es). DSAW Staff will reach out to you to confirm your registration and to send you a personalized link to attend our online courses. Thank you! We look forward to learning with you virtually :)
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Email *
Parent/Guardian Name *
Participant Name *
Participant Age *
Phone *
Address *
Please select the virtual classes for which you would like to register.
DSAW Connects: Move & Grove
Get your sweat on while having fun! We will learn new moves and dance to your favorite music.
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DSAW Connects: Body Blast
A modified and inclusive fitness class for all abilities! Fun workout music and socialization with friends will enhance your experience and keep fitness fun!
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DSAW Connects: Let's Get Connected
Learn how to make new friendships while strengthening current relationships!
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DSAW Connects: Creative Corner
Participants will experience a variety of creative mediums including: cooking, art, writing, and more!
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DSAW Connects: Around the World
Take a trip around the world right from your own computer! Experience new cultures, foods, and languages from different countries across the world.
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DSAW Connects: Boost Your Brain
School may be out, but learning is always in! From mindful meditation to crossing the midline, learn a variety of activities that will teach you brand new ways to boost your brain!
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DSAW Connects: Media Madness
Explore challenges and benefits associated with technology and our expanding social network all while enjoying popular media.
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Check the box below if you/your self-advocate would like to be added to DSAW's virtual Facebook group!
Payment Options *
If you are paying thru CLTS, please list your consultant's or case manager's email address below.
Will your loved one be able to navigate a virtual program independently? If unsure, please contact Chris Gagne (chrisg@dsawfamilyservices.org) to discuss if virtual programs would be a good fit.
Please list any medical conditions or anything else we should know.
Let us know what other virtual programs you would like to see!
DSAW Waiver & Photography Release *
I, the participant, understand that during my participation in the Down Syndrome Association of Wisconsin Inc DSAW Connects series (hereby referred to as the "event") organized by the Down Syndrome Association of Wisconsin Inc and their officers, Board members, directors, employees, volunteers and agents (collectively, “Released Parties”) I may be exposed to a variety of hazards and risks, foreseen or unforeseen, which are inherent in the activities and cannot be eliminated without destroying the unique character of the event. These inherent risks include, but are not limited to, the dangers of technology, serious personal injury, death and property damage (“Injuries and Damages”). While DSAW has enabled all security features on Zoom, I understand that there are still risks in participating in an online class, including seeing or hearing disturbing content from someone inside or outside of the class list. I fully understand that the Released Parties have not tried to contradict or minimize my understanding of these risks. I know that Injuries and Damages can occur by natural causes or activities of other persons, other participants or volunteers or third parties, either as a result of negligence or because of other reasons. I understand the risks of such Injuries and Damages involved in the event and I appreciate that I may have to exercise extra care for my own person and for others around me in the face of such hazards. I further understand that there may not be medical personnel or medical facilities or expertise necessary to deal with the Injuries and Damages to which I may be exposed. In consideration for my acceptance as a virtual participant in the event, and the services and amenities provided by the Released Parties in connection with the event, I CONFIRM MY UNDERSTANDING OF THE FOLLOWING: RELEASE OF LIABILITY. To the fullest extent allowed by law, I agree to WAIVE AND DISCHARGE CLAIMS AGAINST, RELEASE FROM LIABILITY, INDEMNIFY AND HOLD HARMLESS the Released Parties and their officers, Board members, directors, employees, volunteers and agents (collectively, “Released Parties”) from and against ANY AND ALL LIABILITY on account of, or in any way resulting from, my death or personal injury relating to my participation in the event, even if caused by NEGLIGENCE of the Released Parties. Such negligence could involve (a) negligent operation and supervision of the event, (b) negligent maintenance or operation of the site or facilities in which event is conducted, (c) negligent manufacture of or use of equipment to be used in the event, and (d) the negligent provision of emergency response services. I understand and intend that the assumption of risk and release is binding upon my heirs, executors, administrators and assigns. This Waiver and Release is intended to be as broad and inclusive as is permitted by law. If any provision or any part of any provision of this Waiver and Release is held to be invalid or legally unenforceable for any reason, the remainder of this Waiver and Release shall not be affected thereby and shall remain valid and fully enforceable. I have read this Waiver and Release of Liability in its entirety and I freely and voluntarily choose to participate and assume all risks of Injuries and Damages. I agree to obey any rules and regulations that may relate to the event. I acknowledge my waiver of any right I may have to bargain for different terms of this waiver and recognize that a narrower waiver would increase the costs associated with the event and/or limit or preclude my participation in the event. I certify that he or she is the parent or legal guardian of the minor who is participating in the event, consents to his or her participation in the event and executes this Waiver and Release of Liability on behalf of such minor. Consent to Photograph and Release of Name:I hereby authorize the Down Syndrome Association of Wisconsin, and their officers, Board members, directors, employees, volunteers and agents (collectively, “Released Parties”) to photograph, film, or videotape. I hereby agree the Released Parties, collectively or individually, may use such photographs, films or videotapes, with or without prior notice, in general public relations, communications or for commercial purposes. I understand this Consent to Photograph is a valid written consent for purposes of Wis. Stat. § 995.50 and any other similar local, state or federal law regarding a right to privacy.I hereby authorize the Released Parties to use in writing or otherwise the name or identity of the participant.I release the Released Parties from any liability involved with this Consent to Photograph or Release of my Name.
A copy of your responses will be emailed to the address you provided.
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