Accessible and Inclusive Recreation (AIR)

2. Holly Springs Parks & Recreation is committed to providing a safe, comfortable, and fun experience for all participants. Please help us discover what makes each participant SHINE by filling out the following interest form. Our Inclusion Specialist will contact you as soon as possible to gather more information and answer any questions you may have.

   Additionally, by completing our form you will receive a quarterly e-newsletter about upcoming AIR programs and activities offered by Holly Springs Parks & Recreation!

4. Participant First Name*
5. Participant Last Name*
7. Participant Date of Birth*
   Participant Date of Birth
9. Contact First Name
10. Contact Last Name
12. Contact Email Address*
13. Contact Phone Number*
15. Preferred method of contact*

    1. Email
    2. Phone
17. How did you learn about this form? (Optional)

    1. General web search about inclusive activities in the Holly Springs area
    2. I registered for an activity and was directed to this form
    3. I was referred to this page by a friend or family member
    4. I was referred to this page by a teacher or care professional
    5. I was referred to this page by a Holly Springs town employee
    6. Other
19. Would you like to share any disability/health information with our Inclusion team at this time? (Optional)
21. Please tell us a little about the participant. Personality traits, successes/struggles, things that bring them joy, or make them frustrated. (Optional)
23. What supports or accommodations can be made to help the participant SHINE! (Optional)
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field