Sign up Form for Carolina 321 Parent/Guardian Name (or Self, if Independent) * First Name Last Name Email * Phone (###) ### #### Your Name (if signing up for yourself) OR Participant’s Name Date of Birth Would you like to be added to our private Facebook group? Yes, please send an invite! No, not right now. Preferred Method of Contact for Event Updates Email Phone Call Text What type of activities do you enjoy most? (Check all that apply) Social events (bowling, movie nights, parties, etc.) Life skills (cooking, art workshops, budgeting, etc.) Sports & recreation (adaptive fitness, swimming, etc.) Community involvement (volunteering, outings, advocacy events, etc.) How did you hear about the 321 Group? Social Media Word of Mouth Healthcare Provider Event Additional Comments or Special Requests? Thank you!
