PTI Wings for All® Waitlist

Please complete this form to be placed on the wailtist for the Wings for AllĀ® event on October 28, 2017 at Piedmont Triad International Airport (PTI). Participants will be boarding the aircraft at 3:00pm, but we ask that you arrive at the airport by 1:00pm to allow ample time to check-in and pass through security. 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, 1 individual with a disability is allowed to board the plane with 1 family member/support staff per family. However, up to 2 additional family members are allowed to accompany the participant to the event, but will have to wait in the gate area and will NOT be permitted to board the plane. Participants that are attending the event and not boarding the plane will have to register on a separate registration form, located here

T-shirts will be provided for participants with disabilities and the 1 family member who accompanies them onto the plane.  

If you have any questions or need assistance with completing this form, please contact Linda Yurko at Lyurko@arcg.org or 336-373-1076 ext. 103.


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