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Empowerment Forum

Down Syndrome
Connection of the Bay Area
101-J Town and Country Drive
Danville, CA 94526

Phone 925-362-8660
Fax 925-362-8663

2016 Annual Empowerment Forum

The Deadline has passed! You can still register, but your registration will not include lunch. Please plan on bringing your own lunch to the Forum.

HEALTH & WELLNESS, A LIFELONG JOURNEY

With Keynote Speaker, Dr. Dennis McGuire

Child and Youth Track includes:

1) Health Care: Frequently overlooked health issues, communication with physicians & current resources- Dr. Tracy Trotter

2) Parent Care: About infant mental health, range of emotions, and supports for the family. – Lucia Milburn, Ph.D.

3) Child Development, Perspectives from a Developmental Pediatrician- Dr. Ann Parker

Teen and Adult Track includes:

1) Healthy Lifestyle- How to encourage healthy living in your teens and adults- A panel presentation with Jennifer Pleimann, Buddies in Action, Layne Alfrey, Parent

2) Common Behaviors; Sexuality & Safety- Dennis McGuire, Ph.D.

3) Supports and Strategies for Addressing the Long term Challenges of Raising an Adult with Disabilities: An informal discussion with Lucia Milburn, Ph.D., Dennis McGuire, Jennifer Cooper, Marianne Iversen

Click here for more details.

Empowerment Forum Registration

* First Name
* Last Name
* Phone Number
* Street Address 1
Street Address 2
* City
* State
* Zip Code
* Email Address
* Relationship to Individual with Down Syndrome

* How did you hear about the Empowerment Forum?

* Empowerment Forum Tickets

  Entrance for one adult ($50)
  Entrance for two adults ($80)
  Entrance for three adults ($105)

* Please select your desired session track

* Second attendee name (first and last)

* Please select the 2nd attendee's session track

* Third attendee name (first and last)

* Please select 3rd attendee's session track

Please make a lunch selection below for each attendee.

* #dtfield_adult1_lunch_desc#

#dtfield_adult1_lunch#

* #dtfield_adult2_lunch_desc#

#dtfield_adult2_lunch#

* #dtfield_adult3_lunch_desc#

#dtfield_adult3_lunch#

IF THE ENTRANCE FEE ABOVE PROHIBITS YOU FROM ATTENDING PLEASE CALL THE DSCBA AT 925-362-8660.

* Will you be nominating an educator for an Excellence in Education Award?

Yes
No

Child Benefitting from Excellence in Education
Child's Name
Child's Age
Current School Level
Nominator Information
Name
Relationship to Child
Telephone
Email
Nominee Information: (teacher, administrator, therapist, bus driver, aide, paraeducator, SLP, behaviorist or a team etc.)
How Many People Do You Wish to Nominate? (up to 4)
Name
Title
Phone
Email
School
District

Name #2
Title
Phone
Email
School
District

Name #3
Title
Phone
Email
School
District

Name #4
Title
Phone
Email	#dtfield_nomee4_email#
School
District

How has the nominee(s) above made a significant impact in this child's educational experience?

Payment Information

Name on Card
Card Number
Expiration
CVV What's this?

2016 Annual Empowerment Forum

The Deadline has passed! You can still register, but your registration will not include lunch. Please plan on bringing your own lunch to the Forum.

HEALTH & WELLNESS, A LIFELONG JOURNEY

With Keynote Speaker, Dr. Dennis McGuire

Empowerment Forum Registration

Child Benefitting from Excellence in Education

Nominator Information

Nominee Information: (teacher, administrator, therapist, bus driver, aide, paraeducator, SLP, behaviorist or a team etc.)

How has the nominee(s) above made a significant impact in this child's educational experience?

Payment Information