Swim Day | Saturday, June 25th 2022
Make a splash with Whole Spectrum Autism at Xcel Aquatics!

* REGISTRATION REQUIRED -- Please respond by June 17th 2022

DATE:
Saturday, June 25th 2022

TIME:
Session A:   1:00 - 3:00 pm  
Session B:   3:30 - 5:30 pm

LOCATION:  
Xcel Aqautics
125 Marshall Street, 7th Floor
Hoboken, NJ 07030

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Email *
PHONE *
Enter your phone number
NAME of Parent(s) / Guardian(s) *
First Name & Last Name
NAME and AGE(s) of Child with Autism / Special Needs *
First Name and Last Name, Age
GUESTS *
Total number of guests attending (Limit 4 per family)
SESSION CHOICE *
NO-SHOW POLICY *** Please read in full.
Our goal is to ensure a fun and safe event for everyone!  This is a FREE EVENT for those who register and have a child diagnosed with autism and/or special needs.

The event costs must be covered by our non-profit organization in advance.  To prevent additional losses, we are requiring a valid credit card on file in case of any no-shows.

If you do not attend, Whole Spectrum Autism can charge in the guest's absence and immediately collect $10 payment for each guest that is a no-show.
I understand this event requires a credit card to make the reservation. Whole Spectrum Autism reserves the right to charge a cancellation fee of $10 per guest. Please note that any cancellations will only be accepted before 4:00 PM, two days before the event date (June 23rd). *
Required
CREDIT CARD INFORMATION
Please fill out the fields below in their entirety.
Full Name on Credit Card *
Credit Card Number *
Credit Card Expiration Date *
CVV Code on Credit Card *
Billing Zip Code for Credit Card *
Thank you for your interest in Whole Spectrum Autism's Swim Day!
A copy of your responses will be emailed to the address you provided.
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