If you intend to participate, please register so that we can ensure we have the resources to meet demand. Fill out the ATHLETE PROFILE first (you do not have to fill it out every time you register for an event). Once complete, fill out the PROGRAM REGISTRATION FORM to choose what sport or activities you or your athlete would like to participate in. Athletes 10 years old and older can compete. All athletes must complete a Waiver and Release Form in addition to an Athlete Registration Form.

Athlete Profile

Please tell us about the athlete or participant you would like to register with the Dream Program. Fill out the form and sign waiver at the bottom to complete the athlete profile.

Athlete Profile Form

Are you an Athlete or Participant? *

Athlete - You or your child you are registering HAS a disability

Participant - You or your child you are registering DOES NOT HAVE a disability

Name *

First Name

Last Name

Age *

Birth Date *

YYYY

Sex *

Disability *

Please provide information about the type and nature of the athlete's disabilities, if any. If the participant is not disabled, please enter NONE'

Primary Contact Name *

Who should we contact with Dream Program information events, notifications etc?

First Name

Last Name

Primary Contact Address *

Please provide the address where the athlete or participant is at, currently.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Contact Email *

In case we need to reach the primary contact directly.

Primary Contact Phone *

(###)

###

####

Release and Waiver Form

Please read this form carefully and be aware in registering yourself, your child or ward for participation in the DREAM Program you will be waiving and releasing all claims for injuries you or your minor child/ward/adult son or daughter might sustain arising out of program participation. As a participant or parent/guardian of a participant in the DREAM Program, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume full risk of any injuries, property damage or loss which I or my minor child/ward/adult son/or daughter may sustain as a result of participating in any and all activities connected with or associated with the DREAM Program. I agree to waive and relinquish claims I or my minor child/ward/adult son or daughter may have as a result of participating in the program against the DREAM Program and its officers, agents, servants, volunteers, and employees. I further agree to indemnify and hold harmless and defend the DREAM Program and its officers, agents, servants, volunteers, and employees from any claims by other parties resulting from injuries, damages, and losses caused by me or my minor child/ward adult son or daughter arising out of, connected with, or in any way associated with the activities or program offered. In the event of an emergency, I authorize the Dream Program to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my minor child/ward adult son or daughter’s immediate care and agree that I will be responsible for payment of any and all medical services rendered. I have read and fully understand the above program details, waiver, and permission to secure treatment and shall not be modified orally.

Do you give permission to the DREAM Program take pictures to be used for publicity purposes and scrapbooking of your minor child/ward adult son or daughter? *

Waiver Form Signature. *

Please type your name to agree to our waiver.

First Name

Last Name

Thank you for filling out our Athlete Profile form. Your next step is to fill out the Program Registration below.

Program Registration

A Program Registration form should be completed for each participant, each year so that we can make sure we have enough resources for all those who wish to attend.

Program Registration

Name *

First Name

Last Name

Email *

What league category best fits your athlete being registered? *

I would like to register for: *

Please mark all that apply:

Aqua Fitness

Arts & Crafts

Basketball

Bowling

Cheerleading

Flag Football

Music

Soccer Clinic

Softball

Swimming

Zumba

Physical Address *

Please provide the address that the athlete or participant is at, currently.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Phone *

(###)

###

####

Team Tee shirt size

Adult Small

Adult Medium

Adult Large

Adult XL

Adult XXL

Adult XXXL

Thank you!

The Dream Program

3827 Bienville Blvd Ste 8,
Ocean Springs, MS 39564

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Our Partners
Arc of Ms. Gulfport
Gulf Coast Down Syndrome Society
Gulf Coast Foundation HUB
Gulf Coast YMCA OS
Jackson County Exceptional School
Junior Auxiliary of Biloxi Ocean Springs
Kiwanis Club of Pascagoula
Kroc Center Biloxi
Ocean Springs School District
Special Olympics of MS