Inclusion Intake Form
Publish Date: Dec, 09 2019
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 firstname.lastname@example.org for further questions or concerns.