PARENT/LEGAL GUARDIAN MEMBERSHIP

"*" indicates required fields

Primary Parent/Legal Guardian

How do you prefer Manasota BUDS to reach out to your family?*
How did you hear about Manasota BUDS? (Select all that apply)*
Would you like to join our mailing list to receive our newsletter and event updates?*

Additional Parent or Legal Guardian

Individual with Down syndrome

Date of birth of individual with Down syndrome*
Timing of Diagnosis:*
Please list any additional medical conditions your child/teen/adult has or had (Select all that apply):
This individual’s ethnicity is:
This individual’s race:
This individual’s gender:

Household Siblings

If your family member with Down syndrome has adult siblings that live outside your home, please encourage those siblings to become Manasota BUDS members. There is no charge for membership.
Date Of Birth:
Date Of Birth:
Date Of Birth:

Other Information

At the time your doctor first told you that your baby has or likely has Down syndrome, did you receive free information about Down syndrome from the hospital, state, or local organization/s?
Are you interested in potential volunteer opportunities with Manasota BUDS? Acknowledging “YES” grants us permission to contact you regarding your expressed interest.
If your loved one with Down syndrome is an adult, does the individual live: