{"id":45,"date":"2018-08-21T16:12:20","date_gmt":"2018-08-21T16:12:20","guid":{"rendered":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/?page_id=45"},"modified":"2018-12-09T07:59:45","modified_gmt":"2018-12-09T07:59:45","slug":"adaptive-recreation","status":"publish","type":"page","link":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/adaptive-recreation\/","title":{"rendered":"Pasadena Adaptive and Inclusive Recreation"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column width=\"1\/3\"][vc_column_text]<section id=\"content-cards-423300\"><div class=\"card-deck mb-4\"><div class=\"card  pb-3 bg-primary text-white border-light layout-image\"><div class=\"cc-img-wrapper mb-0\"><img loading=\"lazy\" decoding=\"async\" width=\"675\" height=\"346\" src=\"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-content\/uploads\/sites\/33\/PAIRlandscape.jpg\" class=\"card-img-top wp-post-image\" alt=\"\" srcset=\"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-content\/uploads\/sites\/33\/PAIRlandscape.jpg 675w, https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-content\/uploads\/sites\/33\/PAIRlandscape-300x154.jpg 300w\" sizes=\"auto, (max-width: 675px) 100vw, 675px\" \/><\/div><!--\/cc-img-wrapper --><div class=\"card-body pb-0 overflow-auto\"><div class=\"card-block\"><h2 class=\"card-title text-center\"><span class=\"card-header-text\">Pasadena Adaptive and Inclusive Recreation<\/span><\/h2><div class=\"card-text\"><p class=\"lead\"><strong>The City of Pasadena Parks, Recreation and Community Services Department is committed to providing safe, enjoyable, and inclusive recreation opportunities for all abilities.<\/strong><\/p>\n<p>For information about Inclusion Services, contact (626) 744-3829 or <a href=\"mailto:parksandrec@cityofpasadena.net\">parksandrec@cityofpasadena.net<\/a>.<\/p>\n<p>For information about Adaptive Recreation, contact (626) 744-6544 or <a href=\"mailto:elomeli@cityofpasadena.net\">elomeli@cityofpasadena.net<\/a>.<\/p>\n<\/div><!-- \/.card-block --><\/div><\/div><!-- \/.card-body--><\/div><!-- \/.card --><\/section><!-- \/#content-cards -->[\/vc_column_text][\/vc_column][vc_column width=\"2\/3\"][vc_tta_tabs style=\"outline\" color=\"sky\" spacing=\"10\" gap=\"10\" alignment=\"center\" active_section=\"1\"][vc_tta_section title=\"Inclusion Services\" tab_id=\"inclusion-services\"][vc_column_text]<\/p>\n<h4 class=\"card-header-primary\">Inclusion Services<\/h4>\n<p><link rel='stylesheet' id='formidable-css' href='https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-content\/plugins\/formidable\/css\/formidableforms33.css?ver=20261027220811' media='all' \/>\n<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_12_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_79nap\" data-frm-error-config=\"{&quot;includeAlertRole&quot;:false,&quot;focusFirstError&quot;:false,&quot;focusErrorSummary&quot;:true}\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_hidden\">Pasadena Inclusion Services<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"12\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_12\" id=\"frm_hide_fields_12\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"79nap\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_12\" name=\"frm_submit_entry_12\" value=\"c42caba0f7\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/parks-and-rec\/wp-json\/wp\/v2\/pages\/45\" \/><div id=\"frm_field_290_container\" class=\"frm_form_field  frm_html_container form-field\">The City of Pasadena Parks, Recreation and Community Services Department provides Inclusion Services to ensure that individuals with disabilities have an equal opportunity to engage in all recreation programs offered by the department. Inclusion is the process of providing supports, accommodations, and staff training to ensure that the individual needs of program participants are met.<\/p>\n<p>To request Inclusion Services, please follow the steps below:<\/p><\/div>\n<div id=\"frm_field_291_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\" tabindex=\"0\" role=\"button\"><span>Step 1 - Read the Inclusion Services FAQ<\/span> <svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\">\n\t<path d=\"M5 6l5 5 5-5 2 1-7 7-7-7 2-1z\"><\/path>\n\n<\/svg><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\"><path d=\"m15 14-5-5-5 5-2-1 7-7 7 7-2 1z\"\/><\/svg><\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_292_container\" class=\"frm_form_field  frm_html_container form-field\">\n<div class=\"bg-light p-3\"><strong>Who is eligible for Inclusion Services?<\/strong><\/p>\n<p>Any participant who is registered and has a disability that impacts participation in recreation programs may request Inclusion Services.<\/p>\n<hr \/>\n<p><strong>What types of modifications are provided through Inclusion Services?<\/strong><\/p>\n<p>Examples of modifications include, but are not limited to, providing an enhanced staff to participant ratio, development of a behavior support plan, and the provision of auxiliary aids. All modifications must be reasonable and necessary, which is determined on an individual, case by case basis.<\/p>\n<hr \/>\n<p><strong>How do I request Inclusion Services?<\/strong><\/p>\n<ol>\n<li>Read the Inclusion Services FAQ<\/li>\n<li>Register for the recreation program of your choice.<\/li>\n<li>Request Inclusion Services by submitting the online Inclusion Services Request Form and Participant Questionnaire <em>(Participant Questionnaire only required one time per year)<\/em><\/li>\n<\/ol>\n<p>Once you submit your request for Inclusion Services, you will receive an email confirmation that your request has been received. Staff will review your information and contact you regarding your request.<\/p>\n<p><strong>Please note:<\/strong> To allow adequate time for processing and assessment, please request Inclusion Services <u>at least 14 calendar days in advance<\/u> of the recreation program start date.<\/p>\n<hr \/>\n<p><strong>Is there a fee for Inclusion Services?<\/strong><\/p>\n<p>No.<\/p>\n<hr \/>\n<p><strong>Do participants receiving Inclusion Services receive priority in registering for recreation programs? <\/strong><\/p>\n<p>No. Recreation program registration is on a first-come, first-served basis.<\/p>\n<hr \/>\n<p><strong>Do participants receiving Inclusion Services receive exceptions to basic recreation program requirements?<\/strong><\/p>\n<p>No. All program participants must meet basic program requirements such as age and residency.<\/p>\n<hr \/>\n<p><strong>Is transportation provided to and from recreation programs? <\/strong><\/p>\n<p>No. However, transportation may be provided to and from activities that occur during recreation programs. Such transportation is typically via school or charter bus. Please include any accessibility needs related to transportation on the Inclusion Services Request Form and\/or Inclusion Services Questionnaire.<\/p>\n<hr \/>\n<p><strong>Are personal care or health services provided through inclusion services?<\/strong><\/p>\n<p>Maybe. Personal care or health services are generally not provided, unless provision of such services is a part of the program. However, personal care services may be provided if necessary as a reasonable modification, which is determined on an individual, case by case basis. Please include any such personal care needs on the Inclusion Services Request Form and\/or Inclusion Services Questionnaire.<\/p>\n<hr \/>\n<p><strong>Is behavioral therapy provided through Inclusion Services? <\/strong><\/p>\n<p>No. However, as a reasonable modification, a participant may be accompanied by a behavioral therapist during a program.<\/p>\n<hr \/>\n<p><strong>What behavior standards apply to participants receiving Inclusion Services?<\/strong><\/p>\n<p>All program participants, including those receiving Inclusion Services, must abide by program specific codes of conduct and the City of Pasadena Human Services and Recreation Standards of Behavior, with or without reasonable modification. A participant\u2019s Inclusion Services Plan may include provisions to assist the participant with abiding by these expectations.<\/p>\n<hr \/>\n<p><strong>May a participant bring his\/her own 1:1 Aide to provide assistance during a recreation program? <\/strong><\/p>\n<p>Yes. As a reasonable modification, a participant may be accompanied by his\/her own aide during a recreation program. A background check of the aide may be required. If so, you will be provided with additional information during the Inclusion Services assessment process.<\/p>\n<hr \/>\n<p><strong>Why do you ask for a copy of my child\u2019s Individualized Education Plan (IEP) or 504 plan with the Participant Questionnaire? <\/strong><\/p>\n<p>IEPs and 504 plans often include behavioral support strategies, recreational goals, and other information that assists staff with understanding the participant\u2019s needs and developing reasonable modifications in response to those needs.<\/p>\n<hr \/>\n<p><strong>If I am receiving Inclusion Services and something about me or my participation in the recreation program changes, who do I tell? <\/strong><\/p>\n<p>It is the responsibility of the participant or his\/her parent or care provider to inform Inclusion Services of any disability related updates or changes. Non disability related updates or changes should be communicated directly to the recreation program staff.<\/p>\n<hr \/>\n<p><strong>Are there any exceptions to the requirement to accommodate a participant with a disability?<\/strong><\/p>\n<p>Yes. Programs are not required to accommodate a participant with a disability if doing so would fundamentally alter the nature of the program, create an undue financial or administrative burden, or pose a direct threat to the health or safety of others that cannot be eliminated through reasonable modification.<\/p>\n<hr \/>\n<p><strong>Who do I contact for more information about Inclusion Services? <\/strong><\/p>\n<p>For more information, questions, or concerns about Inclusion Services, please contact (626) 744-4364 or <a href=\"mailto:lgarcia-brown@cityofpasadena.net\">lgarcia-brown@cityofpasadena.net<\/a>.<\/p>\n<hr \/>\n<p><strong>Who do I contact for more information about recreation programs?<\/strong><\/p>\n<p>For more information, questions, or concerns regarding a recreation program, please contact the recreation program staff or the location where the recreation program is offered.<\/p><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_294_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\" tabindex=\"0\" role=\"button\"><span>Step 2 - Register for the Recreation Program of Your Choice<\/span> <svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\">\n\t<path d=\"M5 6l5 5 5-5 2 1-7 7-7-7 2-1z\"><\/path>\n\n<\/svg><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\"><path d=\"m15 14-5-5-5 5-2-1 7-7 7 7-2 1z\"\/><\/svg><\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_295_container\" class=\"frm_form_field  frm_html_container form-field\">\n<div class=\"bg-light p-3\">\n<p>Before requesting Inclusion Services, <a href=\"http:\/\/www.cityofpasadena.net\/reserve\">register<\/a> for the recreation program of your choice.<\/p>\n<hr \/>\n<p><em>Not sure what you want to register for? Check out the online Recreation Guide:\u00a0<a href=\"https:\/\/www.cityofpasadena.net\/parks-and-rec\/recreation-guide\/\">www.cityofpasadena.net\/parks-and-rec\/recreation-guide\/<\/a>.<\/em><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_297_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\" tabindex=\"0\" role=\"button\"><span>Step 3 - Request Inclusion Services<\/span> <svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\">\n\t<path d=\"M5 6l5 5 5-5 2 1-7 7-7-7 2-1z\"><\/path>\n\n<\/svg><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\"><path d=\"m15 14-5-5-5 5-2-1 7-7 7 7-2 1z\"\/><\/svg><\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_298_container\" class=\"frm_form_field  frm_html_container form-field\">\n<div class=\"p-3\">The Inclusion Services Request Form must be submitted each time the participant registers for a program, class, or activity and would like to receive Inclusion Services during that program, class, or activity.<\/p>\n<hr \/>\n<\/div>\n<\/div>\n<div id=\"frm_field_299_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n    <label for=\"field_9qg6w\" class=\"frm_primary_label\">Today's Date\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_9qg6w\" name=\"item_meta[299]\" value=\"\"  data-sectionid=\"297\"  maxlength=\"10\" data-reqmsg=\"Today&#039;s Date cannot be blank.\" aria-required=\"true\" data-invmsg=\"Today&#039;s Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_300_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr \/>\n<h4>Participant<\/h4>\n<\/div>\n<div id=\"frm_field_301_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first\">\r\n    <label for=\"field_jl4wd\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_jl4wd\" name=\"item_meta[301]\" value=\"\"  data-sectionid=\"297\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_302_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_zd84n\" class=\"frm_primary_label\">Age\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_with_box\"><input  type=\"text\" id=\"field_zd84n\" name=\"item_meta[302]\" value=\"\"  data-sectionid=\"297\"  data-reqmsg=\"Age cannot be blank.\" aria-required=\"true\" data-invmsg=\"Age is invalid\" class=\"frm-has-number-format\" aria-invalid=\"false\"   \/><\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_303_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_j2uj\" class=\"frm_primary_label\">Date of Birth\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_j2uj\" name=\"item_meta[303]\" value=\"\"  data-sectionid=\"297\"  maxlength=\"10\" data-reqmsg=\"Date of Birth cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date of Birth is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_304_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_3rpz3\" class=\"frm_primary_label\">Address\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <fieldset aria-labelledby=\"field_3rpz3_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tAddress<\/legend>\n<div  class=\"frm_combo_inputs_container\" data-reqmsg=\"Address cannot be blank.\">\n<div id=\"frm_field_304-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_3rpz3_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress\t<\/label>\n\t\t<input type=\"text\" id=\"field_3rpz3_line1\" value=\"\" name=\"item_meta[304][line1]\"  data-sectionid=\"297\"  data-reqmsg=\"Address Line 1 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_304-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_3rpz3_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress\t<\/label>\n\t\t<input type=\"text\" id=\"field_3rpz3_line2\" value=\"\" name=\"item_meta[304][line2]\"  data-sectionid=\"297\"  data-reqmsg=\"Address Line 2 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_304-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_3rpz3_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCity\t<\/label>\n\t\t<input type=\"text\" id=\"field_3rpz3_city\" value=\"\" name=\"item_meta[304][city]\"  data-sectionid=\"297\"  data-reqmsg=\"City cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">City<\/div><\/div>\n<div id=\"frm_field_304-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_3rpz3_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tState\/Province\t<\/label>\n\t\t\t<select name=\"item_meta[304][state]\" id=\"field_3rpz3_state\"  data-sectionid=\"297\"  data-reqmsg=\"State\/Province cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Alabama\">Alabama<\/option><option  value=\"Alaska\">Alaska<\/option><option  value=\"Arkansas\">Arkansas<\/option><option  value=\"Arizona\">Arizona<\/option><option  value=\"California\">California<\/option><option  value=\"Colorado\">Colorado<\/option><option  value=\"Connecticut\">Connecticut<\/option><option  value=\"Delaware\">Delaware<\/option><option  value=\"District of Columbia\">District of Columbia<\/option><option  value=\"Florida\">Florida<\/option><option  value=\"Georgia\">Georgia<\/option><option  value=\"Hawaii\">Hawaii<\/option><option  value=\"Idaho\">Idaho<\/option><option  value=\"Illinois\">Illinois<\/option><option  value=\"Indiana\">Indiana<\/option><option  value=\"Iowa\">Iowa<\/option><option  value=\"Kansas\">Kansas<\/option><option  value=\"Kentucky\">Kentucky<\/option><option  value=\"Louisiana\">Louisiana<\/option><option  value=\"Maine\">Maine<\/option><option  value=\"Maryland\">Maryland<\/option><option  value=\"Massachusetts\">Massachusetts<\/option><option  value=\"Michigan\">Michigan<\/option><option  value=\"Minnesota\">Minnesota<\/option><option  value=\"Mississippi\">Mississippi<\/option><option  value=\"Missouri\">Missouri<\/option><option  value=\"Montana\">Montana<\/option><option  value=\"Nebraska\">Nebraska<\/option><option  value=\"Nevada\">Nevada<\/option><option  value=\"New Hampshire\">New Hampshire<\/option><option  value=\"New Jersey\">New Jersey<\/option><option  value=\"New Mexico\">New Mexico<\/option><option  value=\"New York\">New York<\/option><option  value=\"North Carolina\">North Carolina<\/option><option  value=\"North Dakota\">North Dakota<\/option><option  value=\"Ohio\">Ohio<\/option><option  value=\"Oklahoma\">Oklahoma<\/option><option  value=\"Oregon\">Oregon<\/option><option  value=\"Pennsylvania\">Pennsylvania<\/option><option  value=\"Rhode Island\">Rhode Island<\/option><option  value=\"South Carolina\">South Carolina<\/option><option  value=\"South Dakota\">South Dakota<\/option><option  value=\"Tennessee\">Tennessee<\/option><option  value=\"Texas\">Texas<\/option><option  value=\"Utah\">Utah<\/option><option  value=\"Vermont\">Vermont<\/option><option  value=\"Virginia\">Virginia<\/option><option  value=\"Washington\">Washington<\/option><option  value=\"West Virginia\">West Virginia<\/option><option  value=\"Wisconsin\">Wisconsin<\/option><option  value=\"Wyoming\">Wyoming<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">State\/Province<\/div><\/div>\n<div id=\"frm_field_304-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_3rpz3_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tZip\/Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_3rpz3_zip\" value=\"\" name=\"item_meta[304][zip]\"  data-sectionid=\"297\"  data-reqmsg=\"Zip\/Postal cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">Zip\/Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_305_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr \/>\n<h4>Parent\/Legal Guardian\/Care Provider Information<\/h4>\n<\/div>\n<div id=\"frm_field_306_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_7xp6n\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_7xp6n\" name=\"item_meta[306]\" value=\"\"  data-sectionid=\"297\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_307_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_sgns2\" class=\"frm_primary_label\">Relation\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_sgns2\" name=\"item_meta[307]\" value=\"\"  data-sectionid=\"297\"  data-reqmsg=\"Relation cannot be blank.\" aria-required=\"true\" data-invmsg=\"Relation is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_308_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_x96u0\" class=\"frm_primary_label\">Email Address\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_x96u0\" name=\"item_meta[308]\" value=\"\"  data-sectionid=\"297\"  data-reqmsg=\"Email Address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_309_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_7e079a\" class=\"frm_primary_label\">Home Phone\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_7e079a\" name=\"item_meta[309]\" value=\"\"  data-sectionid=\"297\"  data-frmmask=\"000-000-0000\" data-invmsg=\"Home Phone is invalid\" aria-invalid=\"false\" pattern=\"\\d\\d\\d-\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_310_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_ez0tx\" class=\"frm_primary_label\">Mobile Phone\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_ez0tx\" name=\"item_meta[310]\" value=\"\"  data-sectionid=\"297\"  data-frmmask=\"000-000-0000\" data-reqmsg=\"Mobile Phone cannot be blank.\" aria-required=\"true\" data-invmsg=\"Mobile Phone is invalid\" aria-invalid=\"false\" pattern=\"\\d\\d\\d-\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_311_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr \/>\n<h4>Program Information<\/h4>\n<p>Participant must be registered in program prior to submitting this form<\/p><\/div>\n<div id=\"frm_field_312_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_gnm2w\" class=\"frm_primary_label\">Program\/Activity\/Class\/Event\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_gnm2w\" name=\"item_meta[312]\" value=\"\"  data-sectionid=\"297\"  data-reqmsg=\"Program\/Activity\/Class\/Event cannot be blank.