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2024 Ernie Els #GameON Autism® Golf Clinic Registration

2024 Ernie Els #GameON Autism Golf Clinic Participant Registration

Which regional Golf Challenge event are you attending?(Required)

Participant's Name(Required)

Participant is:(Required)

Participant's golf skill level:(Required)

Participant communicates:(Required)

Participant's receptive language capability:(Required)

Participant's expressive language capability:(Required)

Will the participant come with a support aid or 1:1 companion?(Required)

Parent/Guardian's Name(Required)

VIDEOGRAPHY/PHOTOGRAPHY/AUDIO RELEASE CONSENT

Please choose one:(Required)
Employees/staff/Contractors of the Els for Autism Foundation may use these photographic images, video segments, or audio segments for reasons other than therapeutic purposes, including dissemination on social media.

Please choose one:(Required)

Please choose one:(Required)

Please choose one:(Required)

If you have further questions about the information on this form, you may contact olivia.butler@elsforautism.org.
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