SibTeen Connect: Shoe Box Crafts & Games

Cost: $10 per Sib (Limited scholarships available by request)

Thursday, September, 19, 2024 from 6:00pm-8:00pm

The Arc of Snohomish County Conference Room (127 E. Intercity Ave, Suite B, Everett, WA 98208)

Sibshops are fun-filled events for brothers and sisters of kids with developmental disabilities or complex health needs. Sibs have an opportunity to share joys, concerns, problem solve and have a better understanding of their sibling's disability.

Event Registration

Please enter the first name of the Sibling you are registering for Sibshops

First Name of Child *

Please enter the last name of the Sibling you are registering for Sibshops

Last Name of Child *

Parents e-mail

Email Address *

Phone *

Street Address

City *

Postal Code *

Event Fee(s) *

Sibshop Registration - $ 10.00

Sibshop Registration + Sponsor a Sib - $ 20.00

Event Fee & $5 Donation to Arc Sibshops - $ 15.00

Event Fee & $15 Donation to Arc Sibshops - $ 25.00

ARC STAFF USE ONLY - $ 0.00

Total

SibShop in person*

Is the child attending *

The birthdate of the sibling attending

Birth Date *

Is this your child's first time attending Sibshops? *

Yes No

Diet restrictions *

Any questions your child attending may have? *

Are there any special concerns you may have about your child that will help us understand him/her best *

The sibling who has an intellectual/developmental disability or health concerns

Sib's Name *

Please list any diagnosis or information you are willing to share about the sibling with a developmental disability

Sib's information *

Parents Name and Best # to reach you during the Sibshop event: *

Other emergency contact name *

Other emergency contact # *

I consent to having my child participate in the activities provided by the staff of this Sibshop. The Arc of Snohomish County staff has my permission to authorize emergency medical care and transportation. I will accept financial responsibility for this *

Yes No

Insurance Provider *

Policy # *

Physician *

Physician's Phone # *

I assume all risks & hazards of the conduct of the program & release any person providing organization or facilitation of Sibling Connection. In case of injury, I do hereby waive all claims or legal actions, financial or otherwise, against The Arc of Snohomish County, Snohomish County their elected and appointed officials and employees, the property owners, sponsors, supervisors or volunteers connected with this program. In the absence of signature, payment of fees and participation in Sibshops shall constitute acceptance of the conditions set forth in the release. I grant full permission to use any photographs, videotapes, recordings or any other record of this program for the purpose of education & promotion of Sibshops. I understand that typing my name below constitutes a legal signature.

Parent/Guardian Electronic Signature *

SibTeen Connect: Shoe Box Crafts & Games

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