Enrichment Groups Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. Client Information Client's Name *FirstLastClient's Date of Birth * Scheduling Information Is Client also the Scheduling Contact? *YesNoScheduling Contact's Name *FirstLastScheduling Contact's Email *Contact's Phone# *Group InformationSelect the Group(s) you want to participate in.Social SkillsAdaptive DanceAdaptive ExerciseAdaptive YogaMeditation & MindfulnessCaregiver Support Contact's Select for Meeting Information Preferred meeting day? *Any Day of the Week (Monday-Sunday)Any Weekday (Monday-Friday)Any Weekend Day (Saturday-Sunday)A Specific Day of the WeekPreferred meeting time. *Morning (between 8am and 11am)Midday (between 10am and 2pm)Afternoon (between 2pm and 4pm)Evening (between 4pm and 7pm)Select a specific day for your meeting.MondayTuesdayWednesdayThursdayFridaySaturdaySundayAdditional CommentsSubmit
