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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
Please enter first and last name.
Please enter first and last name.
Emergency Contact
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Personal Information
Weekend Adventures
Take a ride with us down to NYC for the Big Apple Comic Con. Meet some famous creators, enjoy some activities. Enjoy lunch at the Tick Tock Diner. Cosplay encouraged, but not required. Transportation, meal, and admission ticket included with registration.
Join us at The Wolf Conservation Center, in South Salem, NY for an "All Learners Experience" to celebrate World Autism Day! Participants will visit and observe the WCC’s gray wolf ambassadors and participate in hands on learning experiences. Transportation not provided. Meal not included.
Participants will travel to Hartford, CT for Brick Fest Live. LEGO lovers will gather to participate in interactive building activities, exercise their creativity, and witness huge creations. Lunch will be served at Plan B Burgers. Transportation will be provided and meal included.
Sunday Movie Mixer: The Super Mario Bros Movie Participants will meet up at Ridge Hill for a Sunday Movie Matinee and Mix it up at the Yard House after for lunch with friends. Transportation not included. Meal included.
Spend the day by the Hudson River Celebrating Mother Earth. Participants will enjoy Live Music, Hands On Activities, Art and Eco-Demonstrations.
Enjoy an afternoon at the theater seeing High School Musical at the Yorktown Stage. After the matinee, participants will enjoy a stroll through town to go have lunch at Pappous Greek Kitchen.
Meet up at the Croton Train Station and take a ride along the Hudson River to Cold Spring to enjoy lunch, a beautiful Spring walk, and window shopping 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.
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.
