RSVP form for the Support Group for Adults with Developmental Disabilities

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* 1. For the participant:

Full name:

Phone number:

Email address:

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* 2. For any person who will be accompanying participant to the support group:
This person will need to be in the building for care of participants, if needed.

Full name:

Relationship to participant:

Phone number:

Email address:

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* 3. Emergency contact information:

Full name:

Relationship to participant:

Phone number:

Email address:

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* 4. What are the participant’s special needs (quiet volume, increased space for mobility, communication device use)?

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* 5. How does the participant get around (power wheelchair, manual wheelchair, walking, using a walker, etc.)?