Creative Pursuits Registration

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Click here to view the Creative Pursuits Fall 2024 Catalog of courses and events.

You may fill out the form to register for ALL the classes you want at once, or you may fill out the form as many times as needed to add classes any time prior to their registration deadlines.

I am registering as:

A person living with ALSA caregiver of someone living with ALS

Participant Information

First Name

Last Name

Phone Number

State

Zip Code

Registration Date

Please share anything else you think is important for us to know about you or your background in any of these topics.

Acknowledgment

By typing my name and dating below I hereby waive all claims against The ALS Association, sponsors, personnel or any outside contractors for any injury that I may suffer from my participation in this event. I grant full permission for organizers to use photographs, videotapes, motion pictures, recordings or any other record of this event. I confirm that I am of legal age to participate or the parent/ guardian of a minor hereby giving consent to his/ her participation and agreeing to all event waiver terms.

COVID-19 Acknowledgement: I hereby acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending Creative Pursuits program. Further, I knowingly and voluntarily agree to follow all required and relevant federal, state and local guidelines to maintain the health and safety of event attendees. I acknowledge that failure to comply with these practices may result in exposure to, or contraction of, COVID-19 and may put others at risk. I agree that if any portion of this Waiver is deemed to be invalid, the remainder of the Waiver will still be binding and enforceable.

Please type your name below to acknowlege.

Date

You did not select a class, please go back to the previous page and select at least one.

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Cane	Walker	Manual Wheelchair	Power Wheelchair
Grip tools to aid in grasping	Speech to Text Device	Communication Device for Speaking	Head Mouse Device
Eye Gaze Device	Trach	Bi-PAP	Ventilator
Feeding Tube	Other	None of the Above

ALS Association website	Support Group
An ALS Association liaison at the ALS Clinic	ALS Association Newsletter
Email about Creative Pursuits	ALS Association social media post
Another person living with ALS	From Liz Stanley, the Arts Program Manager
Another ALS Association staff member	Other

Creative Pursuits Registration

Online Courses Addtional Questions

In-Person Addtional Questions

Acknowledgment