Skip to Main Content
Loading
Loading
Programs
Locations
Get Involved
About Us
Register
Español
Search
Home
Online Forms
Online Forms
Search Forms:
Search Forms
Select a Category
All Categories
Airport
Building Division
Canines for Clean Water
Central Services
Community Development
Cultural Services
Downtown Watch
Equity and Community Engagement
Eugene Sunday Streets
Family and Medical Leave
Finance
Fire and EMS Services
Housing
HR
Library Forms
LRCS Forms
Map Hub
Municipal Court
Neighborhoods
Parks and Open Space
PDD - BPS - Public Passenger Vehicles
PDD - Community Development
PDD - Recycling and Solid Waste
PDD Business and Economic Development
PDD Waste Prevention Sustainable Event Bins Reservation Form
Planning - Zoning and Land Use Forms
Planning - Zoning and Land Use Forms 3
Planning - Zoning and Land Use Forms 4
Planning- Zoning and Land Use Forms 2
Police
Public Works
Recreation Services
Request Tracker Form
Risk Forms
Smoking Ordinance
Sustainability Comission
User Testing
By
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Inclusion Request
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Steps
1.
Contact Information
This section is complete
This section is incomplete
2.
Details
This section is complete
This section is incomplete
Contact Information
Inclusion Services Request Form
The City of Eugene Recreation Division strives to provide recreation environments that are safe, fun, and respectful for all community members. To help us help you, please complete this form to initiate the inclusion process.
Name
*
New Patron
Existing Patron
(If minor) Name of parent, care provider or primary contact
Phone (primary):
*
Phone (secondary):
Email address
Continue
Details
Which program or programs are you registering for (list barcode)?
Please explain why you are requesting inclusion services.
*
The following accessibility and inclusion support are available with advanced notice. Some requests may take up to
two weeks
to secure:
Accessible vans
Adapted equipment
Assessments
Extra staff
Individualized activity support
Information in large print, Braille, on disc, or a reader
Knowledge and expertise in behavior management and support
Program modification
Resource & information
Service animals allowed in programs
Sign interpreters for the deaf and hard of hearing
An inclusion specialist will contact you within three business days to discuss the information and determine next steps. For more information call Hilyard Community Center 541-682-5311.
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
|
Go Back
* indicates a required field
Rec Guide
Register
Volunteer
Donate
Contact Us
Español
Next
Previous
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow