Are you completing this for yourself or a child?
First and last name
The most important reason this participant is attending the lesson.
What school do they attend?
If yes, please share any additional details about the diagnosis you’d like us to know.
Would you like to add an additional child?
First and last name
The most important reason this child is attending the lesson.
What school do they attend?
If yes, please share any additional details about the diagnosis you’d like us to know.
If yes, please share any additional details about the diagnosis you’d like us to know.
Would you like to add an additional child?
First and last name
The most important reason this child is attending the lesson.
What school do they attend?
If yes, please share any additional details about the diagnosis you’d like us to know.
Would you like to add an additional child?
First and last name
The most important reason this child is attending the lesson.
What school do they attend?
If yes, please share any additional details about the diagnosis you’d like us to know.
Would you like to add an additional child?
First and last name
The most important reason this child is attending the lesson.
What school do they attend?
If yes, please share any additional details about the diagnosis you’d like us to know.

CLASS PARTICIPATION CONSENT AND LIABILITY WAIVER