A Day At The Ballpark Registration Form

A DAY AT THE BALLPARK – Sunday, June 7th, 2026

12 - 12:30PM CHECK-IN: Attendees must pick up their tickets at the Department of Mental Health (DMH) table by the stadium entrance.

Capes & Crowns Theme Day – 1st Pitch @ 1PM

Clover Stadium, 1 Phil Tisi Way, Pomona, NY 10970

Alternate GPS Address: 27 Fireman’s Memorial Drive, Pomona NY 10970

Primary Contact Information:

Contact Person's Name

First NameLast Name

Contact Person's Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Contact Person's Email

example@example.com

Eligibility:

Registration is restricted to adults (ages 18+) who reside within Rockland County and who are eligible through the OPWDD – Office for People with Developmental Disabilities – regardless of the residential placement or affiliation.

Individual's Name

First NameLast Name

Is this individual 18 years of age or older?

Is this individual OPWDD eligible?

Individual's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Describe individual’s living arrangements

CHAPERONE/GUEST INFO:

Each OPWDD eligible adult may invite ONE guest (friend/family member) for free, and may increase their party to three (3) if the chaperone with whom they typically reside or travel will also be attending.

Guest Name

First NameLast Name

Chaperone's Name

First NameLast Name

Chaperone's Cell Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Chaperone's Email Address

example@example.com

TICKETS/SEATING:

Chaperones and guests will be seated in a stadium seat or folding chair next to their individual.

Number of tickets needed

Type of seating requested for individual

EXTRA PERKS:

Each person in attendance may request one (1) Meal Basket voucher, when ordered here with registration.
A Meal Basket voucher entitles bearer to redeem at the nearest concession stand for:
French-fries and a drink, plus one of the following: Hotdog, Hamburger, Cheeseburger, Chicken Nuggets

How many meal basket vouchers would you like?

Would your individual like a promotional superhero cape?

Would your individual like to visit the infield to meet the players for autographs after the game? (wheelchair ramp available in right field)

*If you have dietary restrictions that require a different meal or any questions/concerns, please contact DMH at (845) 364 - 2391 or (845) 364 - 2392.