LOGAN-Resources and Opportunities for People with Disabilities


Meet DDRS Director Shane Spotts
May 30, 6:00 pm SJCPL
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  Ansari Center for Autism
  LOGAN Industries

 
LOGAN Recreation Activities
Winter, 2012
Online Registration
Participant Information
Date
First Name
Last Name
City Zip
Email Address
Confirm Email
Home Phone ex. 555-555-5555 Cell
Birthdate mm/dd/yyyy Age Grade Gender M F
Parent, Legal Guardian, or Agency Information
(First contact in event of an emergency, behavior, or ride if needed)
First Name Last Name
Relationship to Participant
City Zip
Email Address (required)
Confirm Email
Home Phone ex. 555-555-5555 Cell
Work Phone
Activity Enrollment
Please check all activites you would like your child to be registered for. Space is limited; you will be called if your child is put on a waiting list. The first fee listed is the early registration fee. Please check the schedule for deadlines. All fees reflect the entire munber of sessions included, unless otherwise stated as a per week fee. If you register online, you will be contacted regarding payment and permission forms.
 

LOGAN Community Resources, Inc.
2505 E. Jefferson Blvd. • South Bend, IN 46615
(574) 289-4831
logan@logancenter.org
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