Boccia Registration

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Boccia Registration

Thank you for your interest in Boccia Ball! Our program is open to anyone with a physical disability at no cost. We will be meeting up every Thursday. We will have two separate 45-minute-long sessions at 3:45-4:30pm and 4:45-5:30pm. There is a participant spot cap for each session. If you are not able to make a selection for a specific day, then that means that the day has been filled. Registration for Boccia Ball will be done on a month-to-month base. The program will be located at MedStar NRH (102 Irving St NW, Washington, DC 20010).

At Boccia Ball we are only asking everyone to have fun and to make friends! So, no prior experience is required! All instruction and equipment will be provided, and the location of the program will be weather dependent. If it is expected to rain, be too hot, or too cold we will be inside at the Dining Hall of MedStar NRH. And, if it is expected to be nice and sunny, we will be outside at the outdoor sports court. Parking validation is available, and it is convenient for MetroAccess and transportation drop-off. If you have not participated in our programs before, you will be contacted for a program orientation and to confirm your participation.

If there are any questions, please do not hesitate to contact me, Tyra Anderson, at tyra.n.anderson@medstar.net.

Email *

Participant Name *

Participant's Phone Number *

Participant's Date of Birth *

YYYY

Primary Diagnosis (Physical Disability) *

What mobility devices (if any) do you use? *

Power Wheelchair

Manual Wheelchair

Walker

Cane

None

Other:

Allergies, if any? *

Emergency Contact's Name *

Emergency Contact's Telephone Number *

Emergency Contact's Email Address *

Please select attendance time for Thursday, May 2 *

Please select attendance time for Thursday, May 9 *

Please select attendance time for Thursday, May 16 *

Please select attendance time for Thursday, May 23 *

Please select attendance time for Thursday, May 30 *

If you haven't participated in our programs before, please let us know how you learned about them!

Please provide any additional information you feel would be important for our staff to know:

If you have not yet completed the MedStar NRH adaptive sports waiver, please read and complete it by clicking the link: https://editor.smartwaiver.com/w/56dda1b4a94e1/web/ *

I have read and signed the waiver.

Required

A copy of your responses will be emailed to the address you provided.

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