MEMBERSHIP REQUEST FORM

Thank you for taking the time to explore our website. Please take a few minutes to tell us a little about you and your family, so that we may assess whether we are a uniquely audacious fit. Our business hours are below and we are happy to answer questions you may have.

Business Info

Address:

Headquarters, Portland, OR 97212

Email:

info@miracletouchdowns21.com

Phone:

1-800-AUDACITY-21

Opening Hours

Mon - Fri

9:00 am – 5:00 pm

Saturday

CLOSED

Sunday

CLOSED

Contact

Miracle TouchDowns21 New Member Request Form

First name

Last name

Phone

Dropdown

My household is established as a single parent, traditional husband and wife or legally adopted loving family. And we will govern ourselves respectfully within this Miracle TouchDowns 21 community while engaging in the various inclusive and educational platforms. We understand that disruptive or destructive behavior and activity is frowned upon in this mission, ministry and movement and may result in immediate removal of our entire household.

Which of the membership benefits was the driving force leading you to join our community?

Yes, sign me up for the Audacity Ambassador certification course and give me access to the Down Syndrome Xtra Healthcare Provider Playbook, upon approval.