702-648-1990

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High Fives

MEMBER REGISTRATION

Please complete and submit the membership form and waivers below.

If you have more than one child or family member with Down syndrome, please complete separate applications for them. For any non-applicable sections, please put N/A.

If you have any issues completing the registration, please contact Briana at bphilippi@dsosn.org.

Membership Type

Single Membership

Family Membership

Application Date

Your Information

First Name

Email

Last Name

Home Phone

Cell Phone

Address

City

State

Zip Code

I am a(n)....

Parent of a child with Down syndrome

Family member to someone with Down syndrome

Parent of a child with Down syndrome who has passed away

Family member to someone with Down syndrome who has passed away

Individual with Down syndrome

Caregiver to someone with Down syndrome

Guardian to someone with Down syndrome

Individual with Down Syndrome's Information

First Name of Individual with Down Syndrome

Last Name of Individual with Down Syndrome

Date of Birth of Individual with Down Syndrome

Date of Death of Individual with Down Syndrome

Age

Relationship to You

Gender

Pronouns (She/Her; He/His; They/Them)

Family Member(s) Information

First & Last Name of Family Member

Relationship

Date of Birth

First & Last Name of Family Member

Relationship

Date of Birth

First & Last Name of Family Member

Relationship

Date of Birth

First & Last Name of Family Member

Relationship

Date of Birth

Forms & Waivers

Please download, complete, and upload the following forms and waivers before submitting your membership application.

Emergency Contact Form

Emergency Contact Form

Hold Harmless Agreement

Hold Harmless Agreement

Media Waiver

Please upload each form separately in the format:

Last Name, First Name_Name of Form

as supported .doc(x) or .pdf files (Max 15MB).

Emergency Contact Form

Upload File

Upload supported file (Max 15MB)

Hold Harmless Agreement

Upload File

Upload supported file (Max 15MB)

Media Waiver

Upload File

Upload supported file (Max 15MB)

Volunteer Opportunity Interest

Please select the services you would be interested in volunteering with at DSOSN.

Administrative

Advertising

Carpentry

Electrical

Financial

Legal

Medical

Public Relations

Plumbing

Volunteer

Other

N/A

Please select any events that you woul like to serve as a committee member, chair, or volunteer.

Festival of Trees and Lights

Buddy Walk

Socials

Poker Runs

Monday's Dark

Tree-riffic Fun Run

Other

N/A

Thanks for submitting!

As a member, you will receive emails regarding our programs, services, and events.

Please let us know if you have any questions at (702) 648-1990 or dsosn@dsosn.org.

CONTACT US

Phone: (702) 648-1990

Fax: (702) 648-2020

5300 Vegas Drive
Las Vegas, NV 89108

Operating Hours

Monday - Friday: 8 a.m. - 4 p.m.

Saturday & Sunday: Closed

Thanks for submitting, we'll be in contact with you soon!

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©2020 by DOWN SYNDROME ORGANIZATION OF SOUTHERN NEVADA.