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Adaptive Indoor Volleyball

Program Interest Form

Please fill out this survey to help us assess your player(s) needs and preferences to help me assess and develop an appropriate adaptive indoor volleyball program at the right level for your player/group. These programs are for neurodiverse youth and adults. Potential offerings include recreational leagues, clinics, skill development, and training opportunities for participants of all ability and experience levels.

  1. Contact Info
I am completing this survey as....
Participant
Parent/Guardian
Caregiver
Educator/Therapist
Other

Parent/Guardian Name (if participant is under 18)

Preferred Contact Method
Email
Text
Phone Call

________________________________________

  1. Participant Demographics
Gender(s)
Participant Age
Under 8
8 - 12
13 - 17
18 - 54
55+
  1. Neurodiveristy & Support Information

To help create supportive programming, please share any diagnoses, learning differences, or support needs that apply.

Select all that apply
  1. Volleyball Background
Indicate the main level of volleyball experience of the participant(s)
No experience
Adaptive sports program
Casual/recreational
School team
Club team
Competitive league
Comfort level participating in team sports
Preferred learning environment
  1. Program Interest (select all that apply)
YOUTH PROGRAMS

________________________________________

ADULT PROGRAMS

________________________________________

ADDITIONAL SERVICES
  1. Support & Accommodation Needs
Accommodations for participant success (Select all that apply)
  1. Scheduling Preference
Preferred day(s) for the program
Ideal Session Length
Number of Sessions
Season
Preferred Facility Type
Max. preferred travel distance to program
  1. Program Priorites
What is MOST important in an adaptive indoor volleyball program? (max. of 3)
  1. Pricing & Accessibility
Preferred cost ($) per player/session
Are you seeking grants or financial assistance options to increase participation?
  1. Notice for upcoming programs
If an adaptive indoor volleyball program launched, would you like to be notified via email?
  1. Additional Comments/Questions

See what others have said about our programs

Please fill in the below form and we will get back to you!

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