New Participant Registration

Thank you for your interest in Colorado Discover Ability. To participate, we ask that you fill out this registration form so we can best meet your needs. This information also helps us secure funding for programs and offer financial aid. Please be as specific as possible.

If cost is a financial burden, please fill out our Financial Aid Application.

For those who receive support through Strive, MDS, and others, they may be able to help offset costs.

Veterans do not need to fill out the Financial Aid Application. The VA covers the cost of programs.

Program Interest

Please select all programs you would like to participate in.

Cycling

River Rafting

Adventure Camp (ages 8-38)

Tennis

Ice Skating/Puck Play

Alpine Skiing

Alpine Snowboarding

Contact Information

Participant's Name

First Name

Last Name

Age:

Height:

Weight:

Legal Guardian's Name (if Applicable)

First Name

Last Name

Phone

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Emergency Contact

Emergency Contact's Name

First Name

Last Name

Emergency Contact's Relationship to Participant

Phone

Verify Email

Disability Services

Services through Mesa Developmental Services (MDS) and Strive can be billed for the cost of the activities. We will directly bill the assigned caseworker.

Case Worker's Name (If Applicable)

First Name

Last Name

Case Worker's Organization

If the participant has a case worker, many times the case worker's organization will cover CDA participant costs and we will bill them directly.

Case Worker's Phone

Case Worker's Email

Verify Email

Participant Information

This section is intended to provide our staff and volunteers with information to best accommodate the participant. It is vital that we have this information prior to the event. Please be as specific as possible.

Direct Support

Will a Guardian/Caregiver be accompanying the Participant?

Yes

If you selected "yes" for the previous question, please provide the name of the guardian or caregiver attending with participant.

First Name

Last Name

Group Affliation

If you are participating with a group, such as a school, VA Rec, Assisted Living organization, or similar please list it below.

Medical Information

If you checked "yes" for allergies, please list them below.

Does the Participant need to carry medication?

Please note that CDA does not administer medications.

Yes

Does the Participant take any medication that may affect their participation in the events? Please list them.

We ask for this information in case of an emergency so that care can be received immediately and safely.

If you selected "other", please elaborate

Disability

By filling out this section as in depth as possible, CDA can provide the optimal experience and continue funding for programming.

Please describe the extent of the disability/disabilities.

If you selected "other" please elaborate.

Communication

Communication Needs

Only fill this section out if the Participant has communication preferences and/or barriers.

Fluent Aphasia

Non-English Speaking

Non-Fluent Aphasia

Non-Verbal

Uses an Interpreter

Uses American Sign Language (ASL)

Uses a Electronic Communication Cevice

Uses an Interpreter

Other

If you selected "other" please explain:

Mobility

Mobility Considerations

Please explain the Participant's range of mobility such as stamina, balance issues, limb range of motion, or anything else that may impact the Participant's ability to participate in activities.

Veterans

Only veterans need to fill out this section. If the Participant is not a Veteran, please skip to the next section.

Years served in the Military

Military Branch

Is the disability service related?

Yes

Additional Information

This information helps CDA create a tailored experience for individuals.

How does the participant do in a group setting?

Is there anything else that would help us provide the best experience for the participant?

Examples: behavior management techniques, routines, normal behavior traits etc.?)

Media and Release of Liability Waivers

Please complete our release of Liabilty (#1) and Media Waivers (#2). Participants cannot participate without a Release of Liability Waiver. These waivers must be completed yearly. If you have already completed one in the past year, you do not need to resubmit one.

The Media Release Waiver (#2), although optional, allows CDA to use photos on our media.

To fill out these waivers, submit this form then head to our website www.cdagj.org. On the home page, place your cursor on the "Programs" tab. A drop down labeled "Participation Waivers" will appear. Click on this label. It will redirect you to our waiver site.

Or you can copy and paste this URL :

https://www.waiverfile.com/b/ColoradoDiscoverAbility/ChooseWaiver.aspx

Please have these filled out at least 48 hours in advance of the activity you have signed up for.

Colorado Discover Ability's Limitations

Please note that Colorado Discover Ability provides emergency care only. Personal care is the responsibility of the Participant or Caregiver. This includes toileting and administering medications.

Transportation Considerations

At this time Colorado Discover Ability cannot provide transportation to and from activities or events.