Moda Center-Community Event Sign-Up

Moda Center-Community Event Sign-up

This is a community-based event and not a service.This event is designed for individuals receiving support services and their support networks.Space is limited, and participation is optional.
Your Name*

First NameLast Name
Who are you attending with?*
Name of individual receiving support attending:
Your Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Your Email*
example@example.com
Agency you are affiliated with
Which event would you like your name in the drawing for?*
Can we contact you about future events and promotions?*

YesNo
🧾 Acknowledgment & Event Guidelines
By signing below, you acknowledge and agree to the following:
- Participants must have permission from a parent/guardian if under 18 and must be accompanied by a responsible adult at all times.
- This is a community event and not a provided service. No supervision or support is provided by staff.
- Attendees are responsible for their own transportation, parking , food, and beverages.($25-$37 if using a parking garage, some parking is less but you would have to walk further).
- Please respect the privacy of others and obtain consent before taking photos or videos.
- If you are unable to attend, please notify us as soon as possible so we can offer the space to others.
- Repeated no-shows without notice may impact eligibility for future events.
  In limited cases, a fee may apply for no-shows to cover unrecoverable event costs.
- Emergencies will always be considered on a case-by-case basis.
Signature*
Should be Empty:

Moda Center-Community Event Sign-up