Adaptive Sports Day Registration

Hanger Clinic is inviting people with limb loss, orthotic bracing needs, or low vision/blindness to join us for an adaptive field day. Please join us for a day of peer support and activities, including:

- Yoga

- Goalball

- Pickleball

- Recumbent & Upper Extremity Bicycles

- Adaptive Golf

- Wheelchair basketball

- Accessible Board Games

- Educational workshops on health, wellness, and skincare

Supportive family and friends are welcome.

Date/Time: Saturday, June 22, 2024; Registration opens at 8:30 a.m. Event starts at 9:00 a.m. and ends at 3:00 p.m. Lunch will be provided.

Location: Salus University
50 Bryer Drive, Elkins Park, PA 19027

Registration and adaptive sports held at Hafter Student Community Center on Breyer Drive at Salus University; free parking on campus and at the community center.

Questions? Please email Matt Johnson at maJohnson@Hanger.com

Registration Type *

Adaptive Athlete Attendee

Event Volunteer

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Age Group *

How did you hear about the Adaptive Sports Day? *

Are you a person with an orthotic device? *

Yes

No

What orthotic device(s) do you use? *

Are you a person with lower limb loss? *

Yes

No

Are you a person with upper limb loss? *

Yes

No

Are you a person with low vision/blindness? *

Yes

No

Are you a Hanger Clinic patient? * 🛈

Yes

No

Are you interested in participating in wheelchair basketball? * 🛈

Yes

No

Height (of person with limb loss) *

Weight (of person with limb loss) *

What adaptive sports have you play previously? *

Are you bringing a guest? *

Yes

No

Guest Information:

	First Name	Last Name	City, State	Email	Relationship to attendee
Guest #1	First Name	Last Name	City, State	Email	Relationship to attendee
Guest #2	First Name	Last Name	City, State	Email	Relationship to attendee
Guest #3	First Name	Last Name	City, State	Email	Relationship to attendee
Guest #4	First Name	Last Name	City, State	Email	Relationship to attendee

(Optional) Please share any information about your mobility/activity/personal goals that you have for this event.

Additional Requests, Dietary Needs, Comments, or Questions: