NextGen Special Connections

Join us on October 20th for an exciting night of fun and friends for youth ages 12-18 with special needs and different abilities. Session will be by trained mentors but parent or guardian must be present.

Sign in to Google to save your progress. Learn more
Name of youth  *
Age of youth  *
Please detail any and all special needs and different abilities *
Name of parent or guardian *
Phone number of parent or guardian  *
I agree to release ICSD and any and all of its employees and volunteers of all liability. I understand this is not a drop off event and agree to remain present during the entire session.  *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy