Spotlight Series Registration
Event Date: Thursday, March 14th, 2019

Doors will open at 5:45 p.m.

Check In Time: 5:45 p.m., with presentation beginning promptly at 6:00pm

Event Location: Verne Cox Multipurpose Recreation Center

Event Address: 5200 Burke Rd. Pasadena. TX 77504

Contact us: 281.487.1755 or lmitchell@ci.pasadena.tx.us

Spotlight Series Presents: Kim Hegwood from Hegwood Law Group: Life After 18
Presentation Attendee Information:
First & Last Name *
Your answer
Email *
Your answer
Phone *
Your answer
How do you prefer to be reminded? *
Required
During the presentation, the VCMRC will have staff available for Supervised Open Gym, offered to participants that require 1:1 assistance and to those that cannot be left home alone. The gym and staff will be available from 6:00pm until the conclusion of the presentation. Supervised Open Gym will be available for those ages 3+.
Will your Participant(s) need Supervised Open Gym during the presentation? *
If yes, please answer the following questions, for EACH Participant you are registering.
Participants' First & Last Name(s)
Your answer
Has your Participant attended the VCMRC within the last year?
Participants' Age(s)
Your answer
Participant's Disability(ies)
Your answer
Levels of Assistance
1 - Independent - Participant is able to follow 3-4 step instructions independently.
2 - Minimal Assist - Participant is able to complete 75% of the task, with cues.
3 - Moderate Assist - Participant is able to complete 50% of the task, with cues.
4 - Maximum Assist - Participant is able to complete 25% of the task, with cues.
5 - Total Assist - Participant requires 100% assistant to complete the task.
Level of Assistance needed for Participant(s) with disabilities. Type in level from above and elaborate if needed.
Your answer
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