Coffee, Tea and Autism Support Group with the Autism Society of Mahoning Valley
Thursday, May 18, 2023
9:30am-10:30am
Cracker Barrel - 5600 Patriot Blvd, Austintown (80 & 46 intersection)

Thank you to our facilitators, Kesha Lampley, LSW and Robin Suzelis, ASMV Director for hosting.

Covid Requirements:
Please take temperature the morning of the event to make sure you are well. If you have any of the following health issues please do not attend, these are the CDC guidelines for symptoms.
Also, if someone in the family isn't feeling well, please do not attend. If you have been in direct contact with someone in the past 14 days with COVID please do not attend this event. There is no need to call to cancel for this event.
The Autism Society of Mahoning Valley, its board members and its partners are not liable for any exposure to COVID directly or indirectly. By attending you agree to this liability waiver.
Any cancellations will be listed as an event post, so please check the day of the event.
Read all the requirements HERE
Accept Covid Terms and Conditions

* Required Field *Parent's or Caregiver's Name(s):

*Address:

*City:

*State:

*Postal Code:

*Cell Phone Number:

*Email Address:

*Person with Autism Name:

*Person with Autism Date of Birth:

I give permission and consent to allow photographs to be taken during Autism Society of Mahoning Valley activities. I further give permission and consent that any such photographs may be published and used by Autism Society of Mahoning Valley and its agents, to illustrate and promote its programming and fundraising efforts. Furthermore, I grant the Autism Society of Mahoning Valley, its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize the Autism Society of Mahoning Valley, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Autism Society of Mahoning Valley may use such photographs of my family with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. I have read and understand the above: By Submitting this form, I am registering for the event and accepting the terms of this release form.