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Cancellation fees may apply for program withdrawal. Please see our policies on the Registration Information page.
Participant Information
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Contact Information
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Emergency Contact
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Personal Information
Special Events
The SPARC Film Production Red Carpet Event is a not-to-be-missed opportunity to celebrate the talents and creativity of participants from the SPARC Community. Join us for an unforgettable event filled with inspiring short films, a chance to meet the incredible filmmakers, and award presentation. This fun and inclusive event is the culmination of our SPARC Film Production Program and is an opportunity to witness the power of storytelling from a diverse perspective.
Weekend Adventures
4 days and 3 nights of fun and adventure await participants at Camp Jewell! All meals are included in this trip as well as outdoor adventures such as Kayaking, Fishing, Climbing, Arts & Crafts and so much more!
Enjoy the beautiful Lenoir Preserve through a self-guided scavenger hunt and activity provided by parks staff. The Lenoir Preserve Nature Center houses many different nature exhibits as well as a Butterfly & Hummingbird Garden. After the scavenger hunt and exploring the preserve participants will enjoy lunch at Fortina Pizza.
Saturday Movie Mixer: Spider-Man: Across the Spider-Verse!
Participants will meet up at Ridge Hill for a Saturday Movie Matinee of the Newest Spider- Man Movie and Mix it up at the Yard House after for lunch with friends.
B.Y.O.P. - Bring your own picnic and hike with Pygmy Goats
at The Greenburgh Nature Center! Pygmy goats, Maggie and Willow, require a lot of enrichment and exercise to stay happy and healthy. Our SPARC group can provide them with the best possible care by taking them on a forest trail walk with one of the Nature Center's naturalists. Participants will enjoy their picnic lunch after exploring the rest of the Nature Center!
Participants will enjoy a fun filled evening at Monster Mini Golf in Ridge Hill - After Black Light Mini Golf and some time in the Arcade Participants will enjoy a delicious dinner at
Public Pizza Italian Restaurant.
Celebrate the beginning of Summer at Westmoreland Sanctuary in Mount Kisco! Participants will party the night away and enjoy hordouvres and desserts, a special guided night hike, and a live performance by the School of Rock Band!
Tibbets Brook Park features one of the most exciting aqua complexes in the country! Participants can enjoy in-pool basketball and volleyball, a dip in one of the lap lanes, and of course the signature Lazy River! Bring your own Picnic or Purchase something yummy at the Snack Bar!
Program Enrollment
If choosing Link Up, it must be chosen as Selection #1
Please check all that apply.
Please select the SUMMER 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 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.
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.
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.
