P&R Accommodation Request

P&R Accommodation Request

Parks and Recreation Department
The City of Greensboro Parks and Recreation Department offers Inclusion Services to provide accommodations for people with disabilities/special needs to allow everyone to take part in P&R programs and events. Please submit the following information to request an accommodation. The individual must be registered for the class/activity before making an accommodation request. We ask that the request be made two (2) weeks before the start of the activity.

If you need assistance in completing the request form, please contact 336-373-2954.

Anyone who submits a form should be aware that in accordance with the North Carolina Public Records law, found in North Carolina General Statutes Chapter 132, their e-mail address is considered public record.
Registrant's name*

First NameLast Name
Contact person*

First NameLast Name
Phone number*

Phone Number
Cell phone number

Phone Number
Email*
example@example.com
Program title*
Program location*
Program date(s) and time(s)*
List date(s) and time(s)
Has the registrant ever used Inclusion Services before?

YesNo
What type of accommodation is needed to be successful in this activity?
Are there any safety/behavioral concerns for the registrant in this activity?
A staff member from Inclusion Services will contact you within three (3) business days to discuss this information and any additional accommodations, support, and services that may be necessary.
Should be Empty: