Upcoming Events

6/10/2012
Creative Financial Group’s Afternoon Benefit with the Sugarfoot Band: Please join Creative Financial Group and the Sugarfoot Band for an afternoon benefit on "The Deck" …read more...
6/12/2012
36th Annual Tournament of Champions Pro-AM: The 36th Annual Tournament of Champions Pro-AM is a Philadelphia tradition that brings Philadelphia Section PGA, …read more...
All Events »

3rd Annual Autism Awareness Night at Please Touch Museum

Join Variety for our 3rd Annual Autism Awareness Night at the Please Touch Museum on Saturday, April 7th from 6-9PM! For one special night, the Please Touch Museum will open its doors just for Variety's children with autism (up to age 21) and their immediate family members.

Fill in your registration information below. After submitting your information, you will be directed and able to pay the $ 20 registration fee per family online. You will then bring the receipt to Please Touch Museum as your family's ticket to the event on April 7th. Your receipt will be emailed to you.

Please note that tickets will not be mailed but rather you will use your registration receipt as your ticket.

NOTE: Bold fields are required.

Child’s First Name

Child’s Last Name

Address

City

State

Zip Code

Child's Birthday

Child’s Age

Child’s Diagnosed Disability

Child's Member Identification Number

Daytime Phone

Evening/Cell Phone

Email Address

Parent/Guardian’s Main Employer

Who referred you to Variety: The Children's Charity?

Name
Affiliation

Only those people listed below are permitted to attend this event. Please list everyone attending, including the child with a disability.

Attendee #1 (Child)

Name

Attendee #2

Name
Relationship to Child

Attendee #3

Name
Relationship to Child

Attendee #4

Name
Relationship to Child

Attendee #5

Name
Relationship to Child

Attendee #6

Name
Relationship to Child

Waiver of Liability

For and in consideration of free admission into Variety – The Children's Charity's "3rd Annual Autism Awareness Night at Please Touch Museum", an event held on Apr 7, 2012, I, the undersigned, on behalf of myself and as parent and/or legal guardian of all children accompanying my group, do hereby agree as follows:

Whereas the undersigned desire to participate in "3rd Annual Autism Awareness Night at Please Touch Museum", a charitable event sponsored by Variety – The Children's Charity of Greater Philadelphia, I understand and agree that Variety Ð The Children's Charity, Variety Club Camp (and all of its affiliates), Please Touch Museum, Memorial Hall, Fairmount Park, Philadelphia, and all related sponsors, vendors, employees, agents, directors, volunteers and staff (hereinafter collectively referred to as "Released Parties") shall not be responsible or legally liable for any loss of personal property, or any bodily injury, including death, incurred or suffered by me or any children accompanying my group as a result of our participation in "3rd Annual Autism Awareness Night at Please Touch Museum" or our presence on the property of Please Touch Museum, Memorial Hall, Fairmount Park, Philadelphia and/or Variety – The Children's Charity. As a further condition of our participation, we agree to forever remise, release, discharge and hold harmless the Released Parties for any and all claims at law or equity that I or any children accompanying my group, or any heirs, successors and/or assigns have, had or will have stemming from our participation in "3rd Annual Autism Awareness Night at Please Touch Museum" or our presence on the property of Please Touch Museum, Memorial Hall, Fairmount Park, Philadelphia and/or Variety – The Children's Charity.

Additionally, I agree to indemnify and hold harmless the Released Parties from or related to any loss of personal property and/or bodily injury, including death, resulting from our participation in "3rd Annual Autism Awareness Night at Please Touch Museum" or our presence on the property of Please Touch Museum, Memorial Hall, Fairmount Park, Philadelphia and/or Variety – The Children's Charity.

I hereby give my consent for medical treatment should I or any of the children accompanying my group be involved in an accident and/or health-damaging situation while participating in "3rd Annual Autism Awareness Night at Please Touch Museum" or while present on the property of Please Touch Museum, Memorial Hall, Fairmount Park, Philadelphia and/or Variety – The Children's Charity.

Additionally, I give my consent to the Released Parties to use any of my or any of the children accompanying my group's names, photographs, likenesses, writings, audio/visual, motion pictures and biographical information related to this event only, in any media for editorial, educational, promotional or advertising purposes. This consent shall be binding on myself and the heirs, executors, administrators and/or assignees of the children accompanying my group.

Each adult attendee, including myself, has read, understands, and agrees to all the terms of the above Waiver of Liability.

Verification

I verify that all the above information is correct and complete.
Your Name
Relationship to Child