\" aria-required=\"true\" data-invmsg=\"Program\/Activity\/Class\/Event is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_313_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n    <label for=\"field_zuwf9\" class=\"frm_primary_label\">Program Location\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_zuwf9\" name=\"item_meta[313]\" value=\"\"  data-sectionid=\"297\"  data-invmsg=\"Program Location is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_314_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n    <label for=\"field_yi2jg\" class=\"frm_primary_label\">Program Dates\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_yi2jg\" name=\"item_meta[314]\" value=\"\"  data-sectionid=\"297\"  data-invmsg=\"Program Dates is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_315_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_41l1c\" class=\"frm_primary_label\">Time of Attendance - Starting Time\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <select aria-labelledby=\"field_41l1c_label\" name=\"item_meta[315]\" id=\"field_41l1c\"  data-sectionid=\"297\"  data-invmsg=\"Time of Attendance - Starting Time is invalid\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12:00 AM\" >12:00 AM<\/option><option value=\"12:30 AM\" >12:30 AM<\/option><option value=\"1:00 AM\" >1:00 AM<\/option><option value=\"1:30 AM\" >1:30 AM<\/option><option value=\"2:00 AM\" >2:00 AM<\/option><option value=\"2:30 AM\" >2:30 AM<\/option><option value=\"3:00 AM\" >3:00 AM<\/option><option value=\"3:30 AM\" >3:30 AM<\/option><option value=\"4:00 AM\" >4:00 AM<\/option><option value=\"4:30 AM\" >4:30 AM<\/option><option value=\"5:00 AM\" >5:00 AM<\/option><option value=\"5:30 AM\" >5:30 AM<\/option><option value=\"6:00 AM\" >6:00 AM<\/option><option value=\"6:30 AM\" >6:30 AM<\/option><option value=\"7:00 AM\" >7:00 AM<\/option><option value=\"7:30 AM\" >7:30 AM<\/option><option value=\"8:00 AM\" >8:00 AM<\/option><option value=\"8:30 AM\" >8:30 AM<\/option><option value=\"9:00 AM\" >9:00 AM<\/option><option value=\"9:30 AM\" >9:30 AM<\/option><option value=\"10:00 AM\" >10:00 AM<\/option><option value=\"10:30 AM\" >10:30 AM<\/option><option value=\"11:00 AM\" >11:00 AM<\/option><option value=\"11:30 AM\" >11:30 AM<\/option><option value=\"12:00 PM\" >12:00 PM<\/option><option value=\"12:30 PM\" >12:30 PM<\/option><option value=\"1:00 PM\" >1:00 PM<\/option><option value=\"1:30 PM\" >1:30 PM<\/option><option value=\"2:00 PM\" >2:00 PM<\/option><option value=\"2:30 PM\" >2:30 PM<\/option><option value=\"3:00 PM\" >3:00 PM<\/option><option value=\"3:30 PM\" >3:30 PM<\/option><option value=\"4:00 PM\" >4:00 PM<\/option><option value=\"4:30 PM\" >4:30 PM<\/option><option value=\"5:00 PM\" >5:00 PM<\/option><option value=\"5:30 PM\" >5:30 PM<\/option><option value=\"6:00 PM\" >6:00 PM<\/option><option value=\"6:30 PM\" >6:30 PM<\/option><option value=\"7:00 PM\" >7:00 PM<\/option><option value=\"7:30 PM\" >7:30 PM<\/option><option value=\"8:00 PM\" >8:00 PM<\/option><option value=\"8:30 PM\" >8:30 PM<\/option><option value=\"9:00 PM\" >9:00 PM<\/option><option value=\"9:30 PM\" >9:30 PM<\/option><option value=\"10:00 PM\" >10:00 PM<\/option><option value=\"10:30 PM\" >10:30 PM<\/option><option value=\"11:00 PM\" >11:00 PM<\/option><option value=\"11:30 PM\" >11:30 PM<\/option><\/select>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_316_container\" class=\"frm_form_field form-field  frm_top_container frm_half\">\r\n    <label for=\"field_l2jwx\" class=\"frm_primary_label\">Time of Attendance - Ending Time\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <select aria-labelledby=\"field_l2jwx_label\" name=\"item_meta[316]\" id=\"field_l2jwx\"  data-sectionid=\"297\"  data-invmsg=\"Time of Attendance - Ending Time is invalid\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12:00 AM\" >12:00 AM<\/option><option value=\"12:30 AM\" >12:30 AM<\/option><option value=\"1:00 AM\" >1:00 AM<\/option><option value=\"1:30 AM\" >1:30 AM<\/option><option value=\"2:00 AM\" >2:00 AM<\/option><option value=\"2:30 AM\" >2:30 AM<\/option><option value=\"3:00 AM\" >3:00 AM<\/option><option value=\"3:30 AM\" >3:30 AM<\/option><option value=\"4:00 AM\" >4:00 AM<\/option><option value=\"4:30 AM\" >4:30 AM<\/option><option value=\"5:00 AM\" >5:00 AM<\/option><option value=\"5:30 AM\" >5:30 AM<\/option><option value=\"6:00 AM\" >6:00 AM<\/option><option value=\"6:30 AM\" >6:30 AM<\/option><option value=\"7:00 AM\" >7:00 AM<\/option><option value=\"7:30 AM\" >7:30 AM<\/option><option value=\"8:00 AM\" >8:00 AM<\/option><option value=\"8:30 AM\" >8:30 AM<\/option><option value=\"9:00 AM\" >9:00 AM<\/option><option value=\"9:30 AM\" >9:30 AM<\/option><option value=\"10:00 AM\" >10:00 AM<\/option><option value=\"10:30 AM\" >10:30 AM<\/option><option value=\"11:00 AM\" >11:00 AM<\/option><option value=\"11:30 AM\" >11:30 AM<\/option><option value=\"12:00 PM\" >12:00 PM<\/option><option value=\"12:30 PM\" >12:30 PM<\/option><option value=\"1:00 PM\" >1:00 PM<\/option><option value=\"1:30 PM\" >1:30 PM<\/option><option value=\"2:00 PM\" >2:00 PM<\/option><option value=\"2:30 PM\" >2:30 PM<\/option><option value=\"3:00 PM\" >3:00 PM<\/option><option value=\"3:30 PM\" >3:30 PM<\/option><option value=\"4:00 PM\" >4:00 PM<\/option><option value=\"4:30 PM\" >4:30 PM<\/option><option value=\"5:00 PM\" >5:00 PM<\/option><option value=\"5:30 PM\" >5:30 PM<\/option><option value=\"6:00 PM\" >6:00 PM<\/option><option value=\"6:30 PM\" >6:30 PM<\/option><option value=\"7:00 PM\" >7:00 PM<\/option><option value=\"7:30 PM\" >7:30 PM<\/option><option value=\"8:00 PM\" >8:00 PM<\/option><option value=\"8:30 PM\" >8:30 PM<\/option><option value=\"9:00 PM\" >9:00 PM<\/option><option value=\"9:30 PM\" >9:30 PM<\/option><option value=\"10:00 PM\" >10:00 PM<\/option><option value=\"10:30 PM\" >10:30 PM<\/option><option value=\"11:00 PM\" >11:00 PM<\/option><option value=\"11:30 PM\" >11:30 PM<\/option><\/select>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_317_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_i4gn8\" class=\"frm_primary_label\">If attending specific dates, weeks, or days of the week during the program, please specify:\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_i4gn8\" name=\"item_meta[317]\" value=\"\"  data-sectionid=\"297\"  data-invmsg=\"If attending specific dates, weeks, or days of the week during the program, please specify: is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_318_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Has participant previously participated in this type of program?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_318-297-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[318]\" id=\"field_ijem2-0\" value=\"Yes\"\n\t\t data-sectionid=\"297\"  data-reqmsg=\"Has participant previously participated in this type of program? cannot be blank.\" data-invmsg=\"Has participant previously participated in this type of program? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_318-297-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[318]\" id=\"field_ijem2-1\" value=\"No\"\n\t\t data-sectionid=\"297\"  data-reqmsg=\"Has participant previously participated in this type of program? cannot be blank.\" data-invmsg=\"Has participant previously participated in this type of program? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_319_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<\/div>\n<div id=\"frm_field_320_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_p0a3b\" class=\"frm_primary_label\">Participant\u2019s Disability (please list any disability that may impact participation in recreation programs)\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[320]\" id=\"field_p0a3b\" rows=\"5\"  data-sectionid=\"297\"  data-invmsg=\"Participant\u2019s Disability (please list any disability that may impact participation in recreation programs) is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_321_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_2asme\" class=\"frm_primary_label\">Accommodation(s) Requested (if known)\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[321]\" id=\"field_2asme\" rows=\"5\"  data-sectionid=\"297\"  data-invmsg=\"Accommodation(s) Requested (if known) is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_322_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_721r8\" class=\"frm_primary_label\">Additional Comments\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[322]\" id=\"field_721r8\" rows=\"5\"  data-sectionid=\"297\"  data-invmsg=\"Additional Comments is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_323_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Have you submitted the Inclusion Services Participant Questionnaire within the last 12 months?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_323-297-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[323]\" id=\"field_ubgry-0\" value=\"Yes\"\n\t\t data-sectionid=\"297\"  data-invmsg=\"Have you submitted the Inclusion Services Participant Questionnaire within the last 12 months? is invalid\" aria-describedby=\"frm_desc_field_ubgry\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_323-297-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[323]\" id=\"field_ubgry-1\" value=\"No\"\n\t\t data-sectionid=\"297\"  data-invmsg=\"Have you submitted the Inclusion Services Participant Questionnaire within the last 12 months? is invalid\" aria-describedby=\"frm_desc_field_ubgry\"   \/> No<\/label><\/div>\n<\/div>\r\n    <div id=\"frm_desc_field_ubgry\" class=\"frm_description\">If not, select \u201cno\u201d and the Participant Questionnaire will appear. The Participant Questionnaire must be completed one time per year to be considered current. Inclusion Services Request forms submitted without a current Participant Questionnaire will need to be resubmitted. If you are unsure whether you submitted the Participant Questionnaire within the last 12 months, contact Inclusion Services at (626) 744-3829. <\/div>\r\n    \r\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_325_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\"><span>Step 4 - Participant Questionnaire<\/span><\/h3>\r\n\r\n\r\n<div id=\"frm_field_326_container\" class=\"frm_form_field  frm_html_container form-field\">\n<div class=\"p-3\">Please complete this questionnaire to the best of your knowledge. There will be an opportunity to further discuss the information you provide to inclusion services staff. If you are uncertain about any questions, it is okay to leave them blank<\/p>\n<hr>\n<\/div>\n<\/div>\n<div id=\"frm_field_327_container\" class=\"frm_form_field  frm_html_container form-field\">\n<h4>Participant<\/h4>\n<\/div>\n<div id=\"frm_field_328_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_dix4o\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_dix4o\" name=\"item_meta[328]\" value=\"\"  data-sectionid=\"325\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_333_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_z0dr7\" class=\"frm_primary_label\">Date of Birth\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_z0dr7\" name=\"item_meta[333]\" value=\"\"  data-sectionid=\"325\"  data-reqmsg=\"Date of Birth cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date of Birth is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_332_container\" class=\"frm_form_field form-field  frm_top_container frm12 frm_first\">\r\n    <label for=\"field_4ass1\" class=\"frm_primary_label\">Email Address\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_4ass1\" name=\"item_meta[332]\" value=\"\"  data-sectionid=\"325\"  data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_330_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_ijjni\" class=\"frm_primary_label\">Home Phone\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_ijjni\" name=\"item_meta[330]\" value=\"\"  data-sectionid=\"325\"  data-frmmask=\"000-000-0000\" data-invmsg=\"Home Phone is invalid\" aria-invalid=\"false\" pattern=\"\\d\\d\\d-\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_331_container\" class=\"frm_form_field form-field  frm_top_container frm_half\">\r\n    <label for=\"field_ll2mh\" class=\"frm_primary_label\">Mobile Phone\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_ll2mh\" name=\"item_meta[331]\" value=\"\"  data-sectionid=\"325\"  data-frmmask=\"000-000-0000\" data-invmsg=\"Mobile Phone is invalid\" aria-invalid=\"false\" pattern=\"\\d\\d\\d-\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_329_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_8853a\" class=\"frm_primary_label\">Address\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <fieldset aria-labelledby=\"field_8853a_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tAddress<\/legend>\n<div  class=\"frm_combo_inputs_container\" data-reqmsg=\"Address cannot be blank.\">\n<div id=\"frm_field_329-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_8853a_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress\t<\/label>\n\t\t<input type=\"text\" id=\"field_8853a_line1\" value=\"\" name=\"item_meta[329][line1]\"  data-sectionid=\"325\"  data-reqmsg=\"Address Line 1 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_329-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_8853a_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress\t<\/label>\n\t\t<input type=\"text\" id=\"field_8853a_line2\" value=\"\" name=\"item_meta[329][line2]\"  data-sectionid=\"325\"  data-reqmsg=\"Address Line 2 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_329-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_8853a_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCity\t<\/label>\n\t\t<input type=\"text\" id=\"field_8853a_city\" value=\"\" name=\"item_meta[329][city]\"  data-sectionid=\"325\"  data-reqmsg=\"City cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">City<\/div><\/div>\n<div id=\"frm_field_329-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_8853a_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tState\/Province\t<\/label>\n\t\t\t<select name=\"item_meta[329][state]\" id=\"field_8853a_state\"  data-sectionid=\"325\"  data-reqmsg=\"State\/Province cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Alabama\">Alabama<\/option><option  value=\"Alaska\">Alaska<\/option><option  value=\"Arkansas\">Arkansas<\/option><option  value=\"Arizona\">Arizona<\/option><option  value=\"California\">California<\/option><option  value=\"Colorado\">Colorado<\/option><option  value=\"Connecticut\">Connecticut<\/option><option  value=\"Delaware\">Delaware<\/option><option  value=\"District of Columbia\">District of Columbia<\/option><option  value=\"Florida\">Florida<\/option><option  value=\"Georgia\">Georgia<\/option><option  value=\"Hawaii\">Hawaii<\/option><option  value=\"Idaho\">Idaho<\/option><option  value=\"Illinois\">Illinois<\/option><option  value=\"Indiana\">Indiana<\/option><option  value=\"Iowa\">Iowa<\/option><option  value=\"Kansas\">Kansas<\/option><option  value=\"Kentucky\">Kentucky<\/option><option  value=\"Louisiana\">Louisiana<\/option><option  value=\"Maine\">Maine<\/option><option  value=\"Maryland\">Maryland<\/option><option  value=\"Massachusetts\">Massachusetts<\/option><option  value=\"Michigan\">Michigan<\/option><option  value=\"Minnesota\">Minnesota<\/option><option  value=\"Mississippi\">Mississippi<\/option><option  value=\"Missouri\">Missouri<\/option><option  value=\"Montana\">Montana<\/option><option  value=\"Nebraska\">Nebraska<\/option><option  value=\"Nevada\">Nevada<\/option><option  value=\"New Hampshire\">New Hampshire<\/option><option  value=\"New Jersey\">New Jersey<\/option><option  value=\"New Mexico\">New Mexico<\/option><option  value=\"New York\">New York<\/option><option  value=\"North Carolina\">North Carolina<\/option><option  value=\"North Dakota\">North Dakota<\/option><option  value=\"Ohio\">Ohio<\/option><option  value=\"Oklahoma\">Oklahoma<\/option><option  value=\"Oregon\">Oregon<\/option><option  value=\"Pennsylvania\">Pennsylvania<\/option><option  value=\"Rhode Island\">Rhode Island<\/option><option  value=\"South Carolina\">South Carolina<\/option><option  value=\"South Dakota\">South Dakota<\/option><option  value=\"Tennessee\">Tennessee<\/option><option  value=\"Texas\">Texas<\/option><option  value=\"Utah\">Utah<\/option><option  value=\"Vermont\">Vermont<\/option><option  value=\"Virginia\">Virginia<\/option><option  value=\"Washington\">Washington<\/option><option  value=\"West Virginia\">West Virginia<\/option><option  value=\"Wisconsin\">Wisconsin<\/option><option  value=\"Wyoming\">Wyoming<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">State\/Province<\/div><\/div>\n<div id=\"frm_field_329-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_8853a_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tZip\/Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_8853a_zip\" value=\"\" name=\"item_meta[329][zip]\"  data-sectionid=\"325\"  data-reqmsg=\"Zip\/Postal cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">Zip\/Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_334_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Gender\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_334-325-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[334]\" id=\"field_ay7r4-0\" value=\"Male\"\n\t\t data-sectionid=\"325\"  data-invmsg=\"Gender is invalid\"   \/> Male<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_334-325-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[334]\" id=\"field_ay7r4-1\" value=\"Female\"\n\t\t data-sectionid=\"325\"  data-invmsg=\"Gender is invalid\"   \/> Female<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_335_container\" class=\"frm_form_field form-field  frm_top_container frm_half vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Does Participant have a Conservator (adult participants only)?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_335-325-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[335]\" id=\"field_bhs5u-0\" value=\"Yes\"\n\t\t data-sectionid=\"325\"  data-invmsg=\"Does Participant have a Conservator (adult participants only)? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_335-325-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[335]\" id=\"field_bhs5u-1\" value=\"No\"\n\t\t data-sectionid=\"325\"  data-invmsg=\"Does Participant have a Conservator (adult participants only)? is invalid\"   \/> No<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_335-325-2\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[335]\" id=\"field_bhs5u-2\" value=\"N\/A\"\n\t\t data-sectionid=\"325\"  data-invmsg=\"Does Participant have a Conservator (adult participants only)? is invalid\"   \/> N\/A<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_336_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<h4>Primary Contact<\/h4>\n<p>\n(for program updates, day-to-day coordination, other logistics)<\/div>\n<div id=\"frm_field_337_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_rhsys\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_rhsys\" name=\"item_meta[337]\" value=\"\"  data-sectionid=\"325\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_342_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_v70tj\" class=\"frm_primary_label\">Relation\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_v70tj\" name=\"item_meta[342]\" value=\"\"  data-sectionid=\"325\"  data-reqmsg=\"Relation cannot be blank.\" aria-required=\"true\" data-invmsg=\"Relation is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_338_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_bjgl0\" class=\"frm_primary_label\">Email Address\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_bjgl0\" name=\"item_meta[338]\" value=\"\"  data-sectionid=\"325\"  data-reqmsg=\"Email Address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_340_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n    <label for=\"field_2xcgd\" class=\"frm_primary_label\">Home Phone\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_2xcgd\" name=\"item_meta[340]\" value=\"\"  data-sectionid=\"325\"  data-frmmask=\"000-000-0000\" data-invmsg=\"Home Phone is invalid\" aria-invalid=\"false\" pattern=\"\\d\\d\\d-\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_341_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_apfuu\" class=\"frm_primary_label\">Mobile Phone\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_apfuu\" name=\"item_meta[341]\" value=\"\"  data-sectionid=\"325\"  data-frmmask=\"000-000-0000\" data-reqmsg=\"Mobile Phone cannot be blank.\" aria-required=\"true\" data-invmsg=\"Mobile Phone is invalid\" aria-invalid=\"false\" pattern=\"\\d\\d\\d-\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_339_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_8ip34\" class=\"frm_primary_label\">Address\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <fieldset aria-labelledby=\"field_8ip34_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tAddress<\/legend>\n<div  class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_339-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_8ip34_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress\t<\/label>\n\t\t<input type=\"text\" id=\"field_8ip34_line1\" value=\"\" name=\"item_meta[339][line1]\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_339-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_8ip34_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress\t<\/label>\n\t\t<input type=\"text\" id=\"field_8ip34_line2\" value=\"\" name=\"item_meta[339][line2]\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_339-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_8ip34_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCity\t<\/label>\n\t\t<input type=\"text\" id=\"field_8ip34_city\" value=\"\" name=\"item_meta[339][city]\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">City<\/div><\/div>\n<div id=\"frm_field_339-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_8ip34_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tState\/Province\t<\/label>\n\t\t\t<select name=\"item_meta[339][state]\" id=\"field_8ip34_state\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Alabama\">Alabama<\/option><option  value=\"Alaska\">Alaska<\/option><option  value=\"Arkansas\">Arkansas<\/option><option  value=\"Arizona\">Arizona<\/option><option  value=\"California\">California<\/option><option  value=\"Colorado\">Colorado<\/option><option  value=\"Connecticut\">Connecticut<\/option><option  value=\"Delaware\">Delaware<\/option><option  value=\"District of Columbia\">District of Columbia<\/option><option  value=\"Florida\">Florida<\/option><option  value=\"Georgia\">Georgia<\/option><option  value=\"Hawaii\">Hawaii<\/option><option  value=\"Idaho\">Idaho<\/option><option  value=\"Illinois\">Illinois<\/option><option  value=\"Indiana\">Indiana<\/option><option  value=\"Iowa\">Iowa<\/option><option  value=\"Kansas\">Kansas<\/option><option  value=\"Kentucky\">Kentucky<\/option><option  value=\"Louisiana\">Louisiana<\/option><option  value=\"Maine\">Maine<\/option><option  value=\"Maryland\">Maryland<\/option><option  value=\"Massachusetts\">Massachusetts<\/option><option  value=\"Michigan\">Michigan<\/option><option  value=\"Minnesota\">Minnesota<\/option><option  value=\"Mississippi\">Mississippi<\/option><option  value=\"Missouri\">Missouri<\/option><option  value=\"Montana\">Montana<\/option><option  value=\"Nebraska\">Nebraska<\/option><option  value=\"Nevada\">Nevada<\/option><option  value=\"New Hampshire\">New Hampshire<\/option><option  value=\"New Jersey\">New Jersey<\/option><option  value=\"New Mexico\">New Mexico<\/option><option  value=\"New York\">New York<\/option><option  value=\"North Carolina\">North Carolina<\/option><option  value=\"North Dakota\">North Dakota<\/option><option  value=\"Ohio\">Ohio<\/option><option  value=\"Oklahoma\">Oklahoma<\/option><option  value=\"Oregon\">Oregon<\/option><option  value=\"Pennsylvania\">Pennsylvania<\/option><option  value=\"Rhode Island\">Rhode Island<\/option><option  value=\"South Carolina\">South Carolina<\/option><option  value=\"South Dakota\">South Dakota<\/option><option  value=\"Tennessee\">Tennessee<\/option><option  value=\"Texas\">Texas<\/option><option  value=\"Utah\">Utah<\/option><option  value=\"Vermont\">Vermont<\/option><option  value=\"Virginia\">Virginia<\/option><option  value=\"Washington\">Washington<\/option><option  value=\"West Virginia\">West Virginia<\/option><option  