Family Portraits 2020
Sponsored by: Progressive ABA Therapy Group, www.proabatherapy.org
September 19, 2020 from 9am - Noon
Kinsman House - 303 Mahoning Ct. NW, Warren, OH 44483
Sessions: 15 minute mini-sessions

Covid Requirements:
Indoor and Outdoor options (weather permitting).
Masks to be worn by all adults and neurotypical children and special needs individuals who are able to.
Families are to wait in their cars until their session time and they receive a text from volunteers.
Please bring hand sanitizer to use before and after each session.
Please take your temperature the morning of the event to make sure everyone is well. Also if someone in the family isn't feeling well, please cancel even if it is last minute.
We are not liable as a result of any exposure to covid. A covid liability waiver is to be e-signed by all.
Read all the requirements HERE
Accept Covid Terms and Conditions

Family Portraits is currently filled. Please fill out our waitlist form to be notified if there are any cancellations
* Required Field

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


*Address:
*City:
*State:
*Postal Code:
*Phone Number (Cell):
Phone Number (Other):
*Email Address:
(to include you on future event mailings)
Preferred Contact Method:
Home, Cell, Other, Text, Email
*Preferred Photo Setting and Session Time?


Children Information:
 
*Name:
*Age:
*Diagnosis (if applicable):
Name:
Age:
Diagnosis (if applicable):
Name:
Age:
Diagnosis (if applicable):
Name:
Age:
Diagnosis (if applicable):
Name:
Age:
Diagnosis (if applicable):
Name:
Age:
Diagnosis (if applicable):


What types of programs would you like the Autism Society of Mahoning Valley to provide for your child and/or for your family? :


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.

Please read our disclosure: The Autism Society reserves the right to cancel registration to any parties that have had one or more no contact cancellations in the past two years. One member of the family needs to have a diagnosed disability of autism or similar diagnosis to participate.