Inclusion Intake Form

Publish Date: Dec, 09 2019

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If your child has a medical condition that may interfere with participation in a recreation program, please complete this form so that we can offer the appropriate services that will allow your child to be fully engaged and ready to play!

Step 1: Register for Program of Choice

Step 2: Complete Inclusion Participant Profile

Step 3: Turn in Form to Center Director and Program Director of Inclusive Services, Bianca Posada.

Contact Bianca at 510.597.5064 or for further questions or concerns.