value=\"Wisconsin\">Wisconsin<\/option><option  value=\"Wyoming\">Wyoming<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">State\/Province<\/div><\/div>\n<div id=\"frm_field_339-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_8ip34_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tZip\/Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_8ip34_zip\" value=\"\" name=\"item_meta[339][zip]\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">Zip\/Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_343_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr \/>\n<h4>Parent\/Legal Guardian\/Conservator Information<\/h4>\n<p>(if different than primary contact)<\/p><\/div>\n<div id=\"frm_field_344_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n    <label for=\"field_df6ve\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_df6ve\" name=\"item_meta[344]\" value=\"\"  data-sectionid=\"325\"  data-invmsg=\"Name is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_349_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n    <label for=\"field_ie0uz\" class=\"frm_primary_label\">Relation\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_ie0uz\" name=\"item_meta[349]\" value=\"\"  data-sectionid=\"325\"  data-invmsg=\"Relation is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_345_container\" class=\"frm_form_field form-field  frm_top_container frm12 frm_first\">\r\n    <label for=\"field_r7zvz\" class=\"frm_primary_label\">Email Address\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_r7zvz\" name=\"item_meta[345]\" value=\"\"  data-sectionid=\"325\"  data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_347_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n    <label for=\"field_jfovu\" class=\"frm_primary_label\">Home Phone\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_jfovu\" name=\"item_meta[347]\" value=\"\"  data-sectionid=\"325\"  data-invmsg=\"Home Phone is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_348_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n    <label for=\"field_nu115\" class=\"frm_primary_label\">Mobile Phone\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_nu115\" name=\"item_meta[348]\" value=\"\"  data-sectionid=\"325\"  data-frmmask=\"000-000-0000\" data-invmsg=\"Mobile Phone is invalid\" aria-invalid=\"false\" pattern=\"\\d\\d\\d-\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_346_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_7j80s\" class=\"frm_primary_label\">Address\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <fieldset aria-labelledby=\"field_7j80s_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tAddress<\/legend>\n<div  class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_346-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_7j80s_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress\t<\/label>\n\t\t<input type=\"text\" id=\"field_7j80s_line1\" value=\"\" name=\"item_meta[346][line1]\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_346-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_7j80s_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress\t<\/label>\n\t\t<input type=\"text\" id=\"field_7j80s_line2\" value=\"\" name=\"item_meta[346][line2]\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_346-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_7j80s_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCity\t<\/label>\n\t\t<input type=\"text\" id=\"field_7j80s_city\" value=\"\" name=\"item_meta[346][city]\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">City<\/div><\/div>\n<div id=\"frm_field_346-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_7j80s_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tState\/Province\t<\/label>\n\t\t\t<select name=\"item_meta[346][state]\" id=\"field_7j80s_state\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Alabama\">Alabama<\/option><option  value=\"Alaska\">Alaska<\/option><option  value=\"Arkansas\">Arkansas<\/option><option  value=\"Arizona\">Arizona<\/option><option  value=\"California\">California<\/option><option  value=\"Colorado\">Colorado<\/option><option  value=\"Connecticut\">Connecticut<\/option><option  value=\"Delaware\">Delaware<\/option><option  value=\"District of Columbia\">District of Columbia<\/option><option  value=\"Florida\">Florida<\/option><option  value=\"Georgia\">Georgia<\/option><option  value=\"Hawaii\">Hawaii<\/option><option  value=\"Idaho\">Idaho<\/option><option  value=\"Illinois\">Illinois<\/option><option  value=\"Indiana\">Indiana<\/option><option  value=\"Iowa\">Iowa<\/option><option  value=\"Kansas\">Kansas<\/option><option  value=\"Kentucky\">Kentucky<\/option><option  value=\"Louisiana\">Louisiana<\/option><option  value=\"Maine\">Maine<\/option><option  value=\"Maryland\">Maryland<\/option><option  value=\"Massachusetts\">Massachusetts<\/option><option  value=\"Michigan\">Michigan<\/option><option  value=\"Minnesota\">Minnesota<\/option><option  value=\"Mississippi\">Mississippi<\/option><option  value=\"Missouri\">Missouri<\/option><option  value=\"Montana\">Montana<\/option><option  value=\"Nebraska\">Nebraska<\/option><option  value=\"Nevada\">Nevada<\/option><option  value=\"New Hampshire\">New Hampshire<\/option><option  value=\"New Jersey\">New Jersey<\/option><option  value=\"New Mexico\">New Mexico<\/option><option  value=\"New York\">New York<\/option><option  value=\"North Carolina\">North Carolina<\/option><option  value=\"North Dakota\">North Dakota<\/option><option  value=\"Ohio\">Ohio<\/option><option  value=\"Oklahoma\">Oklahoma<\/option><option  value=\"Oregon\">Oregon<\/option><option  value=\"Pennsylvania\">Pennsylvania<\/option><option  value=\"Rhode Island\">Rhode Island<\/option><option  value=\"South Carolina\">South Carolina<\/option><option  value=\"South Dakota\">South Dakota<\/option><option  value=\"Tennessee\">Tennessee<\/option><option  value=\"Texas\">Texas<\/option><option  value=\"Utah\">Utah<\/option><option  value=\"Vermont\">Vermont<\/option><option  value=\"Virginia\">Virginia<\/option><option  value=\"Washington\">Washington<\/option><option  value=\"West Virginia\">West Virginia<\/option><option  value=\"Wisconsin\">Wisconsin<\/option><option  value=\"Wyoming\">Wyoming<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">State\/Province<\/div><\/div>\n<div id=\"frm_field_346-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_7j80s_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tZip\/Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_7j80s_zip\" value=\"\" name=\"item_meta[346][zip]\"  data-sectionid=\"325\"  data-invmsg=\"Address is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">Zip\/Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_350_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<\/div>\n<div id=\"frm_field_351_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio frm_other_container\">\r\n    <label  class=\"frm_primary_label\">Where does the participant reside?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_351-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[351][]\" id=\"field_iceym-0\" value=\"Family\/Own home\"  data-sectionid=\"325\"  data-reqmsg=\"Where does the participant reside? cannot be blank.\" data-invmsg=\"Where does the participant reside? is invalid\"   aria-required=\"true\"  \/> Family\/Own home<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_351-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[351][]\" id=\"field_iceym-1\" value=\"Non-family home\"  data-sectionid=\"325\"  data-reqmsg=\"Where does the participant reside? cannot be blank.\" data-invmsg=\"Where does the participant reside? is invalid\"   \/> Non-family home<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_351-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[351][]\" id=\"field_iceym-2\" value=\"Group home\"  data-sectionid=\"325\"  data-reqmsg=\"Where does the participant reside? cannot be blank.\" data-invmsg=\"Where does the participant reside? is invalid\"   \/> Group home<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_351-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[351][]\" id=\"field_iceym-3\" value=\"Supported Living\"  data-sectionid=\"325\"  data-reqmsg=\"Where does the participant reside? cannot be blank.\" data-invmsg=\"Where does the participant reside? is invalid\"   \/> Supported Living<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_351-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[351][]\" id=\"field_iceym-4\" value=\"Independent Living\"  data-sectionid=\"325\"  data-reqmsg=\"Where does the participant reside? cannot be blank.\" data-invmsg=\"Where does the participant reside? is invalid\"   \/> Independent Living<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_351-325-other_6\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[351][other_6]\" id=\"field_iceym-other_6\" value=\"Other\"  data-sectionid=\"325\"  data-reqmsg=\"Where does the participant reside? cannot be blank.\" data-invmsg=\"Where does the participant reside? is invalid\"   \/> Other<\/label><label for=\"field_iceym-other_6-otext\" class=\"frm_screen_reader frm_hidden\">Other<\/label><input type=\"text\" id=\"field_iceym-other_6-otext\" class=\"frm_other_input frm_pos_none\" name=\"item_meta[other][351][other_6]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_352_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_9cxyz\" class=\"frm_primary_label\">What school does participant attend?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_9cxyz\" name=\"item_meta[352]\" value=\"\"  data-sectionid=\"325\"  data-invmsg=\"What school does participant attend? is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_353_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_o3zfm\" class=\"frm_primary_label\">If applicable, please upload a copy of participant's current Individualized Education Plan (IEP) or 504 Plan.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"hidden\"  data-sectionid=\"325\"  data-invmsg=\"If applicable, please upload a copy of participant&#039;s current Individualized Education Plan (IEP) or 504 Plan, or email it to aeverett@cityofpasadena.net. is invalid\" class=\"auto_width\" aria-invalid=\"false\"   name=\"item_meta[353]\"  value=\"\" data-frmfile=\"353\" \/>\n\n<div class=\"frm_dropzone frm_single_upload frm_clearfix\" id=\"file353_dropzone\" role=\"group\" >\n\t<div class=\"fallback\">\n\t\t<input type=\"file\" name=\"file353\" id=\"field_o3zfm\"\n\t\t\t data-sectionid=\"325\"  data-invmsg=\"If applicable, please upload a copy of participant&#039;s current Individualized Education Plan (IEP) or 504 Plan, or email it to aeverett@cityofpasadena.net. is invalid\" class=\"auto_width\" aria-invalid=\"false\"  \t\t\t\/>\n\t\t\t\t<div class=\"frm_clearfix \"><\/div>\n\t<\/div>\n\t<div class=\"dz-message needsclick\">\n\t\t\t\t<svg  viewBox=\"0 0 18 18\" aria-hidden=\"true\" class=\"frmsvg frm-svg-icon\">\n\t<path viewBox=\"0 0 18 18\" fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M8.2 4v8a.8.8 0 001.5 0V4l2.1 2.2A.7.7 0 1013 5L9.5 1.7a.7.7 0 00-1.1 0L5.1 5.2a.8.8 0 001 1l2.1-2zm7.6 4.3c.4 0 .7.3.7.7v6.8c0 .4-.3.7-.8.7H2.3a.8.8 0 01-.8-.8V9A.8.8 0 013 9v6h12V9c0-.4.3-.8.8-.8z\"><\/path>\n<\/svg>\t\t<span class=\"frm_upload_text\"><button type=\"button\" aria-label=\"If applicable, please upload a copy of participant&#039;s current Individualized Education Plan (IEP) or 504 Plan.. Drop a file here or click to upload. Maximum file size: 20MB\">Drop a file here or click to upload<\/button><\/span>\n\t\t<span class=\"frm_compact_text\"><button type=\"button\" aria-label=\"If applicable, please upload a copy of participant&#039;s current Individualized Education Plan (IEP) or 504 Plan.. Choose File. Maximum file size: 20MB\">Choose File<\/button><\/span>\n\t\t<div class=\"frm_small_text\">\n\t\t\t<p>Maximum file size: 20MB<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_354_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_vxlj0\" class=\"frm_primary_label\">Where does participant work and\/or go to day program?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_vxlj0\" name=\"item_meta[354]\" value=\"\"  data-sectionid=\"325\"  data-invmsg=\"Where does participant work and\/or go to day program? is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_355_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Will caregiver or other support staff accompany participant to recreation programs?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_355-325-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[355]\" id=\"field_y4sjt-0\" value=\"Yes\"\n\t\t data-sectionid=\"325\"  data-reqmsg=\"Will caregiver or other support staff accompany participant to recreation programs? cannot be blank.\" data-invmsg=\"Will caregiver or other support staff accompany participant to recreation programs? is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_355-325-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[355]\" id=\"field_y4sjt-1\" value=\"No\"\n\t\t data-sectionid=\"325\"  data-reqmsg=\"Will caregiver or other support staff accompany participant to recreation programs? cannot be blank.\" data-invmsg=\"Will caregiver or other support staff accompany participant to recreation programs? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_356_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio frm_other_container\">\r\n    <label  class=\"frm_primary_label\">What form of transportation does participant typically use to get to and from recreation programs and activities?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_356-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[356][]\" id=\"field_3b5r1-0\" value=\"Parent\/caregiver transports\"  data-sectionid=\"325\"  data-invmsg=\"What form of transportation does participant typically use to get to and from recreation programs and activities? is invalid\"   \/> Parent\/caregiver transports<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_356-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[356][]\" id=\"field_3b5r1-1\" value=\"Dial-A-Ride\"  data-sectionid=\"325\"  data-invmsg=\"What form of transportation does participant typically use to get to and from recreation programs and activities? is invalid\"   \/> Dial-A-Ride<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_356-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[356][]\" id=\"field_3b5r1-2\" value=\"Access\"  data-sectionid=\"325\"  data-invmsg=\"What form of transportation does participant typically use to get to and from recreation programs and activities? is invalid\"   \/> Access<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_356-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[356][]\" id=\"field_3b5r1-3\" value=\"Bus\"  data-sectionid=\"325\"  data-invmsg=\"What form of transportation does participant typically use to get to and from recreation programs and activities? is invalid\"   \/> Bus<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_356-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[356][]\" id=\"field_3b5r1-4\" value=\"Walk\"  data-sectionid=\"325\"  data-invmsg=\"What form of transportation does participant typically use to get to and from recreation programs and activities? is invalid\"   \/> Walk<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_356-325-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[356][]\" id=\"field_3b5r1-5\" value=\"Bicycle\"  data-sectionid=\"325\"  data-invmsg=\"What form of transportation does participant typically use to get to and from recreation programs and activities? is invalid\"   \/> Bicycle<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_356-325-6\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[356][]\" id=\"field_3b5r1-6\" value=\"Drives self\"  data-sectionid=\"325\"  data-invmsg=\"What form of transportation does participant typically use to get to and from recreation programs and activities? is invalid\"   \/> Drives self<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_356-325-other_7\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[356][other_7]\" id=\"field_3b5r1-other_7\" value=\"Other\"  data-sectionid=\"325\"  data-invmsg=\"What form of transportation does participant typically use to get to and from recreation programs and activities? is invalid\"   \/> Other<\/label><label for=\"field_3b5r1-other_7-otext\" class=\"frm_screen_reader frm_hidden\">Other<\/label><input type=\"text\" id=\"field_3b5r1-other_7-otext\" class=\"frm_other_input frm_pos_none\" name=\"item_meta[other][356][other_7]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_357_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Does participant have an IEP or IPP?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_357-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[357][]\" id=\"field_pfss6-0\" value=\"IEP\"  data-sectionid=\"325\"  data-reqmsg=\"Does participant have an IEP or IPP? cannot be blank.\" data-invmsg=\"Does participant have an IEP or IPP? is invalid\"   aria-required=\"true\"  \/> IEP<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_357-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[357][]\" id=\"field_pfss6-1\" value=\"IPP\"  data-sectionid=\"325\"  data-reqmsg=\"Does participant have an IEP or IPP? cannot be blank.\" data-invmsg=\"Does participant have an IEP or IPP? is invalid\"   \/> IPP<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_357-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[357][]\" id=\"field_pfss6-2\" value=\"Neither\"  data-sectionid=\"325\"  data-reqmsg=\"Does participant have an IEP or IPP? cannot be blank.\" data-invmsg=\"Does participant have an IEP or IPP? is invalid\"   \/> Neither<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_358_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_dxvt7\" class=\"frm_primary_label\">List any medication participant takes that may impact participation. If participant will need to take medication during programs or activities, please include the dosage and time.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[358]\" id=\"field_dxvt7\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"List any medication participant takes that may impact participation. If participant will need to take medication during programs or activities, please include the dosage and time. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_359_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_fa16b\" class=\"frm_primary_label\">List any medical conditions (i.e. diabetes, seizures, asthma, allergies) that may impact participation.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[359]\" id=\"field_fa16b\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"List any medical conditions (i.e. diabetes, seizures, asthma, allergies) that may impact participation. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_360_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_s55q\" class=\"frm_primary_label\">Does participant have any dietary restrictions? Please explain.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[360]\" id=\"field_s55q\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"Does participant have any dietary restrictions? Please explain. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_361_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_ptlim\" class=\"frm_primary_label\">What is participant\u2019s primary method of communication (i.e. verbal, communication board, physical gestures, sign language)?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[361]\" id=\"field_ptlim\" rows=\"5\"  data-sectionid=\"325\"  data-reqmsg=\"What is participant\u2019s primary method of communication (i.e. verbal, communication board, physical gestures, sign language)? cannot be blank.\" aria-required=\"true\" data-invmsg=\"What is participant\u2019s primary method of communication (i.e. verbal, communication board, physical gestures, sign language)? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_362_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_cldzo\" class=\"frm_primary_label\">Does participant use adaptive equipment for purposes other than ambulation? Please explain.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[362]\" id=\"field_cldzo\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"Does participant use adaptive equipment for purposes other than ambulation? Please explain. