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
Heather Cooan
Randy Eskelson
Jeff Gibson
John Hughes
Richard W. Jones, MD
Cathy Pai
Denny Rausch

MASD currently has one
open position!

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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