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Yoga Registration Form

This program is held every Thursday from 4-5pm virtually for ages 13+.

It is open to individuals with Down syndrome and other intellectual and developmental disabilities

This program is provided free to families by the Down Syndrome Association of Delaware.

Please complete the following registration form to reserve your spot in our virtual Yoga classes.

Questions? Contact Jess at jess@dsadelaware.org.

Thank you!

Participant Contact Information

Participant Name

First Name

Last Name

Participant Email

Verify Email

Participant Phone

Participant Date of Birth

(mm/dd/yyyy)

Does the participant have Down syndrome?

Yes

What diagnosis does the participant have?

Are there any health or behavioral concerns for the participant that we need keep in mind?

Please provide the following information for an adult support contact.

Support Contact Name

First Name

Last Name

Support Contact Email

Verify Email

Support Contact Phone

Type of Adult Support

Parent

Guardian

Other Support Person

I understand by clicking SUBMIT I am registering for the virtual Yoga class.

Yes, I understand.