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Inclusion Request
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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.
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