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SNRP Family Storytime and Crafts Registration
Registration Deadline: May 1, 2019
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* Indicates required question
First & Last Name of Child who is Deaf or Hard of Hearing
*
Your answer
Age of Child who is Deaf or Hard of Hearing
*
Your answer
Grade of Child who is Deaf or Hard of Hearing
*
Your answer
Preferred Method of Communication of Child who is Deaf or Hard of Hearing
*
Oral
Sign Language
Total Communication
Other:
Please check if your child who is Deaf or Hard of Hearing uses any of the following types of amplification:
*
Hearing Aid(s)
Cochlear Implant(s)
BAHA
None at this time
Other:
Required
School District
*
Your answer
Name(s) of Parents/Guardians attending event
*
Please Note: One parent/guardian is required to attend with their child.
Your answer
Name(s) and Age(s) of Siblings attending event
*
Please Note: This event is for immediate family members only and is most appropriate for children ages 8 and younger. Please type "none" if no siblings will be attending.
Your answer
Email Address
*
Please use an email that will be checked often as activity confirmation details will be sent via email.
Your answer
Best Contact Phone Number & Name
*
Your answer
Alternate Contact Phone Number & Name
Your answer
Emergency Contact Phone Number & Name
*
Please list a name and phone number of an adult who will NOT be at the event with you that we should contact should an emergency occur during the event.
Your answer
Food Allergies or Restrictions
Your answer
Accommodations Needed
*
Your answer
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