Mailing List Registration

BOARD OF DIRECTORS

Dave Neumeyer
- President
John Krecek
- President Elect
Shaun Clark
- Treasurer
John Alig
- Secretary
Barb Peacock
- Mesa Public Schools Representative
Mark Grant
- City of Mesa Representative
Miles Beccia
Randy Eskelson
Jeff Gibson
John Hughes
Richard W. Jones, MD
Cathy Pai

MASD currently has open positions!

How to Join the MASD Mailing List:

Complete the form below and click "join" at the bottom of the page,
or if you would like to print it and mail it, click the link below -

Adaptive Recreation Mailing List

Mesa Association of Sports for the Disabled
59 East Broadway Road in
Mesa, AZ 85210

Adaptive Recreation Mailing List Sign Up Form

First Name:

Last Name:

Street Address:

City :

State:

Zip:

Primary Phone:

Secondary Phone:

Email Adress:

Disability: (optional)

Age Range
5 - 7	16 - 24	41 - 60
8 - 15	25 - 40	61 and over

Participation Level
Participant	Coach	Sponsor
Volunteer	Parent/Gaurdian	Professional

Intellectually Disabled Activities

Special Olympic Sports:

Aquatics
Baseball
Basketball
Bocce Ball
Bowling
Cheerleading
Floor Hockey
Golf
Gymnastics
Soccer
Tennis
Track & Field

Special Events:

Fundraisers
Tournaments
Other

Social Activities:

TGIF (Thank Goodness Its Friday)
"You Look Marvelous" Fashion Show
Holiday Dances

Outdoor Adventure:

Hiking Club
Kayaking

Trips:

Camp Grant
California Adventure (Disneyland)
Other

Physically Challenged Activities

PC Sports:

Aquatics
Archery
Boccia Ball
Bowling
Cycling
Goalball
Power Soccer
Track & Field
Wheelchair Basketball
Tennis

Outdoor Adventure:

Kayaking
Ski-Able
Water Skiing

Special Events:

Trips
Fundraisers
Tournaments
Other

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