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_363_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio frm_other_container\">\r\n    <label  class=\"frm_primary_label\">Assistive Devices for Ambulation\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_363-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[363][]\" id=\"field_tfjxb-0\" value=\"None\"  data-sectionid=\"325\"  data-invmsg=\"Assistive Devices for Ambulation is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_363-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[363][]\" id=\"field_tfjxb-1\" value=\"Manual Wheelchair\"  data-sectionid=\"325\"  data-invmsg=\"Assistive Devices for Ambulation is invalid\"   \/> Manual Wheelchair<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_363-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[363][]\" id=\"field_tfjxb-2\" value=\"Motorized Wheelchair\"  data-sectionid=\"325\"  data-invmsg=\"Assistive Devices for Ambulation is invalid\"   \/> Motorized Wheelchair<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_363-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[363][]\" id=\"field_tfjxb-3\" value=\"Walker\"  data-sectionid=\"325\"  data-invmsg=\"Assistive Devices for Ambulation is invalid\"   \/> Walker<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_363-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[363][]\" id=\"field_tfjxb-4\" value=\"Crutches\"  data-sectionid=\"325\"  data-invmsg=\"Assistive Devices for Ambulation is invalid\"   \/> Crutches<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_363-325-other_5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[363][other_5]\" id=\"field_tfjxb-other_5\" value=\"Other\"  data-sectionid=\"325\"  data-invmsg=\"Assistive Devices for Ambulation is invalid\"   \/> Other<\/label><label for=\"field_tfjxb-other_5-otext\" class=\"frm_screen_reader frm_hidden\">Other<\/label><input type=\"text\" id=\"field_tfjxb-other_5-otext\" class=\"frm_other_input frm_pos_none\" name=\"item_meta[other][363][other_5]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_364_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Ambulation Duration\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_364-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[364][]\" id=\"field_clmac-0\" value=\"Travels independently for extended distances\"  data-sectionid=\"325\"  data-invmsg=\"Ambulation Duration is invalid\"   \/> Travels independently for extended distances<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_364-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[364][]\" id=\"field_clmac-1\" value=\"Requires physical assistance or breaks when traveling 0-50 yards\"  data-sectionid=\"325\"  data-invmsg=\"Ambulation Duration is invalid\"   \/> Requires physical assistance or breaks when traveling 0-50 yards<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_364-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[364][]\" id=\"field_clmac-2\" value=\"Requires physical assistance or breaks when traveling 50-100 yards\"  data-sectionid=\"325\"  data-invmsg=\"Ambulation Duration is invalid\"   \/> Requires physical assistance or breaks when traveling 50-100 yards<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_364-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[364][]\" id=\"field_clmac-3\" value=\"Requires physical assistance or breaks when traveling further than 100 yards\"  data-sectionid=\"325\"  data-invmsg=\"Ambulation Duration is invalid\"   \/> Requires physical assistance or breaks when traveling further than 100 yards<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_365_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Physical Activity\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_365-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[365][]\" id=\"field_u38rh-0\" value=\"Participates in physical activity independently\"  data-sectionid=\"325\"  data-invmsg=\"Physical Activity is invalid\"   \/> Participates in physical activity independently<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_365-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[365][]\" id=\"field_u38rh-1\" value=\"Participates in physical activity with assistance\"  data-sectionid=\"325\"  data-invmsg=\"Physical Activity is invalid\"   \/> Participates in physical activity with assistance<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_365-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[365][]\" id=\"field_u38rh-2\" value=\"Requires frequent breaks to participate in physical activity\"  data-sectionid=\"325\"  data-invmsg=\"Physical Activity is invalid\"   \/> Requires frequent breaks to participate in physical activity<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_365-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[365][]\" id=\"field_u38rh-3\" value=\"Does not participate in physical activity\"  data-sectionid=\"325\"  data-invmsg=\"Physical Activity is invalid\"   \/> Does not participate in physical activity<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_366_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Eating\/Drinking\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_366-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[366][]\" id=\"field_1i6yy-0\" value=\"Eats\/drinks independently\"  data-sectionid=\"325\"  data-invmsg=\"Eating\/Drinking is invalid\"   \/> Eats\/drinks independently<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_366-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[366][]\" id=\"field_1i6yy-1\" value=\"Eats\/drinks with some assistance\"  data-sectionid=\"325\"  data-invmsg=\"Eating\/Drinking is invalid\"   \/> Eats\/drinks with some assistance<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_366-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[366][]\" id=\"field_1i6yy-2\" value=\"Eats\/drinks with total assistance\"  data-sectionid=\"325\"  data-invmsg=\"Eating\/Drinking is invalid\"   \/> Eats\/drinks with total assistance<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_366-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[366][]\" id=\"field_1i6yy-3\" value=\"Needs assistance with opening containers\"  data-sectionid=\"325\"  data-invmsg=\"Eating\/Drinking is invalid\"   \/> Needs assistance with opening containers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_367_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Dressing\/Undressing (if participating in a program that requires changing clothes)\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_367-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[367][]\" id=\"field_pnvde-0\" value=\"Dresses\/undresses independently\"  data-sectionid=\"325\"  data-invmsg=\"Dressing\/Undressing (if participating in a program that requires changing clothes) is invalid\"   \/> Dresses\/undresses independently<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_367-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[367][]\" id=\"field_pnvde-1\" value=\"Needs assistance with buttons and zippers\"  data-sectionid=\"325\"  data-invmsg=\"Dressing\/Undressing (if participating in a program that requires changing clothes) is invalid\"   \/> Needs assistance with buttons and zippers<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_367-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[367][]\" id=\"field_pnvde-2\" value=\"Needs assistance with changing shirt\"  data-sectionid=\"325\"  data-invmsg=\"Dressing\/Undressing (if participating in a program that requires changing clothes) is invalid\"   \/> Needs assistance with changing shirt<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_367-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[367][]\" id=\"field_pnvde-3\" value=\"Needs assistance with changing pants\"  data-sectionid=\"325\"  data-invmsg=\"Dressing\/Undressing (if participating in a program that requires changing clothes) is invalid\"   \/> Needs assistance with changing pants<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_367-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[367][]\" id=\"field_pnvde-4\" value=\"Needs assistance with changing bathing suit\"  data-sectionid=\"325\"  data-invmsg=\"Dressing\/Undressing (if participating in a program that requires changing clothes) is invalid\"   \/> Needs assistance with changing bathing suit<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_368_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Bathroom\/Toilet Use*\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_368-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[368][]\" id=\"field_1ehia-0\" value=\"Uses the bathroom independently\"  data-sectionid=\"325\"  data-invmsg=\"Bathroom\/Toilet Use* is invalid\" aria-describedby=\"frm_desc_field_1ehia\"   \/> Uses the bathroom independently<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_368-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[368][]\" id=\"field_1ehia-1\" value=\"Wears briefs\"  data-sectionid=\"325\"  data-invmsg=\"Bathroom\/Toilet Use* is invalid\" aria-describedby=\"frm_desc_field_1ehia\"   \/> Wears briefs<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_368-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[368][]\" id=\"field_1ehia-2\" value=\"Requires verbal cues to use the toilet\"  data-sectionid=\"325\"  data-invmsg=\"Bathroom\/Toilet Use* is invalid\" aria-describedby=\"frm_desc_field_1ehia\"   \/> Requires verbal cues to use the toilet<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_368-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[368][]\" id=\"field_1ehia-3\" value=\"Requires physical assistance to use the toilet\"  data-sectionid=\"325\"  data-invmsg=\"Bathroom\/Toilet Use* is invalid\" aria-describedby=\"frm_desc_field_1ehia\"   \/> Requires physical assistance to use the toilet<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_368-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[368][]\" id=\"field_1ehia-4\" value=\"Requires verbal cues to wash hands\"  data-sectionid=\"325\"  data-invmsg=\"Bathroom\/Toilet Use* is invalid\" aria-describedby=\"frm_desc_field_1ehia\"   \/> Requires verbal cues to wash hands<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_368-325-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[368][]\" id=\"field_1ehia-5\" value=\"Requires physical assistance to wash hands\"  data-sectionid=\"325\"  data-invmsg=\"Bathroom\/Toilet Use* is invalid\" aria-describedby=\"frm_desc_field_1ehia\"   \/> Requires physical assistance to wash hands<\/label><\/div>\n<\/div>\r\n    <div id=\"frm_desc_field_1ehia\" class=\"frm_description\">*City staff does not provide physical assistance with using the toilet<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_369_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_wyst0\" class=\"frm_primary_label\">How would you describe participant's personality (i.e. friendly, outing, quiet, shy, etc.)\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[369]\" id=\"field_wyst0\" rows=\"5\"  data-sectionid=\"325\"  data-reqmsg=\"How would you describe participant&#039;s personality (i.e. friendly, outing, quiet, shy, etc.) cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would you describe participant&#039;s personality (i.e. friendly, outing, quiet, shy, etc.) is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_370_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_dixz4\" class=\"frm_primary_label\">What are the participant\u2019s strengths?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[370]\" id=\"field_dixz4\" rows=\"5\"  data-sectionid=\"325\"  data-reqmsg=\"What are the participant\u2019s strengths? cannot be blank.\" aria-required=\"true\" data-invmsg=\"What are the participant\u2019s strengths? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_371_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_y6aax\" class=\"frm_primary_label\">What are the participant\u2019s favorite activities (indoor and outdoor)?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[371]\" id=\"field_y6aax\" rows=\"5\"  data-sectionid=\"325\"  data-reqmsg=\"What are the participant\u2019s favorite activities (indoor and outdoor)? cannot be blank.\" aria-required=\"true\" data-invmsg=\"What are the participant\u2019s favorite activities (indoor and outdoor)? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_372_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Following Direction\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_372-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[372][]\" id=\"field_h2nvv-0\" value=\"Clearly understands and follows directions\"  data-sectionid=\"325\"  data-invmsg=\"Following Direction is invalid\" aria-describedby=\"frm_desc_field_h2nvv\"   \/> Clearly understands and follows directions<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_372-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[372][]\" id=\"field_h2nvv-1\" value=\"Understands and follows 1-2 step directions\"  data-sectionid=\"325\"  data-invmsg=\"Following Direction is invalid\" aria-describedby=\"frm_desc_field_h2nvv\"   \/> Understands and follows 1-2 step directions<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_372-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[372][]\" id=\"field_h2nvv-2\" value=\"Understands and follows 3-4 step directions\"  data-sectionid=\"325\"  data-invmsg=\"Following Direction is invalid\" aria-describedby=\"frm_desc_field_h2nvv\"   \/> Understands and follows 3-4 step directions<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_372-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[372][]\" id=\"field_h2nvv-3\" value=\"Requires prompting to follow directions\"  data-sectionid=\"325\"  data-invmsg=\"Following Direction is invalid\" aria-describedby=\"frm_desc_field_h2nvv\"   \/> Requires prompting to follow directions<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_372-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[372][]\" id=\"field_h2nvv-4\" value=\"Needs visual cues to understand and follow directions\"  data-sectionid=\"325\"  data-invmsg=\"Following Direction is invalid\" aria-describedby=\"frm_desc_field_h2nvv\"   \/> Needs visual cues to understand and follow directions<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_372-325-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[372][]\" id=\"field_h2nvv-5\" value=\"Needs hands on assistance to understand and follow directions\"  data-sectionid=\"325\"  data-invmsg=\"Following Direction is invalid\" aria-describedby=\"frm_desc_field_h2nvv\"   \/> Needs hands on assistance to understand and follow directions<\/label><\/div>\n<\/div>\r\n    <div id=\"frm_desc_field_h2nvv\" class=\"frm_description\">(Check all that apply)<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_373_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Attention span when engaged in an activity of preference?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_373-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[373][]\" id=\"field_53zql-0\" value=\"0-10 minutes\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity of preference? is invalid\"   \/> 0-10 minutes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_373-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[373][]\" id=\"field_53zql-1\" value=\"10-20 minutes\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity of preference? is invalid\"   \/> 10-20 minutes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_373-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[373][]\" id=\"field_53zql-2\" value=\"20-30 minutes\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity of preference? is invalid\"   \/> 20-30 minutes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_373-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[373][]\" id=\"field_53zql-3\" value=\"30-45 minutes\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity of preference? is invalid\"   \/> 30-45 minutes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_373-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[373][]\" id=\"field_53zql-4\" value=\"45-60 minutes\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity of preference? is invalid\"   \/> 45-60 minutes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_373-325-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[373][]\" id=\"field_53zql-5\" value=\"More than an hour\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity of preference? is invalid\"   \/> More than an hour<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_374_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Attention span when engaged in an activity NOT of preference?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_374-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[374][]\" id=\"field_7r7bo-0\" value=\"0-10 minutes\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity NOT of preference? is invalid\"   \/> 0-10 minutes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_374-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[374][]\" id=\"field_7r7bo-1\" value=\"10-20 minutes\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity NOT of preference? is invalid\"   \/> 10-20 minutes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_374-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[374][]\" id=\"field_7r7bo-2\" value=\"20-30 minutes\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity NOT of preference? is invalid\"   \/> 20-30 minutes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_374-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[374][]\" id=\"field_7r7bo-3\" value=\"30-45 minutes\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity NOT of preference? is invalid\"   \/> 30-45 minutes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_374-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[374][]\" id=\"field_7r7bo-4\" value=\"More than an hour\"  data-sectionid=\"325\"  data-invmsg=\"Attention span when engaged in an activity NOT of preference? is invalid\"   \/> More than an hour<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_375_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Social Skills\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_375-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[375][]\" id=\"field_ab5n7-0\" value=\"Demonstrates awareness of others\"  data-sectionid=\"325\"  data-invmsg=\"Social Skills is invalid\" aria-describedby=\"frm_desc_field_ab5n7\"   \/> Demonstrates awareness of others<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_375-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[375][]\" id=\"field_ab5n7-1\" value=\"Initiates interactions with others\"  data-sectionid=\"325\"  data-invmsg=\"Social Skills is invalid\" aria-describedby=\"frm_desc_field_ab5n7\"   \/> Initiates interactions with others<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_375-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[375][]\" id=\"field_ab5n7-2\" value=\"Responds to interaction from others\"  data-sectionid=\"325\"  data-invmsg=\"Social Skills is invalid\" aria-describedby=\"frm_desc_field_ab5n7\"   \/> Responds to interaction from others<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_375-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[375][]\" id=\"field_ab5n7-3\" value=\"Interacts appropriately with others\"  data-sectionid=\"325\"  data-invmsg=\"Social Skills is invalid\" aria-describedby=\"frm_desc_field_ab5n7\"   \/> Interacts appropriately with others<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_375-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[375][]\" id=\"field_ab5n7-4\" value=\"Is aware of personal space and maintains appropriate distances\"  data-sectionid=\"325\"  data-invmsg=\"Social Skills is invalid\" aria-describedby=\"frm_desc_field_ab5n7\"   \/> Is aware of personal space and maintains appropriate distances<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_375-325-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[375][]\" id=\"field_ab5n7-5\" value=\"Prefers to be around others\"  data-sectionid=\"325\"  data-invmsg=\"Social Skills is invalid\" aria-describedby=\"frm_desc_field_ab5n7\"   \/> Prefers to be around others<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_375-325-6\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[375][]\" id=\"field_ab5n7-6\" value=\"Prefers to be alone\"  data-sectionid=\"325\"  data-invmsg=\"Social Skills is invalid\" aria-describedby=\"frm_desc_field_ab5n7\"   \/> Prefers to be alone<\/label><\/div>\n<\/div>\r\n    <div id=\"frm_desc_field_ab5n7\" class=\"frm_description\">(Check all that apply)<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_376_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio frm_other_container\">\r\n    <label  class=\"frm_primary_label\">Supervision (most programs and activities provide a 1:10 staff to participant ratio)\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_376-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[376][]\" id=\"field_jq4yv-0\" value=\"No additional supervision needed\"  data-sectionid=\"325\"  data-invmsg=\"Supervision (most programs and activities provide a 1:10 staff to participant ratio) is invalid\"   \/> No additional supervision needed<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_376-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[376][]\" id=\"field_jq4yv-1\" value=\"Some additional supervision needed\"  data-sectionid=\"325\"  data-invmsg=\"Supervision (most programs and activities provide a 1:10 staff to participant ratio) is invalid\"   \/> Some additional supervision needed<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_376-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[376][]\" id=\"field_jq4yv-2\" value=\"Constant additional supervision needed\"  data-sectionid=\"325\"  data-invmsg=\"Supervision (most programs and activities provide a 1:10 staff to participant ratio) is invalid\"   \/> Constant additional supervision needed<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_376-325-other_3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[376][other_3]\" id=\"field_jq4yv-other_3\" value=\"Other\"  data-sectionid=\"325\"  data-invmsg=\"Supervision (most programs and activities provide a 1:10 staff to participant ratio) is invalid\"   \/> Other<\/label><label for=\"field_jq4yv-other_3-otext\" class=\"frm_screen_reader frm_hidden\">Other<\/label><input type=\"text\" id=\"field_jq4yv-other_3-otext\" class=\"frm_other_input frm_pos_none\" name=\"item_meta[other][376][other_3]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_377_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_6yemv\" class=\"frm_primary_label\">What techniques work best to motivate, redirect, and\/or maintain participant\u2019s engagement in activities?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[377]\" id=\"field_6yemv\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"What techniques work best to motivate, redirect, and\/or maintain participant\u2019s engagement in activities? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_378_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_6i0nc\" class=\"frm_primary_label\">What techniques work best to ease transitions and\/or changes in routine?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[378]\" id=\"field_6i0nc\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"What techniques work best to ease transitions and\/or changes in routine? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_379_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_kcx9l\" class=\"frm_primary_label\">What causes the participant to become upset or overstimulated (i.e. loud noises, touch, losing a game)?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[379]\" id=\"field_kcx9l\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"What causes the participant to become upset or overstimulated (i.e. loud noises, touch, losing a game)? