Adventure Island Playground Anniversary Booth Registration form
Tables, chairs, and tablecloths will be provided. We have space for approximately 40 booths for businesses or organizations that support families and children who have disabilities.
We ask that you plan to have an activity and/or fun giveaways for children of all ages and abilities, however per our agreement with the City of Meridian, we are not allowing sales of products or food.
Information About You
Are you a:
Parent
Professional
First Name:
Last Name:
Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaskan Native
Other
Unknown
Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Phone Number:
Email Address:
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Mailing Address
Mailing City
Mailing State
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AL
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FL
GA
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IL
IN
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KS
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LA
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OR
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Zip Code
This address is my
Home
Work
Professional Information
Organization Name:
My Title:
Phone Number:
Only if different from above
Email Address:
Only if different from above
Information About Your Child
Please only enter information for an individual child, you will be able to add more children below.
Child's First Name:
Child's Last Name:
Child's Gender:
Female
Male
Child's Birthdate:
Child's Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaska Native
Other
Unknown
Child's Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Child's Diagnosis:
Do You Have Another Child to Enter?
Yes
No
Information About Your Child (2)
Please only enter information for an individual child, you will be able to add more children below.
Child 2's First Name:
Child 2's Last Name:
Child 2's Gender:
Female
Male
Child 2's Birthdate:
Child 2's Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaska Native
Other
Unknown
Child 2's Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Child 2's Diagnosis:
Do You Have Another Child to Enter?
Yes
No
Information About Your Child (3)
Please only enter information for an individual child, you will be able to add more children below.
Child 3's First Name:
Child 3's Last Name:
Child 3's Gender:
Female
Male
Child 3's Birthdate:
Child 3's Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaska Native
Other
Unknown
Child 3's Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Child 3's Diagnosis:
If you have more than three children that you need assistance with, our Parent Education Coordinator will take your information directly.
I will be needing a booth as
A Standard Business ($100)
A Non-Profit ($50)
Other (Contact Us)
After registration is complete, you will be sent an email with a paypal link - your registration will be complete once you have paid. if you have any questions about your status at all please contact us at
adventureIsland@ipulidaho.org
Event Information
Training Name
Please select...
August 2022 - Back to School Basics
September 2022 - Understanding the IEP: Reading The Actual Document
October 2022 - Self-Advocacy for All
November 2022 - PT 1 - Understanding Idaho Medicaid Services
November 2022 - PT 2 - ABC's of Katie Beckett and DD Services
December 2022 - Dispute Resolution Services for Special Education in Idaho
January 2023 - Positive Behavior Strategies
February 2023 - Understanding the YES Program and Other Mental Health Services
March 2023 - Developing A Strengths-Based IEP
April 2023 - Getting And Keeping A Job
May 2023 - Having High Expectations When you Don't Know What To Expect
June 2023 - Power of Positive Partnerships
July 2023 - Transition to Adulthood (pre-recorded)
August 2023 - Back to School Basics: Strategies for a Successful Start to School
Champions for Change - Self guided training module
Dispute Resolution - Self-Guided Module
November 2023 - Self-Guided Deep Dive into the IEP
December 2023 - Self-Guided Monthly Training - All Behavior is Communication - PBIS and You
January 2024 - Deciphering Idaho's Medicaid Systems
Settler's Park Anniversary Booth Registration
Incredibly Important Back End Stuff
(Hidden from person filling form, but
needs to be set up when building the registration or everything will be for naught and you will spend several days trying to fix your data WITH WOE IN YOUR HEART AND A POX UPON YOUR HOUSE)
Funding Source
separate with semicolon and put in
Default Value
under
Options
EXAMPLE
:
MCHB F2FHIC; PTI
(THESE NEED TO MATCH SALESFORCE OR PAIN WILL RESULT)