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Accommodation Requests
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Accommodation Requests
Name
*
First
Last
Parent or Guardian Name (if under 18)
Phone
*
Email
*
Participation activity or activities that you would like to participate in (check all the apply):
*
Swim Lessons
Recreational Swimming
Strength & Conditioning
Fitness Assessment
Personal Training
Group Fitness
Small Group Training
Massage Therapy
Boating
Climbing Wall
Disc Golf
Sailing
Challenge Course
Open Recreation
Adaptive Sports
Other
If you selected "other," please explain.
*
Location
*
Southwest Recreation Center
Student Recreation & Fitness Center
Broward Outdoor Recreation Center
Lake Wauburg
Date Requested
*
MM slash DD slash YYYY
Time Requested
*
:
Hours
Minutes
AM
PM
AM/PM
Duration of Activities
*
15 Minutes
30 Minutes
45 Minutes
1 Hour
If you require accommodations in order to participate, please contact MartyD@recsports.ufl.edu. Please identify barriers that may impact your time at the Rec Center below:
*
Please check if you will be bringing a Personal Care Attendant with you.
Yes. I will be bringing a care attendant with me.
Please rate how you feel about using the RecSports facilities and programs. These activities can include accessing and exiting the facilities, participation in programs, and participation in cardio and weight equipment.
*
5. Completely comfortable using without accommodation support.
4. Could utilize fairly effectively without accommodation support.
3. Could utilize, but not as effectively as I could with accommodation support.
2. Could utilize few areas without accommodation support.
1. Could not utilize without accommodation support.
Do you have any additional requests?
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