Wings for Autism® Registration

Please complete this registration form for all individuals that will be participating in the Wings for AutismĀ® event on April 28, 2018 at Fort Wayne International Airport (FWA). Participants will be boarding the aircraft at 4:45pm, but we ask that you arrive at the airport at 3:00pm 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 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 *
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. *