Specialized Recreation Mailing List

2. Sign up to be included on our Specialized Recreation mailing list or have our our activity guide mailed to you. Simply complete the following information and submit.

   Sign up to be included on our Specialized Recreation mailing list or have our our activity guide mailed to you. Simply complete the following information and submit.

4. First Name*

5. Last Name*

7. Mailing Address*

9. City*

10. State *

11. Zip Code*

13. Email*

15. Are you a Parent or Participant?*
    -- Select One --ParentParticipant

16. Which of the COVID-19 phases are you comfortable participating in Specialized Recreation activities?

    More than one Phase can be selected.

    1. Phase 1
    2. Phase 2
    3. Phase 3
    4. Phase 4
    5. Beyond Phase 4
18. Select Preferred Program Types*

    1. Virtual
    2. In Person
    3. Special Olympics

19. Would you like to receive our quarterly Specialized Recreation guide?
    -- Select One --YesNo

Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field