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Explore ADL Registration Form

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Please complete the registration form below.

Once the registration form is completed and the $35 registration fee is paid, you will receive an emailed invoice totally the required amount due for enrollment, based on the options you choose below. Invoice must be paid before October 16th in order for individuals to participate in the upcoming week's activities.

Please keep in mind the fees only covers

  • general programming

  • supplies

  • basic community outings like bowling, movies, etc. that cost under $8 per person. Any specialty community outings that cost more will be the responsibility of the individual should they choose to participate. Notification will go out in advance of all specialty community outings.

Required documents needed for your signature and weekly schedules notification will be emailed after enrollment has been secured.  

Registration Form
Participant Diagnosis (Check all that applies)
Does participant use an assistive device
Does participant have food allergies, and/or requires medication during the day
Please select participant's enrollment option.
Will participant require transportation to and from program?
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