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Cancellation fees may apply for program withdrawal. Please see our policies on the Registration Information page.
Participant Information
Please enter first and last name.
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Contact Information
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Please enter first and last name.
Emergency Contact
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Personal Information
Summer Adventure Trips 2021
(Exploring Ossining, waterfall trail, lunch at the beach, social and recreation time, dessert, games and more)
(Live baseball game, opportunity to purchase sports merchandise and
dinner with friends)
(Fireworks, hiking, trails, Valhalla Crossing meal at picnic tables, outdoor yoga, homemade ice cream and more)
(BYO picnic dinner and outdoor movie with friends)
(Tibbetts Park adventures including mini golf and meal with friends)
(Picnic, live music and dinner with friends)
(Swimming and walk into town for dinner with friends)
(High-energy reggae band concert and dinner with friends)
(Metro North travel, outdoor wildlife exhibits, specialized zoo shuttle tour, and dinner with friends)
https://bronxzoo.com/things-to-do/experiences/zoo-shuttle
(Tour of Rye, dinner at Bare Burger, homemade ice cream @ Longfords and stroll around town with friends)
(Dance party Jams with DJ Slinger, Kara and Musical Guest Kerryn)
(Live concert in the park and dinner with friends)
(Rope ladder course, ax throwing, laser tag, arcade games and dining with friends)
(Tour and learn the history of the many gardens at the Conservatory and picnic with friends)
(Outdoor movie viewing of Sonic the Hedgehog and dinner with friends)
(Dine at picnic tables, Special Olympics relays, (special guest) hikes, trails, make your own healthy dessert, games and more with friends)
(Hikes, trails, kick ball game and picnic in the park with friends)
(Swimming and walk into town for dinner with friends)
(Outdoor magic show in the park and dinner with friends)
(River trip cruise, learn about the history of the Hudson Highlands, be on the lookout for eagles, walk into town and dinner with friends)
(BYO picnic dinner and outdoor movie with friends)
(No bake cooking-healthy dessert (special guest) life skills workshop, a series of workouts, the track, walk through town, dining with friends and more)
(Dance party Jams with Magical Memories Entertainment, Kara and Musical Guest Kerryn)
(Artists Market live music, outdoor shopping, dine with friends, cheesecake and more)
(Barnyard, birds of prey, Native American Village, organic garden, native plant meadow, beehives, butterfly arbor, great lawn, live animal exhibits, volunteering, trails and more)
(Beach, amusement rides, arcade games, mini golf, boardwalk and dinner on the water with friends, bamboo forest and more)
(Lunch and a movie with friends)
Program Enrollment
If choosing Link Up, it must be chosen as Selection #1
Please check all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
Please select number of days the participant will attend program each week. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
If choosing Link Up, it must be chosen as Selection #1
Please select all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
If choosing Link Up, it must be chosen as Selection #1
Please select all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
If choosing Link Up, it must be chosen as Selection #1
Please select all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
If choosing Link Up, it must be chosen as Selection #1
Please select all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
If choosing Link Up, it must be chosen as Selection #1
Please select all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
If choosing Link Up, it must be chosen as Selection #1
Please select all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
If choosing Link Up, it must be chosen as Selection #1
Please select all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
If choosing Link Up, it must be chosen as Selection #1
Please select all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
If choosing Link Up, it must be chosen as Selection #1
Please select all that apply.
Please select the program you are registering for. The price will be displayed in the "total" field at the bottom of the page. Prices reflect Medicaid Respite eligibility. For non-medicaid prices please inquire.
Participation Consent
The participant has permission to participate in the activities registered for on this form.
I consent to receiving emails and/or text messages about the participant listed on this form.
I consent to allowing the participant to be transported and treated at the nearest medical facility.
I consent to photographs or videos of the participant being used for educational or SPARC promotion.
Billing Information
Price:
$0.00
$0.00
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My signature is valid for ongoing enrollment in SPARC unless otherwise indicated.
By participating in SPARC programs, the parent/guardian of each participant and the participant agree to indemnify, release and hold harmless SPARC, its officers, directors, employees, consultants, agents (including independent contractors, if applicable), and volunteers from any and all liability or causes of action whatsoever arising out of, or which may result from such participation.
