Come for an evening of Halloween Music, Games, Costumes, Food, and...Jupiter the Therapy Dog!

This event is open to adolescents with developmental disabilities who are between 12-21 years old. Siblings and/or friends (age 12-21) are also welcome to come join the fun! Each individual will need to register as a separate participant.

The event will be staffed by trained, experienced professionals in the field of developmental disabilities.

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* 1. Participant information

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* 2. Guardian's information
In the unlikely event we need to contact you during the event, we ask that you remain available by phone, or designate another responsible person for us to contact during the event if necessary (use the Emergency/alternate contact field below).

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* 3. Emergency/alternate contact information (if different from Guardian)
If the Guardian listed above will not be available by phone during the event, please use this area to designate another responsible person for us to contact during the event if necessary.

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* 4. Please indicate any relevant health, behavior, or other concerns such as allergies, sensory issues, emotional challenges, communication challenges, dietary restrictions, and/or other information that would be beneficial for the staff and/or directors to be aware of to help ensure the most positive experience possible for this individual and all participants.

If the participant will be accompanied by their own paid support staff, please provide the staff's name here. (Paid support staff do not need to register separately.)

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* 5. Participants are encouraged to come in costume! We have a few guidelines to help make sure everyone has a great time. Please review these with the participant.
  • nothing overly gory or bloody
  • nothing overly revealing or sexual
  • nothing political
  • nothing with vulgar or obscene language
  • no costumes or props intended to provoke or offend
  • no weapons or overtly violent costumes or props
  • masks are permitted, but the participant must remove their mask during certain activities and any other time requested
The Staff reserves the right to determine the appropriateness of any participant's costume and/or accompanying props and require modifications.

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* 6. All participants will be expected to manage themselves appropriately to the best of their ability in a group setting. This includes, but may not be limited to:
  • remaining in designated areas at all times
  • treating other participants, staff, and volunteers with respect 
  • treating the facility and property with respect
Participants who do not meet these expectations may be asked to leave the event (no refund will be granted).

Space is limited! Advance tickets are $25 by mail only - your spot is guaranteed once payment is made. Please send a check or money order payable to
Northland Social & Behavioral Supports
4444 N. Belleview Ave., Suite 107
Kansas City, MO 64116

Include the name(s) of the participant(s) on your check. You'll receive an email confirmation that we've received your payment and your spot at the event is guaranteed.

Registered participants can buy tickets at the door for $28 if space is available, payable by check or money order (no cash or credit/debit accepted). Remember, your spot is only guaranteed once payment is received.

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* 7. I hereby agree to hold Jeffery D. Janney, LLC, its members, officers, and staff, and the Episcopal Church of the Good Shepherd, its members, officers, and staff, harmless from any liability arising out of the use of the Church facility and its premises.

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