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_380_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio frm_other_container\">\r\n    <label  class=\"frm_primary_label\">Behavioral communication when upset or overstimulated\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][]\" id=\"field_qqpns-0\" value=\"None\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][]\" id=\"field_qqpns-1\" value=\"Stims\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> Stims<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][]\" id=\"field_qqpns-2\" value=\"Cries\/screams\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> Cries\/screams<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][]\" id=\"field_qqpns-3\" value=\"Anger\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> Anger<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][]\" id=\"field_qqpns-4\" value=\"Argumentative\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> Argumentative<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][]\" id=\"field_qqpns-5\" value=\"Destroys or throws things\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> Destroys or throws things<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-6\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][]\" id=\"field_qqpns-6\" value=\"Hits, punches, kicks, bites, scratches, pinches, spits\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> Hits, punches, kicks, bites, scratches, pinches, spits<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-7\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][]\" id=\"field_qqpns-7\" value=\"Self-harm\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> Self-harm<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-8\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][]\" id=\"field_qqpns-8\" value=\"Flight risk\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> Flight risk<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_380-325-other_9\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[380][other_9]\" id=\"field_qqpns-other_9\" value=\"Other\"  data-sectionid=\"325\"  data-invmsg=\"Behavioral communication when upset or overstimulated is invalid\"   \/> Other<\/label><label for=\"field_qqpns-other_9-otext\" class=\"frm_screen_reader frm_hidden\">Other<\/label><input type=\"text\" id=\"field_qqpns-other_9-otext\" class=\"frm_other_input frm_pos_none\" name=\"item_meta[other][380][other_9]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_381_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_d19o5\" class=\"frm_primary_label\">What is the most effective response when the participant becomes upset or overstimulated (i.e. quiet time, talking calmly, removal from area of activity)?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[381]\" id=\"field_d19o5\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"What is the most effective response when the participant becomes upset or overstimulated (i.e. quiet time, talking calmly, removal from area of activity)? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_382_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_a2mgz\" class=\"frm_primary_label\">Does participant display common behaviors that staff should be aware of?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[382]\" id=\"field_a2mgz\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"Does participant display common behaviors that staff should be aware of? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_383_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_juqhe\" class=\"frm_primary_label\">Please share any other information you believe will be helpful:\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[383]\" id=\"field_juqhe\" rows=\"5\"  data-sectionid=\"325\"  data-invmsg=\"Please share any other information you believe will be helpful: is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_764_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_792_container\">\n\t\t\t<label for=\"field_i15hd\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_i15hd\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[792]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"iFtBTJtgbONr57qGwbVO+2ntRu38AzXLebXBKtsXi\/yNixULE83rGu5IWU09eFmz\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"4\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><\/form>\n<\/div>\n[\/vc_column_text][\/vc_tta_section][vc_tta_section title=\"Servicios de Inclusi\u00f3n\" tab_id=\"servicios-de-inclusi\u00f3n\"][vc_column_text]<\/p>\n<h4 class=\"card-header-primary\">Servicios de Inclusi\u00f3n<\/h4>\n<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_14_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_79nap2\" data-frm-error-config=\"{&quot;includeAlertRole&quot;:false,&quot;focusFirstError&quot;:false,&quot;focusErrorSummary&quot;:true}\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_hidden\">Pasadena Inclusion Services (Spanish)<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"14\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_14\" id=\"frm_hide_fields_14\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"79nap2\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_14\" name=\"frm_submit_entry_14\" value=\"c42caba0f7\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/parks-and-rec\/wp-json\/wp\/v2\/pages\/45\" \/><div id=\"frm_field_413_container\" class=\"frm_form_field  frm_html_container form-field\">El Departamento de servicios humanos y recreaci\u00f3n de la ciudad de Pasadena brinda servicios de inclusi\u00f3n para garantizar que las personas con discapacidades tengan la misma oportunidad de participar en todos los programas de recreaci\u00f3n que ofrece el departamento. Inclusi\u00f3n es el proceso de brindar apoyo, hacer acomodaciones y capacitar el personal para garantizar que se satisfagan las necesidades individuales de los participantes del programa.<\/p>\n<p>Para solicitar servicios de inclusi\u00f3n, siga los pasos a continuaci\u00f3n:<br \/>\n<\/div>\n<div id=\"frm_field_414_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\" tabindex=\"0\" role=\"button\"><span>Paso 1 \u2013 Lea las preguntas frecuentes sobre los Servicios de Inclusion<\/span> <svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\">\n\t<path d=\"M5 6l5 5 5-5 2 1-7 7-7-7 2-1z\"><\/path>\n\n<\/svg><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\"><path d=\"m15 14-5-5-5 5-2-1 7-7 7 7-2 1z\"\/><\/svg><\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_415_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p><span style=\"text-decoration: underline;\"><strong>\u00bfQui\u00e9n es elegible para los Servicios de Inclusi\u00f3n?<\/strong><\/span><\/p>\n<p>Cualquier participante que este registrado y tenga una discapacidad que afecte su participaci\u00f3n en los programas de recreaci\u00f3n puede solicitar Servicios de Inclusi\u00f3n.<\/p>\n<hr \/>\n<p><span style=\"text-decoration: underline;\"><strong>\u00bfQu\u00e9 tipos de acomodaciones se brindan a trav\u00e9s de los Servicios de Inclusi\u00f3n<\/strong><\/span><\/p>\n<p>Los ejemplos de acomodaciones, entre otros, proporcionar una proporci\u00f3n m\u00e1s alta de personal por un participante, desarrollar un plan de apoyo de conducta y proporcionar asistencia auxiliar. Todas las acomodaciones deben ser razonables y necesarias, que se determinaran caso por caso.<\/p>\n<hr \/>\n<p><span style=\"text-decoration: underline;\"><strong>\u00bfC\u00f3mo solicito Servicios de Inclusi\u00f3n?<\/strong><\/span><\/p>\n<ol>\n<li>1. Lea las preguntas frecuentes sobre los Servicios de Inclusi\u00f3n<\/li>\n<li>2. Reg\u00edstrese para el programa de recreaci\u00f3n de su elecci\u00f3n<\/li>\n<li>3. Solicite Servicios de Inclusi\u00f3n enviando el Formulario de Solicitud de Servicios de Inclusi\u00f3n y el Cuestionario del Participante en l\u00ednea <em>(solo se requiere el Cuestionario del Participante una vez al a\u00f1o)<\/em><\/li>\n<\/ol>\n<p>Una vez que envi\u00e9 su solicitud de Servicios de Inclusi\u00f3n, recibir\u00e1 un correo electr\u00f3nico con la confirmaci\u00f3n de que se recibi\u00f3 su solicitud. El personal revisara su informaci\u00f3n y se comunicara con usted con respecto a su solicitud.<\/p>\n<p><strong>Por favor tenga en cuenta:<\/strong>Para permitir un tiempo adecuado para el procesamiento y la evaluaci\u00f3n, solicite los Servicios de Inclusi\u00f3n al menos 14 d\u00edas de calendario antes de la fecha de inicio del programa de recreaci\u00f3n.<\/p>\n<hr \/>\n<p><span style=\"text-decoration: underline;\"><strong>\u00bfHay una tarifa por los Servicios de Inclusi\u00f3n?<\/strong><\/span><\/p>\n<p>No.<\/p>\n<hr \/>\n<p><strong><span style=\"text-decoration: underline;\">\u00bfLos participantes que reciben Servicios de Inclusi\u00f3n reciben prioridad para inscribirse en los programas de recreaci\u00f3n? <\/span> <\/strong><\/p>\n<p>No. El registro del programa de recreaci\u00f3n es por orden de llegada.<\/p>\n<hr \/>\n<p><span style=\"text-decoration: underline;\"><strong>\u00bfLos participantes que reciben Servicios de Inclusi\u00f3n reciben excepciones a los requisitos b\u00e1sicos del programa de recreaci\u00f3n?<\/strong><\/span><\/p>\n<p>No. Todos los participantes del programa deben cumplir con los requisitos b\u00e1sicos del programa, como la edad y la residencia.<\/p>\n<hr \/>\n<p><strong><span style=\"text-decoration: underline;\">\u00bfSe proporcionar\u00e1 transporte de y hacia el programa de recreaci\u00f3n?<\/span> <\/strong><\/p>\n<p>No. Sin embargo, se puede proveer transporte hacia y desde actividades que ocurren durante los programas de recreaci\u00f3n. Tal transporte es t\u00edpicamente a trav\u00e9s del autob\u00fas escolar o el autob\u00fas ch\u00e1rter. Incluya cualquier necesidad de accesibilidad relacionada con el transporte en el Formulario de solicitud de servicios de inclusi\u00f3n y \/ o el Cuestionario de servicios de inclusi\u00f3n.<\/p>\n<hr \/>\n<p><span style=\"text-decoration: underline;\"><strong>\u00bfLos servicios de atenci\u00f3n personal o de salud son proporcionados por los Servicios de Inclusi\u00f3n?<\/strong><\/span><\/p>\n<p>Tal vez. Por lo general, no se brindan servicios de cuidado personal o de salud, a menos que la provisi\u00f3n de estos servicios sea parte del programa. Sin embargo, los servicios de cuidado personal se pueden proporcionar si es necesario como una acomodaci\u00f3n razonable, que se determinara de forma individual, caso por caso. Incluya cualquier necesidad de cuidado personal en el Formulario de solicitud de Servicios de Inclusi\u00f3n y\/o el Cuestionario de Servicios de Inclusi\u00f3n.<\/p>\n<hr \/>\n<p><strong><span style=\"text-decoration: underline;\">\u00bfEs la terapia de conducta proporcionada a trav\u00e9s de los Servicios de Inclusi\u00f3n? <\/span> <\/strong><\/p>\n<p>No, Sin embargo, como una acomodaci\u00f3n razonable, un participante puede ser acompa\u00f1ado por un terapeuta de conducta durante el programa.<\/p>\n<hr \/>\n<p><span style=\"text-decoration: underline;\"><strong>\u00bfQu\u00e9 normas de comportamiento se aplican a los participantes que reciben Servicios de Inclusi\u00f3n?<\/strong><\/span><\/p>\n<p>Todos los participantes del programa, incluyendo los que reciben Servicios de Inclusi\u00f3n, deben cumplir con los c\u00f3digos de conducta espec\u00edficos del programa y con los Est\u00e1ndares de Comportamiento de Servicios Humanos y Recreaci\u00f3n de la Ciudad de Pasadena, con o sin acomodaci\u00f3n. El Plan de Servicios de Inclusi\u00f3n de un participante puede incluir disposiciones para ayudar al participante a cumplir con estas expectativas.<\/p>\n<hr \/>\n<p><strong>\u00a0<\/strong><strong><span style=\"text-decoration: underline;\">\u00bfPuede un participante traer su propio ayudante para proporcionar asistencia durante un programa de recreaci\u00f3n? <\/span> <\/strong><\/p>\n<p>Si. Como acomodaci\u00f3n razonable un participante puede ser acompa\u00f1ado por su propio ayudante durante el programa de recreaci\u00f3n. Posiblemente se pueda requerir una verificaci\u00f3n de antecedentes del ayudante. De ser as\u00ed, se le proporcionara m\u00e1s informaci\u00f3n durante el proceso de evaluaci\u00f3n de Servicios de Inclusi\u00f3n.<\/p>\n<hr \/>\n<p><strong><span style=\"text-decoration: underline;\">\u00bfPor qu\u00e9 se solicita una copia del Plan de educaci\u00f3n individualizado (IEP) o el plan de educaci\u00f3n 504 con el cuestionario del participante? <\/span> <\/strong><\/p>\n<p>Los IEP\u2019s y el plan de educaci\u00f3n 504 incluyen estrategias de apoyo de conducta, metas recreacionales, y otra informaci\u00f3n que ayude al personal a comprender las necesidades del participante y a desarrollar acomodaciones basadas en esas necesidades.<\/p>\n<hr \/>\n<p><strong><span style=\"text-decoration: underline;\">\u00bfSi recibo Servicios de Inclusi\u00f3n y algo sobre mi o mi participaci\u00f3n en el programa de recreaci\u00f3n cambia, a quien puedo avisarle? <\/span> <\/strong><\/p>\n<p>Es la responsabilidad del participante, del padre, o del proveedor de cuidado actualizar a los Servicios de Inclusi\u00f3n sobre un cambio relacionado con la discapacidad. Las actualizaciones o cambios no relacionados con la discapacidad se deben comunicar directamente al personal del programa de recreaci\u00f3n.<\/p>\n<hr \/>\n<p><span style=\"text-decoration: underline;\"><strong>\u00bfHay alguna excepci\u00f3n al requisito de acomodar a un participante con una discapacidad?<\/strong><\/span><\/p>\n<p>Si. Los programas no est\u00e1n obligados a acomodar a un participante con una discapacidad si hacerlo alterar\u00eda fundamentalmente la naturaleza del programa, crear\u00eda una carga financiera o administrativa excesiva, o plantear\u00eda una amenaza directa a la salud o seguridad de los dem\u00e1s, que no se puede eliminar a trav\u00e9s de las acomodaciones razonables.<\/p>\n<hr \/>\n<p><strong><span style=\"text-decoration: underline;\">\u00bfCon qui\u00e9n me comunico para obtener m\u00e1s informaci\u00f3n sobre los Servicios de Inclusi\u00f3n? <\/span> <\/strong><\/p>\n<p>Para obtener m\u00e1s informaci\u00f3n preguntas o inquietudes sobre los Servicios de Inclusi\u00f3n, comun\u00edquese al (626)744-3829 o env\u00ede un correo electr\u00f3nico a <a href=\"mailto:sgoldman@cityofpasadena.net\">sgoldman@cityofpasadena.net<\/a>.<\/p>\n<hr \/>\n<p><span style=\"text-decoration: underline;\"><strong>\u00bfA qui\u00e9n debo contactar para obtener m\u00e1s informaci\u00f3n sobre los programas de recreaci\u00f3n?<\/strong><\/span><\/p>\n<p>Para obtener m\u00e1s informaci\u00f3n, preguntas o inquietudes sobre un programa de recreaci\u00f3n, comun\u00edquese con el personal del programa de recreaci\u00f3n o la ubicaci\u00f3n donde se ofrece el programa de recreaci\u00f3n.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_417_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\" tabindex=\"0\" role=\"button\"><span>Paso 2 - Reg\u00edstrese para el programa de recreaci\u00f3n de su elecci\u00f3n<\/span> <svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\">\n\t<path d=\"M5 6l5 5 5-5 2 1-7 7-7-7 2-1z\"><\/path>\n\n<\/svg><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\"><path d=\"m15 14-5-5-5 5-2-1 7-7 7 7-2 1z\"\/><\/svg><\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_418_container\" class=\"frm_form_field  frm_html_container form-field\">Antes de solicitar Servicios de Inclusi\u00f3n, reg\u00edstrese para el programa de recreaci\u00f3n de su elecci\u00f3n: <a href=\"http:\/\/www.cityofpasadena.net\/reserve\">www.cityofpasadena.net\/reserve<\/a>.<\/p>\n<hr \/>\n<p><em>\u00bfNo est\u00e1s seguro de para qu\u00e9 registrarte? Consulte la Gu\u00eda de recreaci\u00f3n en l\u00ednea:\u00a0<a href=\"http:\/\/www.cityofpasadena.net\/parks-and-rec\/recreation-guide\/\">www.cityofpasadena.net\/human-services\/recreation-guide\/<\/a>.<\/em><\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_420_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\" tabindex=\"0\" role=\"button\"><span>Paso 3 - Solicite Servicios de Inclusi\u00f3n<\/span> <svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\">\n\t<path d=\"M5 6l5 5 5-5 2 1-7 7-7-7 2-1z\"><\/path>\n\n<\/svg><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" aria-expanded=\"false\" aria-label=\"Toggle fields\" class=\"frmsvg frm-svg-icon\"><path d=\"m15 14-5-5-5 5-2-1 7-7 7 7-2 1z\"\/><\/svg><\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_421_container\" class=\"frm_form_field  frm_html_container form-field\">The Inclusion Services Request Form must be submitted each time the participant registers for a program, class, or activity and would like to receive Inclusion Services during that program, class, or activity.<\/p>\n<hr>\n<\/div>\n<div id=\"frm_field_422_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_9qg6w2\" class=\"frm_primary_label\">Fecha de hoy:\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_9qg6w2\" name=\"item_meta[422]\" value=\"\"  data-sectionid=\"420\"  maxlength=\"10\" data-reqmsg=\"Fecha de hoy: cannot be blank.\" aria-required=\"true\" data-invmsg=\"Today&#039;s Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_423_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<h4>Informaci\u00f3n del participante:<\/h4>\n<\/div>\n<div id=\"frm_field_424_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_jl4wd2\" class=\"frm_primary_label\">Nombre\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_jl4wd2\" name=\"item_meta[424]\" value=\"\"  data-sectionid=\"420\"  data-reqmsg=\"Nombre cannot be blank.\" aria-required=\"true\" data-invmsg=\"Nombre is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_425_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_zd84n2\" class=\"frm_primary_label\">Edad\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_zd84n2\" name=\"item_meta[425]\" value=\"\"  data-sectionid=\"420\"  data-reqmsg=\"Edad cannot be blank.\" aria-required=\"true\" data-invmsg=\"Edad is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_426_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_j2uj2\" class=\"frm_primary_label\">Fecha de nacimiento\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_j2uj2\" name=\"item_meta[426]\" value=\"\"  data-sectionid=\"420\"  maxlength=\"10\" data-reqmsg=\"Fecha de nacimiento cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date of Birth is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_427_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_3rpz32\" class=\"frm_primary_label\">Direcci\u00f3n\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <fieldset aria-labelledby=\"field_3rpz32_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tDirecci\u00f3n<\/legend>\n<div  class=\"frm_combo_inputs_container\" data-reqmsg=\"Direcci\u00f3n cannot be blank.\">\n<div id=\"frm_field_427-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_3rpz32_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tDirecci\u00f3n\t<\/label>\n\t\t<input type=\"text\" id=\"field_3rpz32_line1\" value=\"\" name=\"item_meta[427][line1]\"  data-sectionid=\"420\"  data-reqmsg=\"Direcci\u00f3n Line 1 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_427-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_3rpz32_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tDirecci\u00f3n\t<\/label>\n\t\t<input type=\"text\" id=\"field_3rpz32_line2\" value=\"\" name=\"item_meta[427][line2]\"  data-sectionid=\"420\"  data-reqmsg=\"Direcci\u00f3n Line 2 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_427-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_3rpz32_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCiudad\t<\/label>\n\t\t<input type=\"text\" id=\"field_3rpz32_city\" value=\"\" name=\"item_meta[427][city]\"  data-sectionid=\"420\"  data-reqmsg=\"Ciudad cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">Ciudad<\/div><\/div>\n<div id=\"frm_field_427-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_3rpz32_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tEstado\t<\/label>\n\t\t\t<select name=\"item_meta[427][state]\" id=\"field_3rpz32_state\"  data-sectionid=\"420\"  data-reqmsg=\"Estado cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Alabama\">Alabama<\/option><option  value=\"Alaska\">Alaska<\/option><option  value=\"Arkansas\">Arkansas<\/option><option  value=\"Arizona\">Arizona<\/option><option  value=\"California\">California<\/option><option  value=\"Colorado\">Colorado<\/option><option  value=\"Connecticut\">Connecticut<\/option><option  value=\"Delaware\">Delaware<\/option><option  value=\"District of Columbia\">District of Columbia<\/option><option  value=\"Florida\">Florida<\/option><option  value=\"Georgia\">Georgia<\/option><option  value=\"Hawaii\">Hawaii<\/option><option  value=\"Idaho\">Idaho<\/option><option  value=\"Illinois\">Illinois<\/option><option  value=\"Indiana\">Indiana<\/option><option  value=\"Iowa\">Iowa<\/option><option  value=\"Kansas\">Kansas<\/option><option  value=\"Kentucky\">Kentucky<\/option><option  value=\"Louisiana\">Louisiana<\/option><option  value=\"Maine\">Maine<\/option><option  value=\"Maryland\">Maryland<\/option><option  value=\"Massachusetts\">Massachusetts<\/option><option  value=\"Michigan\">Michigan<\/option><option  value=\"Minnesota\">Minnesota<\/option><option  value=\"Mississippi\">Mississippi<\/option><option  value=\"Missouri\">Missouri<\/option><option  value=\"Montana\">Montana<\/option><option  value=\"Nebraska\">Nebraska<\/option><option  value=\"Nevada\">Nevada<\/option><option  value=\"New Hampshire\">New Hampshire<\/option><option  value=\"New Jersey\">New Jersey<\/option><option  value=\"New Mexico\">New Mexico<\/option><option  value=\"New York\">New York<\/option><option  value=\"North Carolina\">North Carolina<\/option><option  value=\"North Dakota\">North Dakota<\/option><option  value=\"Ohio\">Ohio<\/option><option  value=\"Oklahoma\">Oklahoma<\/option><option  value=\"Oregon\">Oregon<\/option><option  value=\"Pennsylvania\">Pennsylvania<\/option><option  value=\"Rhode Island\">Rhode Island<\/option><option  value=\"South Carolina\">South Carolina<\/option><option  value=\"South Dakota\">South Dakota<\/option><option  value=\"Tennessee\">Tennessee<\/option><option  value=\"Texas\">Texas<\/option><option  value=\"Utah\">Utah<\/option><option  value=\"Vermont\">Vermont<\/option><option  value=\"Virginia\">Virginia<\/option><option  value=\"Washington\">Washington<\/option><option  value=\"West Virginia\">West Virginia<\/option><option  value=\"Wisconsin\">Wisconsin<\/option><option  value=\"Wyoming\">Wyoming<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">Estado<\/div><\/div>\n<div id=\"frm_field_427-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_3rpz32_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tC\u00f3digo Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_3rpz32_zip\" value=\"\" name=\"item_meta[427][zip]\"  data-sectionid=\"420\"  data-reqmsg=\"C\u00f3digo Postal cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">C\u00f3digo Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_428_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<h4>Padre\/Tutor Legal\/Proveedor de cuidado<\/h4>\n<\/div>\n<div id=\"frm_field_429_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_7xp6n2\" class=\"frm_primary_label\">Nombre\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_7xp6n2\" name=\"item_meta[429]\" value=\"\"  data-sectionid=\"420\"  data-reqmsg=\"Nombre cannot be blank.\" aria-required=\"true\" data-invmsg=\"Nombre is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_430_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_sgns\" class=\"frm_primary_label\">Relaci\u00f3n\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_sgns\" name=\"item_meta[430]\" value=\"\"  data-sectionid=\"420\"  data-reqmsg=\"Relaci\u00f3n cannot be blank.