Wings for All® Registration

Please complete this registration form for all individuals that will be participating in the Wings for AllĀ® event on April 27, 2019 at Fort Wayne International Airport (FWA). Participants will be boarding the aircraft at 3:00pm, but we ask that you arrive at the airport at 1:00pm to allow ample time to check-in and pass through security. A small reception will follow participants de-boarding the aircraft.

All individuals 18 years old and over are required to bring a valid form of government-issued ID to be allowed through security.

Due to limited space, 2 individuals with a disability are allowed to attend with up to 2 family members/support staff accompanying them to the event. 

If you have any questions or need assistance with completing this form, please contact Janet Schutte at jschutte@esarc.org or 260.456.4534 ext. 344.

 
First Participant
Full legal name (as it appears on a government-issued ID) of participant with disability:
Gender Identity *
calendar
Ethnicity
 
Diagnosis of individual with disability: * 
 
T-shirts will be available at this event. Please provide your size. *
 
I consent to having my photo taken as part of this event. *