Holidays Party for Deaf Children

Adult #1 First Name

Adult #1 Last Name

Deaf/HH/Cochlear

Hearing

Adult #2 First Name

Adult #2 Last Name

Deaf/HH/Cochlear

Hearing

Street Address

City

State

Zip Code

Home Phone

Work Phone

Your Name

Your E-mail

How many adults are coming?

How many children are coming?

First Name

Last Name

Age

Male

Female

Deaf/HH/Cochlear

Hearing

First Name

Last Name

Age

Male

Female

Deaf/HH/Cochlear

Hearing

First Name

Last Name

Age

Male

Female

Deaf/HH/Cochlear

Hearing

Additional Information or Questions

Please provide the following information for each child attending:

Please provide the following contact information for adults attending the party:

ASDC Oregon/Washington

Holidays Party for Deaf Children

Holidays Party Reservation Form

Reservations are required by November 28, to be sure we have enough food and presents for everyone.

No one will be admitted without reservations.

Important Note:

To ensure that the most number of deaf children and children of deaf adults are able to attend, family members are limited to parents/guardians and siblings. If for any reason you are unable to use your reservations, please contact us as soon as possible so that we can extend an invitation to a family on the waiting list. Please be considerate so that the most number of deaf children and children of deaf adults can enjoy the Holidays Party.

Click on the Submit button at the bottom of the page to send your reservation to us.

If you don't hear from Chris within 48 hours, please email her directly here.