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Event registration
Time:
Sessions vary by date
Event Address:
City Athletics, 1901 W. Tioga St. Philadelphia, PA 19140
Contact us at:
(267) 258-8687; elijah@peea.org; www.peea.org
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Email
*
Your email
Participant full name
*
Your answer
Date of birth
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MM
/
DD
/
YYYY
Home address including zip code
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Your answer
School (if applies). If not type NA
*
Your answer
Gender
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Male
Female
Prefer not to say
Is the participant mobile?
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Yes
No
Is the participant verbal?
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Yes
No
Does the participant require direct supports?
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Yes
No
Parent or guardian full name
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Your answer
Parent or guardian email address
*
Your answer
Parent or guardian best contact number
*
Your answer
Onsite best contact number
*
Your answer
What session(s) will the participant attend?
(check all that apply)
*
Janu, 2023
January 21, 2023
February 4, 2023
February 18, 2023
March 4, 2023
March 18, 2023
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Dietary restrictions (check all that apply)
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Vegetarian
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Nuts
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Gluten-free
None
Fish
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