Future Reflections                                                                                     Spring/Summer 2004

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NOPBC 2004 Activities Preregistration

Mail to:

Sandy Taboada, NOPBC Preregistration
6960 South Fieldgate Court
Baton Rouge, Louisiana 70808-5455
Email: smerchant@mail.vetmed.lsu.edu

Fees: $10, one adult, no children

$15 one adult, children   •     $25, two adults, children

Adult Name(s). Please include first and last name of each adult and indicate if the adult is a parent, grandparent, blind parent, teacher, other relative, etc.

1.______________________________________________________________________

2.______________________________________________________________________

Address_________________________________________________________________

City ___________________________State__________________  ZIP_______________

Telephone (     ) __________________________________________________________

Email __________________________________________________________________

Fee enclosed (make checks payable to NOPBC)  $ ___________

REMEMBER TO DEDUCT $5 IF YOU PREREGISTER BY JUNE 1

The fee includes at-large membership in the NOPBC and it covers all NOPBC workshops described in the “As the Twig Is Bent” 2004 convention article about NOPBC activities. It does NOT include the NFB convention registration fee which is $15 per person (including children) and must be paid in person at the convention on June 30 or at other designated times throughout the convention. It also does NOT include cost for NFB Camp (childcare), see elsewhere in this issue.

Will you be bringing children? [ ] Yes   [ ] No   [ ] Undecided

If yes or undecided, please list names and birth dates of child(ren); reading mode (Braille, print, large print, non-reader); and brief description of characteristics of which Carnival Buddies and other volunteers should be aware. Examples: Mild autism; wears hearing aid; has ADHD; shy—doesn’t talk to strangers.

Finally, in order to help us plan to have enough materials and volunteers for the children’s activities, please check the program your child may be interested in attending. Please note the age restrictions. Please copy this form or add a sheet of paper if you need space to register more children.

CHILDREN

1. Name/birth date__________________________  Reading mode__________________

Characteristics (please be sure to tell us if your child is blind or sighted): _____________ ___________________________________________________________________

Please check the activities you think your child might attend:

[ ] Braille Carnival (age 6 - up)  
[ ] Exploring the Solar System: Youth Scavenger Hunt (age 8 - up)
[ ] Audio Description: The Visual Made Verbal  (sighted high school students)
[ ] Audio Describers Review and Judging (blind middle and high school students)
[ ] Teen Discussion Groups  (teens ages 14 - 18)
[ ] Teen Get-Acquainted Party (all teens, blind and sighted)
[ ] Astronomy Is for Everyone (all ages, children must be accompanied by an adult)
[ ] Audio-Described Family Night at the Movies
   
(all ages, children must be accompanied by an adult)

2. Name/birth date__________________________ Reading mode__________________
Characteristics (please be sure to tell us if your child is blind or sighted): _____________ ________________________________________________________________________

Please check the activities you think your child might attend:
[ ] Braille Carnival (age 6 - up)  
[ ] Exploring the Solar System: Youth Scavenger Hunt (age 8 - up)
[ ] Audio Description: The Visual Made Verbal  (sighted high school students)
[ ] Audio Describers Review and Judging (blind middle and high school students)
[ ] Teen Discussion Groups  (teens ages 14 - 18)
[ ] Teen Get-Acquainted Party (all teens, blind and sighted)
[ ] Astronomy Is for Everyone (all ages, children must be accompanied by an adult)
[ ] Audio-Described Family Night at the Movies
    
(all ages, children must be accompanied by an adult)

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