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« All Events
This event has passed.
2nd Annual “HOPE-N” Show
May 17 @ 10:00 am
-
10:00 pm
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Details
Date:
May 17
Time:
10:00 am - 10:00 pm
Event Category:
Events
Organizer
Stir-n-Up Hope
Email
ravensnuh@gmail.com
Venue
Spencer County Youth & Community Center
1101 E County Rd 800 N
Chrisney
,
IN
47611
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Who We Are
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our herd
testimonials
news
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programs
apparel
donations
Calendar
blog
contact us
volunteer
FILL OUT THE PRELIMINARY APPLICATION BELOW
Precautions & Contraindications
Prospective Participant Name
DOB
Height
Weight
Street Address
City, State, Zip Code
Doctor Name
Doctor Phone Number
Behavior Concerns (i.e. elopement, aggression)
Please describe mobility level/needs. Do they require support while sitting?
Health Concerns/Diagnoses (i.e. hemophilia, seizures, Down Syndrome, implanted devices)
Is Axial Skeleton closed? (for Down Syndrome only)
Date of Last Seizure (if applicable)
Contact Name
Contact Phone
Contact Email
Relationship to Participant
In Case of Emergency Call
How did you hear about us?
What outcomes are you hoping will result from time at Stir-n-Up Hope?
We Are Ready To Hear From You