\" aria-required=\"true\" data-invmsg=\"Relaci\u00f3n is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_431_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_x96u02\" class=\"frm_primary_label\">Corre Electronico\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_x96u02\" name=\"item_meta[431]\" value=\"\"  data-sectionid=\"420\"  data-reqmsg=\"Corre Electronico cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_432_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_7e079a2\" class=\"frm_primary_label\">Tel\u00e9fono de Casa\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_7e079a2\" name=\"item_meta[432]\" value=\"\"  data-sectionid=\"420\"  data-invmsg=\"Home Phone is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_433_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_ez0tx2\" class=\"frm_primary_label\">Tel\u00e9fono de M\u00f3vil\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_ez0tx2\" name=\"item_meta[433]\" value=\"\"  data-sectionid=\"420\"  data-reqmsg=\"Tel\u00e9fono de M\u00f3vil cannot be blank.\" aria-required=\"true\" data-invmsg=\"Mobile Phone is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_434_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<h4>Informaci\u00f3n del programa <\/h4>\n<p><i>(El participante debe estar registrado en el programa antes de enviar este formulario)<\/i><\/div>\n<div id=\"frm_field_435_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_gnm2w2\" class=\"frm_primary_label\">Programa\/Actividad\/Clase\/Evento\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_gnm2w2\" name=\"item_meta[435]\" value=\"\"  data-sectionid=\"420\"  data-reqmsg=\"Programa\/Actividad\/Clase\/Evento cannot be blank.\" aria-required=\"true\" data-invmsg=\"Programa\/Actividad\/Clase\/Evento is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_436_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_zuwf92\" class=\"frm_primary_label\">Ubicaci\u00f3n del programa\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_zuwf92\" name=\"item_meta[436]\" value=\"\"  data-sectionid=\"420\"  data-invmsg=\"Ubicaci\u00f3n del programa is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_437_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_yi2jg2\" class=\"frm_primary_label\">Fechas de asistencia\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_yi2jg2\" name=\"item_meta[437]\" value=\"\"  data-sectionid=\"420\"  data-invmsg=\"Fechas de asistencia is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_438_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_41l1c2\" class=\"frm_primary_label\">Horas de asistencia - Starting Time\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_time_wrap\"><span dir=\"ltr\">\r\n<select aria-label=\"Horas de asistencia - Starting Time ... hour\" name=\"item_meta[438][H]\" id=\"field_41l1c2_H\"  data-sectionid=\"420\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-invmsg=\"Time of Attendance - Starting Time is invalid\" class=\"auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12\" >12<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><\/select>\r\n<span class=\"frm_time_sep\" aria-hidden=\"true\">:<\/span>\r\n<select aria-label=\"Horas de asistencia - Starting Time ... minute\" name=\"item_meta[438][m]\" id=\"field_41l1c2_m\"  data-sectionid=\"420\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-invmsg=\"Time of Attendance - Starting Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"00\" >00<\/option><option value=\"30\" >30<\/option><\/select>\r\n<\/span>\r\n<select aria-label=\"Horas de asistencia - Starting Time\" name=\"item_meta[438][A]\" id=\"field_41l1c2_A\"  data-sectionid=\"420\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-invmsg=\"Time of Attendance - Starting Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"AM\" >AM<\/option><option value=\"PM\" >PM<\/option><\/select>\r\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_439_container\" class=\"frm_form_field form-field  frm_top_container frm_half\">\r\n    <label for=\"field_l2jwx2\" class=\"frm_primary_label\">Horas de asistencia - Ending Time\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_time_wrap\"><span dir=\"ltr\">\r\n<select aria-label=\"Horas de asistencia - Ending Time ... hour\" name=\"item_meta[439][H]\" id=\"field_l2jwx2_H\"  data-sectionid=\"420\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-invmsg=\"Time of Attendance - Ending Time is invalid\" class=\"auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12\" >12<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><\/select>\r\n<span class=\"frm_time_sep\" aria-hidden=\"true\">:<\/span>\r\n<select aria-label=\"Horas de asistencia - Ending Time ... minute\" name=\"item_meta[439][m]\" id=\"field_l2jwx2_m\"  data-sectionid=\"420\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-invmsg=\"Time of Attendance - Ending Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"00\" >00<\/option><option value=\"30\" >30<\/option><\/select>\r\n<\/span>\r\n<select aria-label=\"Horas de asistencia - Ending Time\" name=\"item_meta[439][A]\" id=\"field_l2jwx2_A\"  data-sectionid=\"420\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-invmsg=\"Time of Attendance - Ending Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"AM\" >AM<\/option><option value=\"PM\" >PM<\/option><\/select>\r\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_440_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_i4gn82\" class=\"frm_primary_label\">Por favor especifique si asistir\u00e1 al programa en fechas espec\u00edficas, ciertas semanas, o ciertos d\u00edas de la semana.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_i4gn82\" name=\"item_meta[440]\" value=\"\"  data-sectionid=\"420\"  data-invmsg=\"Por favor especifique si asistir\u00e1 al programa en fechas espec\u00edficas, ciertas semanas, o ciertos d\u00edas de la semana. is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_441_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">\u00bfHa participado en este tipo de programas?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_441-420-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[441]\" id=\"field_ijem-0\" value=\"Si\"\n\t\t data-sectionid=\"420\"  data-reqmsg=\"\u00bfHa participado en este tipo de programas? cannot be blank.\" data-invmsg=\"\u00bfHa participado en este tipo de programas? is invalid\"   \/> Si<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_441-420-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[441]\" id=\"field_ijem-1\" value=\"No\"\n\t\t data-sectionid=\"420\"  data-reqmsg=\"\u00bfHa participado en este tipo de programas? cannot be blank.\" data-invmsg=\"\u00bfHa participado en este tipo de programas? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_442_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<\/div>\n<div id=\"frm_field_443_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_p0a3b2\" class=\"frm_primary_label\">Discapacidades del participante (Por favor indique si el participante tiene discapacidades que puedan afectar su participaci\u00f3n en los programas recreacionales)\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[443]\" id=\"field_p0a3b2\" rows=\"5\"  data-sectionid=\"420\"  data-invmsg=\"Discapacidades del participante (Por favor indique si el participante tiene discapacidades que puedan afectar su participaci\u00f3n en los programas recreacionales) is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_444_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_2asme2\" class=\"frm_primary_label\">Acommodacion(es) Solicitada\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[444]\" id=\"field_2asme2\" rows=\"5\"  data-sectionid=\"420\"  data-invmsg=\"Acommodacion(es) Solicitada is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_445_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_721r82\" class=\"frm_primary_label\">Comentarios Adicionales\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[445]\" id=\"field_721r82\" rows=\"5\"  data-sectionid=\"420\"  data-invmsg=\"Comentarios Adicionales is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_446_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">\u00bfHa enviado el Cuestionario de Participante de los Servicios de Inclusi\u00f3n en los \u00faltimos 12 meses?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_446-420-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[446]\" id=\"field_ubgry2-0\" value=\"Si\"\n\t\t data-sectionid=\"420\"  data-invmsg=\"\u00bfHa enviado el Cuestionario de Participante de los Servicios de Inclusi\u00f3n en los \u00faltimos 12 meses? is invalid\"   \/> Si<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_446-420-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[446]\" id=\"field_ubgry2-1\" value=\"No\"\n\t\t data-sectionid=\"420\"  data-invmsg=\"\u00bfHa enviado el Cuestionario de Participante de los Servicios de Inclusi\u00f3n en los \u00faltimos 12 meses? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_448_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\"><span>Paso 4 - Cuestionario del Participante<\/span><\/h3>\r\n\r\n\r\n<div id=\"frm_field_449_container\" class=\"frm_form_field  frm_html_container form-field\">Por favor complete el siguiente cuestionario. Habr\u00e1 una oportunidad para repasar la informaci\u00f3n que ha proporcionado con el personal de servicios de inclusi\u00f3n. Si no est\u00e1 segura\/o de como completar algunas de las preguntas puede dejarlo en blanco.  <\/p>\n<hr>\n<\/div>\n<div id=\"frm_field_450_container\" class=\"frm_form_field  frm_html_container form-field\">\n<h4>Participante<\/h4>\n<\/div>\n<div id=\"frm_field_451_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_dix4o2\" class=\"frm_primary_label\">Nombre\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_dix4o2\" name=\"item_meta[451]\" value=\"\"  data-sectionid=\"448\"  data-reqmsg=\"Nombre cannot be blank.\" aria-required=\"true\" data-invmsg=\"Nombre is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_452_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_8853a2\" class=\"frm_primary_label\">Direcci\u00f3n\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <fieldset aria-labelledby=\"field_8853a2_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tDirecci\u00f3n<\/legend>\n<div  class=\"frm_combo_inputs_container\" data-reqmsg=\"Direcci\u00f3n cannot be blank.\">\n<div id=\"frm_field_452-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_8853a2_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tDirecci\u00f3n\t<\/label>\n\t\t<input type=\"text\" id=\"field_8853a2_line1\" value=\"\" name=\"item_meta[452][line1]\"  data-sectionid=\"448\"  data-reqmsg=\"Direcci\u00f3n Line 1 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_452-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_8853a2_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tDirecci\u00f3n\t<\/label>\n\t\t<input type=\"text\" id=\"field_8853a2_line2\" value=\"\" name=\"item_meta[452][line2]\"  data-sectionid=\"448\"  data-reqmsg=\"Direcci\u00f3n Line 2 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_452-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_8853a2_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCiudad\t<\/label>\n\t\t<input type=\"text\" id=\"field_8853a2_city\" value=\"\" name=\"item_meta[452][city]\"  data-sectionid=\"448\"  data-reqmsg=\"Ciudad cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">Ciudad<\/div><\/div>\n<div id=\"frm_field_452-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_8853a2_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tEstado\t<\/label>\n\t\t\t<select name=\"item_meta[452][state]\" id=\"field_8853a2_state\"  data-sectionid=\"448\"  data-reqmsg=\"Estado cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Alabama\">Alabama<\/option><option  value=\"Alaska\">Alaska<\/option><option  value=\"Arkansas\">Arkansas<\/option><option  value=\"Arizona\">Arizona<\/option><option  value=\"California\">California<\/option><option  value=\"Colorado\">Colorado<\/option><option  value=\"Connecticut\">Connecticut<\/option><option  value=\"Delaware\">Delaware<\/option><option  value=\"District of Columbia\">District of Columbia<\/option><option  value=\"Florida\">Florida<\/option><option  value=\"Georgia\">Georgia<\/option><option  value=\"Hawaii\">Hawaii<\/option><option  value=\"Idaho\">Idaho<\/option><option  value=\"Illinois\">Illinois<\/option><option  value=\"Indiana\">Indiana<\/option><option  value=\"Iowa\">Iowa<\/option><option  value=\"Kansas\">Kansas<\/option><option  value=\"Kentucky\">Kentucky<\/option><option  value=\"Louisiana\">Louisiana<\/option><option  value=\"Maine\">Maine<\/option><option  value=\"Maryland\">Maryland<\/option><option  value=\"Massachusetts\">Massachusetts<\/option><option  value=\"Michigan\">Michigan<\/option><option  value=\"Minnesota\">Minnesota<\/option><option  value=\"Mississippi\">Mississippi<\/option><option  value=\"Missouri\">Missouri<\/option><option  value=\"Montana\">Montana<\/option><option  value=\"Nebraska\">Nebraska<\/option><option  value=\"Nevada\">Nevada<\/option><option  value=\"New Hampshire\">New Hampshire<\/option><option  value=\"New Jersey\">New Jersey<\/option><option  value=\"New Mexico\">New Mexico<\/option><option  value=\"New York\">New York<\/option><option  value=\"North Carolina\">North Carolina<\/option><option  value=\"North Dakota\">North Dakota<\/option><option  value=\"Ohio\">Ohio<\/option><option  value=\"Oklahoma\">Oklahoma<\/option><option  value=\"Oregon\">Oregon<\/option><option  value=\"Pennsylvania\">Pennsylvania<\/option><option  value=\"Rhode Island\">Rhode Island<\/option><option  value=\"South Carolina\">South Carolina<\/option><option  value=\"South Dakota\">South Dakota<\/option><option  value=\"Tennessee\">Tennessee<\/option><option  value=\"Texas\">Texas<\/option><option  value=\"Utah\">Utah<\/option><option  value=\"Vermont\">Vermont<\/option><option  value=\"Virginia\">Virginia<\/option><option  value=\"Washington\">Washington<\/option><option  value=\"West Virginia\">West Virginia<\/option><option  value=\"Wisconsin\">Wisconsin<\/option><option  value=\"Wyoming\">Wyoming<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">Estado<\/div><\/div>\n<div id=\"frm_field_452-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_8853a2_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tC\u00f3digo Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_8853a2_zip\" value=\"\" name=\"item_meta[452][zip]\"  data-sectionid=\"448\"  data-reqmsg=\"C\u00f3digo Postal cannot be blank.\" aria-required=\"true\" data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">C\u00f3digo Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_453_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_ijjni2\" class=\"frm_primary_label\">Tel\u00e9fono de Casa\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_ijjni2\" name=\"item_meta[453]\" value=\"\" data-sectionid=\"448\"  data-invmsg=\"Home Phone is invalid\" aria-invalid=\"false\"   min=\"0\" max=\"9999999\" step=\"any\" \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_454_container\" class=\"frm_form_field form-field  frm_top_container frm_half\">\r\n    <label for=\"field_ll2mh2\" class=\"frm_primary_label\">Tel\u00e9fono de M\u00f3vil\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_ll2mh2\" name=\"item_meta[454]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Tel\u00e9fono de M\u00f3vil is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_455_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_4ass12\" class=\"frm_primary_label\">Correo Electr\u00f3nico\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_4ass12\" name=\"item_meta[455]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_456_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_z0dr72\" class=\"frm_primary_label\">Fecha de Nacimiento\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_z0dr72\" name=\"item_meta[456]\" value=\"\"  data-sectionid=\"448\"  data-reqmsg=\"Fecha de Nacimiento cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date of Birth is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_457_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Sexo\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_457-448-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[457]\" id=\"field_ay7r42-0\" value=\"Male\"\n\t\t data-sectionid=\"448\"  data-invmsg=\"Sexo is invalid\"   \/> Male<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_457-448-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[457]\" id=\"field_ay7r42-1\" value=\"Female\"\n\t\t data-sectionid=\"448\"  data-invmsg=\"Sexo is invalid\"   \/> Female<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_458_container\" class=\"frm_form_field form-field  frm_top_container frm_half vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Conservador\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_458-448-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[458]\" id=\"field_bhs5u2-0\" value=\"Yes\"\n\t\t data-sectionid=\"448\"  data-invmsg=\"Conservador is invalid\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_458-448-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[458]\" id=\"field_bhs5u2-1\" value=\"No\"\n\t\t data-sectionid=\"448\"  data-invmsg=\"Conservador is invalid\"   \/> No<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_458-448-2\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[458]\" id=\"field_bhs5u2-2\" value=\"N\/A\"\n\t\t data-sectionid=\"448\"  data-invmsg=\"Conservador is invalid\"   \/> N\/A<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_459_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<h4>Primer Contacto<\/h4>\n<p>\n(para actualizaciones del programa, coordinaci\u00f3n de d\u00eda a d\u00eda, u otras log\u00edsticas)<\/div>\n<div id=\"frm_field_460_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_rhsys2\" class=\"frm_primary_label\">Nombre\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_rhsys2\" name=\"item_meta[460]\" value=\"\"  data-sectionid=\"448\"  data-reqmsg=\"Nombre cannot be blank.\" aria-required=\"true\" data-invmsg=\"Nombre is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_461_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_bjgl02\" class=\"frm_primary_label\">Correo Electr\u00f3nico\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_bjgl02\" name=\"item_meta[461]\" value=\"\"  data-sectionid=\"448\"  data-reqmsg=\"Correo Electr\u00f3nico cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_462_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_8ip342\" class=\"frm_primary_label\">Direcci\u00f3n\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <fieldset aria-labelledby=\"field_8ip342_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tDirecci\u00f3n<\/legend>\n<div  class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_462-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_8ip342_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tDirecci\u00f3n\t<\/label>\n\t\t<input type=\"text\" id=\"field_8ip342_line1\" value=\"\" name=\"item_meta[462][line1]\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_462-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_8ip342_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tDirecci\u00f3n\t<\/label>\n\t\t<input type=\"text\" id=\"field_8ip342_line2\" value=\"\" name=\"item_meta[462][line2]\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_462-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_8ip342_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCiudad\t<\/label>\n\t\t<input type=\"text\" id=\"field_8ip342_city\" value=\"\" name=\"item_meta[462][city]\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">Ciudad<\/div><\/div>\n<div id=\"frm_field_462-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_8ip342_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tEstado\t<\/label>\n\t\t\t<select name=\"item_meta[462][state]\" id=\"field_8ip342_state\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Alabama\">Alabama<\/option><option  value=\"Alaska\">Alaska<\/option><option  value=\"Arkansas\">Arkansas<\/option><option  value=\"Arizona\">Arizona<\/option><option  value=\"California\">California<\/option><option  value=\"Colorado\">Colorado<\/option><option  value=\"Connecticut\">Connecticut<\/option><option  value=\"Delaware\">Delaware<\/option><option  value=\"District of Columbia\">District of Columbia<\/option><option  value=\"Florida\">Florida<\/option><option  value=\"Georgia\">Georgia<\/option><option  value=\"Hawaii\">Hawaii<\/option><option  value=\"Idaho\">Idaho<\/option><option  value=\"Illinois\">Illinois<\/option><option  value=\"Indiana\">Indiana<\/option><option  value=\"Iowa\">Iowa<\/option><option  value=\"Kansas\">Kansas<\/option><option  value=\"Kentucky\">Kentucky<\/option><option  value=\"Louisiana\">Louisiana<\/option><option  value=\"Maine\">Maine<\/option><option  value=\"Maryland\">Maryland<\/option><option  value=\"Massachusetts\">Massachusetts<\/option><option  value=\"Michigan\">Michigan<\/option><option  value=\"Minnesota\">Minnesota<\/option><option  value=\"Mississippi\">Mississippi<\/option><option  value=\"Missouri\">Missouri<\/option><option  value=\"Montana\">Montana<\/option><option  value=\"Nebraska\">Nebraska<\/option><option  value=\"Nevada\">Nevada<\/option><option  value=\"New Hampshire\">New Hampshire<\/option><option  value=\"New Jersey\">New Jersey<\/option><option  value=\"New Mexico\">New Mexico<\/option><option  value=\"New York\">New York<\/option><option  value=\"North Carolina\">North Carolina<\/option><option  value=\"North Dakota\">North Dakota<\/option><option  value=\"Ohio\">Ohio<\/option><option  value=\"Oklahoma\">Oklahoma<\/option><option  value=\"Oregon\">Oregon<\/option><option  value=\"Pennsylvania\">Pennsylvania<\/option><option  value=\"Rhode Island\">Rhode Island<\/option><option  value=\"South Carolina\">South Carolina<\/option><option  value=\"South Dakota\">South Dakota<\/option><option  value=\"Tennessee\">Tennessee<\/option><option  value=\"Texas\">Texas<\/option><option  value=\"Utah\">Utah<\/option><option  value=\"Vermont\">Vermont<\/option><option  value=\"Virginia\">Virginia<\/option><option  value=\"Washington\">Washington<\/option><option  value=\"West Virginia\">West Virginia<\/option><option  value=\"Wisconsin\">Wisconsin<\/option><option  value=\"Wyoming\">Wyoming<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">Estado<\/div><\/div>\n<div id=\"frm_field_462-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_8ip342_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tC\u00f3digo Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_8ip342_zip\" value=\"\" name=\"item_meta[462][zip]\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">C\u00f3digo Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_463_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_2xcgd2\" class=\"frm_primary_label\">Tel\u00e9fono de Casa\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_2xcgd2\" name=\"item_meta[463]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Tel\u00e9fono de Casa is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_464_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_apfuu2\" class=\"frm_primary_label\">Tel\u00e9fono de M\u00f3vil\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_apfuu2\" name=\"item_meta[464]\" value=\"\"  data-sectionid=\"448\"  data-reqmsg=\"Tel\u00e9fono de M\u00f3vil cannot be blank.\" aria-required=\"true\" data-invmsg=\"Tel\u00e9fono de M\u00f3vil is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_465_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_v70tj2\" class=\"frm_primary_label\">Relaci\u00f3n\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_v70tj2\" name=\"item_meta[465]\" value=\"\"  data-sectionid=\"448\"  data-reqmsg=\"Relaci\u00f3n cannot be blank.\" aria-required=\"true\" data-invmsg=\"Relaci\u00f3n is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_466_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<h4>Padre\/Tutor Legal\/Conservador<\/h4>\n<p>(si es diferente del primario)<\/p><\/div>\n<div id=\"frm_field_467_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_df6ve2\" class=\"frm_primary_label\">Nombre\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_df6ve2\" name=\"item_meta[467]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Nombre is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_468_container\" class=\"frm_form_field form-field  frm_top_container frm_half\">\r\n    <label for=\"field_r7zvz2\" class=\"frm_primary_label\">Correo Electr\u00f3nico\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_r7zvz2\" name=\"item_meta[468]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_469_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_7j80s2\" class=\"frm_primary_label\">Direcci\u00f3n\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <fieldset aria-labelledby=\"field_7j80s2_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tDirecci\u00f3n<\/legend>\n<div  class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_469-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_7j80s2_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tDirecci\u00f3n\t<\/label>\n\t\t<input type=\"text\" id=\"field_7j80s2_line1\" value=\"\" name=\"item_meta[469][line1]\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_469-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_7j80s2_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tDirecci\u00f3n\t<\/label>\n\t\t<input type=\"text\" id=\"field_7j80s2_line2\" value=\"\" name=\"item_meta[469][line2]\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_469-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_7j80s2_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCiudad\t<\/label>\n\t\t<input type=\"text\" id=\"field_7j80s2_city\" value=\"\" name=\"item_meta[469][city]\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">Ciudad<\/div><\/div>\n<div id=\"frm_field_469-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_7j80s2_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tEstado\t<\/label>\n\t\t\t<select name=\"item_meta[469][state]\" id=\"field_7j80s2_state\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Alabama\">Alabama<\/option><option  value=\"Alaska\">Alaska<\/option><option  value=\"Arkansas\">Arkansas<\/option><option  value=\"Arizona\">Arizona<\/option><option  value=\"California\">California<\/option><option  value=\"Colorado\">Colorado<\/option><option  value=\"Connecticut\">Connecticut<\/option><option  value=\"Delaware\">Delaware<\/option><option  value=\"District of Columbia\">District of Columbia<\/option><option  value=\"Florida\">Florida<\/option><option  value=\"Georgia\">Georgia<\/option><option  value=\"Hawaii\">Hawaii<\/option><option  value=\"Idaho\">Idaho<\/option><option  value=\"Illinois\">Illinois<\/option><option  value=\"Indiana\">Indiana<\/option><option  value=\"Iowa\">Iowa<\/option><option  value=\"Kansas\">Kansas<\/option><option  value=\"Kentucky\">Kentucky<\/option><option  value=\"Louisiana\">Louisiana<\/option><option  value=\"Maine\">Maine<\/option><option  value=\"Maryland\">Maryland<\/option><option  value=\"Massachusetts\">Massachusetts<\/option><option  value=\"Michigan\">Michigan<\/option><option  value=\"Minnesota\">Minnesota<\/option><option  value=\"Mississippi\">Mississippi<\/option><option  value=\"Missouri\">Missouri<\/option><option  value=\"Montana\">Montana<\/option><option  value=\"Nebraska\">Nebraska<\/option><option  value=\"Nevada\">Nevada<\/option><option  value=\"New Hampshire\">New Hampshire<\/option><option  value=\"New Jersey\">New Jersey<\/option><option  value=\"New Mexico\">New Mexico<\/option><option  value=\"New York\">New York<\/option><option  value=\"North Carolina\">North Carolina<\/option><option  value=\"North Dakota\">North Dakota<\/option><option  value=\"Ohio\">Ohio<\/option><option  value=\"Oklahoma\">Oklahoma<\/option><option  value=\"Oregon\">Oregon<\/option><option  value=\"Pennsylvania\">Pennsylvania<\/option><option  value=\"Rhode Island\">Rhode Island<\/option><option  value=\"South Carolina\">South Carolina<\/option><option  value=\"South Dakota\">South Dakota<\/option><option  value=\"Tennessee\">Tennessee<\/option><option  value=\"Texas\">Texas<\/option><option  value=\"Utah\">Utah<\/option><option  value=\"Vermont\">Vermont<\/option><option  value=\"Virginia\">Virginia<\/option><option  value=\"Washington\">Washington<\/option><option  value=\"West Virginia\">West Virginia<\/option><option  value=\"Wisconsin\">Wisconsin<\/option><option  value=\"Wyoming\">Wyoming<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">Estado<\/div><\/div>\n<div id=\"frm_field_469-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_7j80s2_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tC\u00f3digo Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_7j80s2_zip\" value=\"\" name=\"item_meta[469][zip]\"  data-sectionid=\"448\"  data-invmsg=\"Direcci\u00f3n is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">C\u00f3digo Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_470_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_jfovu2\" class=\"frm_primary_label\">Tel\u00e9fono de Casa\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_jfovu2\" name=\"item_meta[470]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Tel\u00e9fono de Casa is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_471_container\" class=\"frm_form_field form-field  frm_top_container frm_half\">\r\n    <label for=\"field_nu1152\" class=\"frm_primary_label\">Tel\u00e9fono de M\u00f3vil\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_nu1152\" name=\"item_meta[471]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Tel\u00e9fono de M\u00f3vil is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_472_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_ie0uz2\" class=\"frm_primary_label\">Relaci\u00f3n\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_ie0uz2\" name=\"item_meta[472]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Relaci\u00f3n is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_473_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<h4>Contacto de Emergencia<\/h4>\n<\/div>\n<div id=\"frm_field_474_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_bn6xk\" class=\"frm_primary_label\">Nombre\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_bn6xk\" name=\"item_meta[474]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Nombre is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_475_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_8khyd\" class=\"frm_primary_label\">Tel\u00e9fono de Casa\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_8khyd\" name=\"item_meta[475]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Tel\u00e9fono de Casa is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_476_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_b6xe4\" class=\"frm_primary_label\">Tel\u00e9fono de M\u00f3vil\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_b6xe4\" name=\"item_meta[476]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Tel\u00e9fono de M\u00f3vil is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_477_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_fod8b\" class=\"frm_primary_label\">Relaci\u00f3n\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_fod8b\" name=\"item_meta[477]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"Relaci\u00f3n is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_478_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr>\n<\/div>\n<div id=\"frm_field_479_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio frm_other_container\">\r\n    <label  class=\"frm_primary_label\">\u00bfD\u00f3nde vive el participante?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_479-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[479][]\" id=\"field_iceym2-0\" value=\"Familia\/Propia casa\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfD\u00f3nde vive el participante? cannot be blank.\" data-invmsg=\"\u00bfD\u00f3nde vive el participante? is invalid\"   aria-required=\"true\"  \/> Familia\/Propia casa<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_479-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[479][]\" id=\"field_iceym2-1\" value=\"Casa no familiar\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfD\u00f3nde vive el participante? cannot be blank.\" data-invmsg=\"\u00bfD\u00f3nde vive el participante? is invalid\"   \/> Casa no familiar<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_479-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[479][]\" id=\"field_iceym2-2\" value=\"Casa de grupo\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfD\u00f3nde vive el participante? cannot be blank.\" data-invmsg=\"\u00bfD\u00f3nde vive el participante? is invalid\"   \/> Casa de grupo<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_479-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[479][]\" id=\"field_iceym2-3\" value=\"Vivencia asistida\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfD\u00f3nde vive el participante? cannot be blank.\" data-invmsg=\"\u00bfD\u00f3nde vive el participante? is invalid\"   \/> Vivencia asistida<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_479-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[479][]\" id=\"field_iceym2-4\" value=\"Vivencia independiente\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfD\u00f3nde vive el participante? cannot be blank.\" data-invmsg=\"\u00bfD\u00f3nde vive el participante? is invalid\"   \/> Vivencia independiente<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_479-448-other_6\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[479][other_6]\" id=\"field_iceym2-other_6\" value=\"Otro\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfD\u00f3nde vive el participante? cannot be blank.\" data-invmsg=\"\u00bfD\u00f3nde vive el participante? is invalid\"   \/> Otro<\/label><label for=\"field_iceym2-other_6-otext\" class=\"frm_screen_reader frm_hidden\">Otro<\/label><input type=\"text\" id=\"field_iceym2-other_6-otext\" class=\"frm_other_input frm_pos_none\" name=\"item_meta[other][479][other_6]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_480_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_9cxyz2\" class=\"frm_primary_label\">\u00bfA qu\u00e9 escuela asiste el participante?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_9cxyz2\" name=\"item_meta[480]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfA qu\u00e9 escuela asiste el participante? is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_481_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_o3zfm2\" class=\"frm_primary_label\">Si corresponde, cargue una copia del Plan de Educaci\u00f3n Individualizada (IEP) del participante o Plan 504, o env\u00edela por correo electr\u00f3nico a aeverett@cityofpasadena.net.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"hidden\"  data-sectionid=\"448\"  data-invmsg=\"If applicable, please upload a copy of participant&#039;s current Individualized Education Plan (IEP) or 504 Plan, or email it to aeverett@cityofpasadena.net. is invalid\" class=\"auto_width\" aria-invalid=\"false\"   name=\"item_meta[481]\"  value=\"\" data-frmfile=\"481\" \/>\n\n<div class=\"frm_dropzone frm_single_upload frm_clearfix\" id=\"file481_dropzone\" role=\"group\" >\n\t<div class=\"fallback\">\n\t\t<input type=\"file\" name=\"file481\" id=\"field_o3zfm2\"\n\t\t\t data-sectionid=\"448\"  data-invmsg=\"If applicable, please upload a copy of participant&#039;s current Individualized Education Plan (IEP) or 504 Plan, or email it to aeverett@cityofpasadena.net. is invalid\" class=\"auto_width\" aria-invalid=\"false\"  \t\t\t\/>\n\t\t\t\t<div class=\"frm_clearfix \"><\/div>\n\t<\/div>\n\t<div class=\"dz-message needsclick\">\n\t\t\t\t<svg  viewBox=\"0 0 18 18\" aria-hidden=\"true\" class=\"frmsvg frm-svg-icon\">\n\t<path viewBox=\"0 0 18 18\" fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M8.2 4v8a.8.8 0 001.5 0V4l2.1 2.2A.7.7 0 1013 5L9.5 1.7a.7.7 0 00-1.1 0L5.1 5.2a.8.8 0 001 1l2.1-2zm7.6 4.3c.4 0 .7.3.7.7v6.8c0 .4-.3.7-.8.7H2.3a.8.8 0 01-.8-.8V9A.8.8 0 013 9v6h12V9c0-.4.3-.8.8-.8z\"><\/path>\n<\/svg>\t\t<span class=\"frm_upload_text\"><button type=\"button\" aria-label=\"Si corresponde, cargue una copia del Plan de Educaci\u00f3n Individualizada (IEP) del participante o Plan 504, o env\u00edela por correo electr\u00f3nico a aeverett@cityofpasadena.net.. Drop a file here or click to upload. Maximum file size: 20MB\">Drop a file here or click to upload<\/button><\/span>\n\t\t<span class=\"frm_compact_text\"><button type=\"button\" aria-label=\"Si corresponde, cargue una copia del Plan de Educaci\u00f3n Individualizada (IEP) del participante o Plan 504, o env\u00edela por correo electr\u00f3nico a aeverett@cityofpasadena.net.. Choose File. Maximum file size: 20MB\">Choose File<\/button><\/span>\n\t\t<div class=\"frm_small_text\">\n\t\t\t<p>Maximum file size: 20MB<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_482_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_vxlj02\" class=\"frm_primary_label\">\u00bfD\u00f3nde trabaja el participante o a que programa asiste durante el d\u00eda?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_vxlj02\" name=\"item_meta[482]\" value=\"\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfD\u00f3nde trabaja el participante o a que programa asiste durante el d\u00eda? is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_483_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">\u00bfEl proveedor de cuidado u otro personal de apoyo acompa\u00f1aran al participante a los programas de recreaci\u00f3n?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_483-448-0\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[483]\" id=\"field_y4sjt2-0\" value=\"Si\"\n\t\t data-sectionid=\"448\"  data-reqmsg=\"\u00bfEl proveedor de cuidado u otro personal de apoyo acompa\u00f1aran al participante a los programas de recreaci\u00f3n? cannot be blank.\" data-invmsg=\"\u00bfEl proveedor de cuidado u otro personal de apoyo acompa\u00f1aran al participante a los programas de recreaci\u00f3n? is invalid\"   \/> Si<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_483-448-1\">\t\t\t<label >\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[483]\" id=\"field_y4sjt2-1\" value=\"No\"\n\t\t data-sectionid=\"448\"  data-reqmsg=\"\u00bfEl proveedor de cuidado u otro personal de apoyo acompa\u00f1aran al participante a los programas de recreaci\u00f3n? cannot be blank.\" data-invmsg=\"\u00bfEl proveedor de cuidado u otro personal de apoyo acompa\u00f1aran al participante a los programas de recreaci\u00f3n? is invalid\"   \/> No<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_484_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio frm_other_container\">\r\n    <label  class=\"frm_primary_label\">\u00bfQu\u00e9 tipo de transportaci\u00f3n normalmente usa el participante para asistir a los programas y actividades recreacionales?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_484-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[484][]\" id=\"field_3b5r12-0\" value=\"Padre\/Proveedor de cudidado transporta\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfQu\u00e9 tipo de transportaci\u00f3n normalmente usa el participante para asistir a los programas y actividades recreacionales? is invalid\"   \/> Padre\/Proveedor de cudidado transporta<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_484-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[484][]\" id=\"field_3b5r12-1\" value=\"Dial-A-Ride\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfQu\u00e9 tipo de transportaci\u00f3n normalmente usa el participante para asistir a los programas y actividades recreacionales? is invalid\"   \/> Dial-A-Ride<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_484-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[484][]\" id=\"field_3b5r12-2\" value=\"Access\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfQu\u00e9 tipo de transportaci\u00f3n normalmente usa el participante para asistir a los programas y actividades recreacionales? is invalid\"   \/> Access<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_484-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[484][]\" id=\"field_3b5r12-3\" value=\"Autob\u00fas\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfQu\u00e9 tipo de transportaci\u00f3n normalmente usa el participante para asistir a los programas y actividades recreacionales? is invalid\"   \/> Autob\u00fas<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_484-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[484][]\" id=\"field_3b5r12-4\" value=\"Camina\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfQu\u00e9 tipo de transportaci\u00f3n normalmente usa el participante para asistir a los programas y actividades recreacionales? is invalid\"   \/> Camina<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_484-448-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[484][]\" id=\"field_3b5r12-5\" value=\"Bicicleta\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfQu\u00e9 tipo de transportaci\u00f3n normalmente usa el participante para asistir a los programas y actividades recreacionales? is invalid\"   \/> Bicicleta<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_484-448-6\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[484][]\" id=\"field_3b5r12-6\" value=\"Conduce\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfQu\u00e9 tipo de transportaci\u00f3n normalmente usa el participante para asistir a los programas y actividades recreacionales? is invalid\"   \/> Conduce<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_484-448-other_7\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[484][other_7]\" id=\"field_3b5r12-other_7\" value=\"Otro\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfQu\u00e9 tipo de transportaci\u00f3n normalmente usa el participante para asistir a los programas y actividades recreacionales? is invalid\"   \/> Otro<\/label><label for=\"field_3b5r12-other_7-otext\" class=\"frm_screen_reader frm_hidden\">Otro<\/label><input type=\"text\" id=\"field_3b5r12-other_7-otext\" class=\"frm_other_input frm_pos_none\" name=\"item_meta[other][484][other_7]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_485_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">\u00bfTiene IEP o IPP el participante?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_485-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[485][]\" id=\"field_pfss62-0\" value=\"IEP\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfTiene IEP o IPP el participante? cannot be blank.\" data-invmsg=\"\u00bfTiene IEP o IPP el participante? is invalid\"   aria-required=\"true\"  \/> IEP<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_485-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[485][]\" id=\"field_pfss62-1\" value=\"IPP\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfTiene IEP o IPP el participante? cannot be blank.\" data-invmsg=\"\u00bfTiene IEP o IPP el participante? is invalid\"   \/> IPP<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_485-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[485][]\" id=\"field_pfss62-2\" value=\"Ninguno\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfTiene IEP o IPP el participante? cannot be blank.\" data-invmsg=\"\u00bfTiene IEP o IPP el participante? is invalid\"   \/> Ninguno<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_486_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_dxvt72\" class=\"frm_primary_label\">Por favor indique si toma algunos medicamentos que puedan afectar su participaci\u00f3n. Si el participante ocupa tomar medicamentos durante los programas o actividades, por favor indique la dosis y la hora en la que debe tomarla.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[486]\" id=\"field_dxvt72\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"Por favor indique si toma algunos medicamentos que puedan afectar su participaci\u00f3n. Si el participante ocupa tomar medicamentos durante los programas o actividades, por favor indique la dosis y la hora en la que debe tomarla. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_487_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_fa16b2\" class=\"frm_primary_label\">Por favor indique si parece de alguna condici\u00f3n m\u00e9dica (diabetes, convulsiones, asma, alergias) que puede afectar su participaci\u00f3n.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[487]\" id=\"field_fa16b2\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"Por favor indique si parece de alguna condici\u00f3n m\u00e9dica (diabetes, convulsiones, asma, alergias) que puede afectar su participaci\u00f3n. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_488_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_s55q2\" class=\"frm_primary_label\">\u00bfEl participante tiene restricciones diet\u00e9ticas? Por favor explique.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[488]\" id=\"field_s55q2\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfEl participante tiene restricciones diet\u00e9ticas? Por favor explique. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_489_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_ptlim2\" class=\"frm_primary_label\">Cu\u00e1l es el primer m\u00e9todo de comunicaci\u00f3n del participante (verbal, tablero de comunicaci\u00f3n, gestos f\u00edsicos, lenguaje de se\u00f1as)?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[489]\" id=\"field_ptlim2\" rows=\"5\"  data-sectionid=\"448\"  data-reqmsg=\"Cu\u00e1l es el primer m\u00e9todo de comunicaci\u00f3n del participante (verbal, tablero de comunicaci\u00f3n, gestos f\u00edsicos, lenguaje de se\u00f1as)? cannot be blank.\" aria-required=\"true\" data-invmsg=\"Cu\u00e1l es el primer m\u00e9todo de comunicaci\u00f3n del participante (verbal, tablero de comunicaci\u00f3n, gestos f\u00edsicos, lenguaje de se\u00f1as)? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_490_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_cldzo2\" class=\"frm_primary_label\">Utiliza el participante equipos adaptivos para otros prop\u00f3sitos que no sean de ambulaci\u00f3n. Por favor explique.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[490]\" id=\"field_cldzo2\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"Utiliza el participante equipos adaptivos para otros prop\u00f3sitos que no sean de ambulaci\u00f3n. Por favor explique. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_491_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio frm_other_container\">\r\n    <label  class=\"frm_primary_label\">Dispositivos de ayuda para la ambulaci\u00f3n\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_491-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[491][]\" id=\"field_tfjxb2-0\" value=\"Ninguno\"  data-sectionid=\"448\"  data-invmsg=\"Dispositivos de ayuda para la ambulaci\u00f3n is invalid\"   \/> Ninguno<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_491-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[491][]\" id=\"field_tfjxb2-1\" value=\"Silla de ruedas manual\"  data-sectionid=\"448\"  data-invmsg=\"Dispositivos de ayuda para la ambulaci\u00f3n is invalid\"   \/> Silla de ruedas manual<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_491-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[491][]\" id=\"field_tfjxb2-2\" value=\"Silla de ruedas motorizada\"  data-sectionid=\"448\"  data-invmsg=\"Dispositivos de ayuda para la ambulaci\u00f3n is invalid\"   \/> Silla de ruedas motorizada<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_491-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[491][]\" id=\"field_tfjxb2-3\" value=\"Caminante\"  data-sectionid=\"448\"  data-invmsg=\"Dispositivos de ayuda para la ambulaci\u00f3n is invalid\"   \/> Caminante<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_491-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[491][]\" id=\"field_tfjxb2-4\" value=\"Muletas\"  data-sectionid=\"448\"  data-invmsg=\"Dispositivos de ayuda para la ambulaci\u00f3n is invalid\"   \/> Muletas<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_491-448-other_5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[491][other_5]\" id=\"field_tfjxb2-other_5\" value=\"Otro\"  data-sectionid=\"448\"  data-invmsg=\"Dispositivos de ayuda para la ambulaci\u00f3n is invalid\"   \/> Otro<\/label><label for=\"field_tfjxb2-other_5-otext\" class=\"frm_screen_reader frm_hidden\">Otro<\/label><input type=\"text\" id=\"field_tfjxb2-other_5-otext\" class=\"frm_other_input frm_pos_none\" name=\"item_meta[other][491][other_5]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_492_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Duraci\u00f3n de ambulaci\u00f3n\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_492-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[492][]\" id=\"field_clmac2-0\" value=\"Se moviliza de forma independiente por distancias extendidas)\"  data-sectionid=\"448\"  data-invmsg=\"Duraci\u00f3n de ambulaci\u00f3n is invalid\"   \/> Se moviliza de forma independiente por distancias extendidas)<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_492-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[492][]\" id=\"field_clmac2-1\" value=\"Requiere asistencia f\u00edsica o pausas cuando viaja de 0-50 yardas\"  data-sectionid=\"448\"  data-invmsg=\"Duraci\u00f3n de ambulaci\u00f3n is invalid\"   \/> Requiere asistencia f\u00edsica o pausas cuando viaja de 0-50 yardas<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_492-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[492][]\" id=\"field_clmac2-2\" value=\"Requiere asistencia f\u00edsica o pausas cuando viaja de 50-100 yardas\"  data-sectionid=\"448\"  data-invmsg=\"Duraci\u00f3n de ambulaci\u00f3n is invalid\"   \/> Requiere asistencia f\u00edsica o pausas cuando viaja de 50-100 yardas<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_492-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[492][]\" id=\"field_clmac2-3\" value=\"Requiere asistencia f\u00edsica o pausas cuando viaja m\u00e1s de 100 yardas\"  data-sectionid=\"448\"  data-invmsg=\"Duraci\u00f3n de ambulaci\u00f3n is invalid\"   \/> Requiere asistencia f\u00edsica o pausas cuando viaja m\u00e1s de 100 yardas<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_493_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Actividad F\u00edsica\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_493-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[493][]\" id=\"field_u38rh2-0\" value=\"Participa en actividad f\u00edsica de forma independiente\"  data-sectionid=\"448\"  data-invmsg=\"Actividad F\u00edsica is invalid\"   \/> Participa en actividad f\u00edsica de forma independiente<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_493-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[493][]\" id=\"field_u38rh2-1\" value=\"Participa en actividad f\u00edsica con asistencia\"  data-sectionid=\"448\"  data-invmsg=\"Actividad F\u00edsica is invalid\"   \/> Participa en actividad f\u00edsica con asistencia<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_493-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[493][]\" id=\"field_u38rh2-2\" value=\"Requiere pausas frecuentes cuando participa en actividad f\u00edsica\"  data-sectionid=\"448\"  data-invmsg=\"Actividad F\u00edsica is invalid\"   \/> Requiere pausas frecuentes cuando participa en actividad f\u00edsica<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_493-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[493][]\" id=\"field_u38rh2-3\" value=\"No participa en actividad f\u00edsica\"  data-sectionid=\"448\"  data-invmsg=\"Actividad F\u00edsica is invalid\"   \/> No participa en actividad f\u00edsica<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_494_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Comer\/Tomar\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_494-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[494][]\" id=\"field_1i6yy2-0\" value=\"Come\/Toma de forma independiente\"  data-sectionid=\"448\"  data-invmsg=\"Comer\/Tomar is invalid\"   \/> Come\/Toma de forma independiente<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_494-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[494][]\" id=\"field_1i6yy2-1\" value=\"Come\/Toma con asistencia\"  data-sectionid=\"448\"  data-invmsg=\"Comer\/Tomar is invalid\"   \/> Come\/Toma con asistencia<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_494-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[494][]\" id=\"field_1i6yy2-2\" value=\"Come\/Toma con total asistencia\"  data-sectionid=\"448\"  data-invmsg=\"Comer\/Tomar is invalid\"   \/> Come\/Toma con total asistencia<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_494-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[494][]\" id=\"field_1i6yy2-3\" value=\"Necesita asistencia para abrir los envases\"  data-sectionid=\"448\"  data-invmsg=\"Comer\/Tomar is invalid\"   \/> Necesita asistencia para abrir los envases<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_495_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Vestir\/Desvestir (si participa en un programa que requiere cambiarse de ropa) No aplica\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_495-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[495][]\" id=\"field_pnvde2-0\" value=\"Se viste y desviste de forma independiente\"  data-sectionid=\"448\"  data-invmsg=\"Vestir\/Desvestir (si participa en un programa que requiere cambiarse de ropa) No aplica is invalid\"   \/> Se viste y desviste de forma independiente<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_495-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[495][]\" id=\"field_pnvde2-1\" value=\"Necesita asistencia con botones y zipper\"  data-sectionid=\"448\"  data-invmsg=\"Vestir\/Desvestir (si participa en un programa que requiere cambiarse de ropa) No aplica is invalid\"   \/> Necesita asistencia con botones y zipper<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_495-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[495][]\" id=\"field_pnvde2-2\" value=\"Necesita ayuda para cambiar camisa\"  data-sectionid=\"448\"  data-invmsg=\"Vestir\/Desvestir (si participa en un programa que requiere cambiarse de ropa) No aplica is invalid\"   \/> Necesita ayuda para cambiar camisa<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_495-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[495][]\" id=\"field_pnvde2-3\" value=\"Necesita ayuda para cambiar pantal\u00f3n\"  data-sectionid=\"448\"  data-invmsg=\"Vestir\/Desvestir (si participa en un programa que requiere cambiarse de ropa) No aplica is invalid\"   \/> Necesita ayuda para cambiar pantal\u00f3n<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_495-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[495][]\" id=\"field_pnvde2-4\" value=\"Necesita ayuda para cambiar traje de ba\u00f1o \"  data-sectionid=\"448\"  data-invmsg=\"Vestir\/Desvestir (si participa en un programa que requiere cambiarse de ropa) No aplica is invalid\"   \/> Necesita ayuda para cambiar traje de ba\u00f1o <\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_496_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Uso del ba\u00f1o\/inodoro\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_496-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[496][]\" id=\"field_1ehia2-0\" value=\"El personal de la ciudad no brinda asistencia f\u00edsica para usar el ba\u00f1o\"  data-sectionid=\"448\"  data-invmsg=\"Uso del ba\u00f1o\/inodoro is invalid\" aria-describedby=\"frm_desc_field_1ehia2\"   \/> El personal de la ciudad no brinda asistencia f\u00edsica para usar el ba\u00f1o<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_496-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[496][]\" id=\"field_1ehia2-1\" value=\"Usa el ba\u00f1o de forma independiente \"  data-sectionid=\"448\"  data-invmsg=\"Uso del ba\u00f1o\/inodoro is invalid\" aria-describedby=\"frm_desc_field_1ehia2\"   \/> Usa el ba\u00f1o de forma independiente <\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_496-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[496][]\" id=\"field_1ehia2-2\" value=\"Usa calzoncillos\"  data-sectionid=\"448\"  data-invmsg=\"Uso del ba\u00f1o\/inodoro is invalid\" aria-describedby=\"frm_desc_field_1ehia2\"   \/> Usa calzoncillos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_496-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[496][]\" id=\"field_1ehia2-3\" value=\"Necesita se\u00f1as verbales para usar el ba\u00f1o\"  data-sectionid=\"448\"  data-invmsg=\"Uso del ba\u00f1o\/inodoro is invalid\" aria-describedby=\"frm_desc_field_1ehia2\"   \/> Necesita se\u00f1as verbales para usar el ba\u00f1o<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_496-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[496][]\" id=\"field_1ehia2-4\" value=\"Necesita asistencia f\u00edsica para usar el ba\u00f1o\"  data-sectionid=\"448\"  data-invmsg=\"Uso del ba\u00f1o\/inodoro is invalid\" aria-describedby=\"frm_desc_field_1ehia2\"   \/> Necesita asistencia f\u00edsica para usar el ba\u00f1o<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_496-448-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[496][]\" id=\"field_1ehia2-5\" value=\"Necesita se\u00f1as verbales para lavarse las manos\"  data-sectionid=\"448\"  data-invmsg=\"Uso del ba\u00f1o\/inodoro is invalid\" aria-describedby=\"frm_desc_field_1ehia2\"   \/> Necesita se\u00f1as verbales para lavarse las manos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_496-448-6\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[496][]\" id=\"field_1ehia2-6\" value=\"Necesita asistencia f\u00edsica para lavarse las manos\"  data-sectionid=\"448\"  data-invmsg=\"Uso del ba\u00f1o\/inodoro is invalid\" aria-describedby=\"frm_desc_field_1ehia2\"   \/> Necesita asistencia f\u00edsica para lavarse las manos<\/label><\/div>\n<\/div>\r\n    <div id=\"frm_desc_field_1ehia2\" class=\"frm_description\">*City staff does not provide physical assistance with using the toilet<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_497_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_wyst02\" class=\"frm_primary_label\">\u00bfC\u00f3mo describir\u00eda la personalidad del paciente? (i.e. amable,  extrovertida(o), calmada(o), t\u00edmida(o), etc.)\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[497]\" id=\"field_wyst02\" rows=\"5\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfC\u00f3mo describir\u00eda la personalidad del paciente? (i.e. amable,  extrovertida(o), calmada(o), t\u00edmida(o), etc.) cannot be blank.\" aria-required=\"true\" data-invmsg=\"\u00bfC\u00f3mo describir\u00eda la personalidad del paciente? (i.e. amable,  extrovertida(o), calmada(o), t\u00edmida(o), etc.) is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_498_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_dixz42\" class=\"frm_primary_label\">\u00bfCu\u00e1les son los puntos fuertes del participante?\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[498]\" id=\"field_dixz42\" rows=\"5\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfCu\u00e1les son los puntos fuertes del participante? cannot be blank.\" aria-required=\"true\" data-invmsg=\"\u00bfCu\u00e1les son los puntos fuertes del participante? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_499_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_y6aax2\" class=\"frm_primary_label\">\u00bfCu\u00e1les son las actividades favoritas del participante? (Actividades interiores o exteriores)\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[499]\" id=\"field_y6aax2\" rows=\"5\"  data-sectionid=\"448\"  data-reqmsg=\"\u00bfCu\u00e1les son las actividades favoritas del participante? (Actividades interiores o exteriores) cannot be blank.\" aria-required=\"true\" data-invmsg=\"\u00bfCu\u00e1les son las actividades favoritas del participante? (Actividades interiores o exteriores) is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_500_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Seguir Instrucciones\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_500-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[500][]\" id=\"field_h2nvv2-0\" value=\"Entiende y sigue claramente las instrucciones\"  data-sectionid=\"448\"  data-invmsg=\"Seguir Instrucciones is invalid\" aria-describedby=\"frm_desc_field_h2nvv2\"   \/> Entiende y sigue claramente las instrucciones<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_500-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[500][]\" id=\"field_h2nvv2-1\" value=\"Entiende y sigue de 1-2 instrucciones\"  data-sectionid=\"448\"  data-invmsg=\"Seguir Instrucciones is invalid\" aria-describedby=\"frm_desc_field_h2nvv2\"   \/> Entiende y sigue de 1-2 instrucciones<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_500-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[500][]\" id=\"field_h2nvv2-2\" value=\"Entiende y sigue de 3-4 instrucciones \"  data-sectionid=\"448\"  data-invmsg=\"Seguir Instrucciones is invalid\" aria-describedby=\"frm_desc_field_h2nvv2\"   \/> Entiende y sigue de 3-4 instrucciones <\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_500-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[500][]\" id=\"field_h2nvv2-3\" value=\"Necesita indicaciones pare seguir instrucciones\"  data-sectionid=\"448\"  data-invmsg=\"Seguir Instrucciones is invalid\" aria-describedby=\"frm_desc_field_h2nvv2\"   \/> Necesita indicaciones pare seguir instrucciones<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_500-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[500][]\" id=\"field_h2nvv2-4\" value=\"Necesita se\u00f1as visuales para entender y seguir instrucciones\"  data-sectionid=\"448\"  data-invmsg=\"Seguir Instrucciones is invalid\" aria-describedby=\"frm_desc_field_h2nvv2\"   \/> Necesita se\u00f1as visuales para entender y seguir instrucciones<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_500-448-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[500][]\" id=\"field_h2nvv2-5\" value=\"Necesita ayuda practica para entender y seguir instrucciones\"  data-sectionid=\"448\"  data-invmsg=\"Seguir Instrucciones is invalid\" aria-describedby=\"frm_desc_field_h2nvv2\"   \/> Necesita ayuda practica para entender y seguir instrucciones<\/label><\/div>\n<\/div>\r\n    <div id=\"frm_desc_field_h2nvv2\" class=\"frm_description\">(Check all that apply)<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_501_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad de preferencia?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_501-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[501][]\" id=\"field_53zql2-0\" value=\"0-10 minutos\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad de preferencia? is invalid\"   \/> 0-10 minutos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_501-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[501][]\" id=\"field_53zql2-1\" value=\"10-20 minutos\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad de preferencia? is invalid\"   \/> 10-20 minutos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_501-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[501][]\" id=\"field_53zql2-2\" value=\"20-30 minutos\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad de preferencia? is invalid\"   \/> 20-30 minutos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_501-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[501][]\" id=\"field_53zql2-3\" value=\"30-45 minutos\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad de preferencia? is invalid\"   \/> 30-45 minutos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_501-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[501][]\" id=\"field_53zql2-4\" value=\"45-60 minutos\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad de preferencia? is invalid\"   \/> 45-60 minutos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_501-448-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[501][]\" id=\"field_53zql2-5\" value=\"M\u00e1s de una hora\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad de preferencia? is invalid\"   \/> M\u00e1s de una hora<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_502_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad que no es de su preferencia?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_502-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[502][]\" id=\"field_7r7bo2-0\" value=\"0-10 minutos\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad que no es de su preferencia? is invalid\"   \/> 0-10 minutos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_502-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[502][]\" id=\"field_7r7bo2-1\" value=\"10-20 minutos\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad que no es de su preferencia? is invalid\"   \/> 10-20 minutos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_502-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[502][]\" id=\"field_7r7bo2-2\" value=\"20-30 minutos\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad que no es de su preferencia? is invalid\"   \/> 20-30 minutos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_502-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[502][]\" id=\"field_7r7bo2-3\" value=\"30-45 minutos\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad que no es de su preferencia? is invalid\"   \/> 30-45 minutos<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_502-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[502][]\" id=\"field_7r7bo2-4\" value=\"M\u00e1s de una hora\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfCu\u00e1l es su lapso de atenci\u00f3n cuando participa en una actividad que no es de su preferencia? is invalid\"   \/> M\u00e1s de una hora<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_503_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Habilidades Sociales\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_503-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[503][]\" id=\"field_ab5n72-0\" value=\"Demuestra conciencia de los dem\u00e1s\"  data-sectionid=\"448\"  data-invmsg=\"Habilidades Sociales is invalid\" aria-describedby=\"frm_desc_field_ab5n72\"   \/> Demuestra conciencia de los dem\u00e1s<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_503-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[503][]\" id=\"field_ab5n72-1\" value=\"Inicia interacciones con otros\"  data-sectionid=\"448\"  data-invmsg=\"Habilidades Sociales is invalid\" aria-describedby=\"frm_desc_field_ab5n72\"   \/> Inicia interacciones con otros<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_503-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[503][]\" id=\"field_ab5n72-2\" value=\"Responde a interacciones con otros\"  data-sectionid=\"448\"  data-invmsg=\"Habilidades Sociales is invalid\" aria-describedby=\"frm_desc_field_ab5n72\"   \/> Responde a interacciones con otros<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_503-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[503][]\" id=\"field_ab5n72-3\" value=\"Interact\u00faa inapropiadamente con otros\"  data-sectionid=\"448\"  data-invmsg=\"Habilidades Sociales is invalid\" aria-describedby=\"frm_desc_field_ab5n72\"   \/> Interact\u00faa inapropiadamente con otros<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_503-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[503][]\" id=\"field_ab5n72-4\" value=\"Conoce el espacio personal y mantiene las distancias apropiadas\"  data-sectionid=\"448\"  data-invmsg=\"Habilidades Sociales is invalid\" aria-describedby=\"frm_desc_field_ab5n72\"   \/> Conoce el espacio personal y mantiene las distancias apropiadas<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_503-448-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[503][]\" id=\"field_ab5n72-5\" value=\"Prefiere estar acompa\u00f1ada(o)\"  data-sectionid=\"448\"  data-invmsg=\"Habilidades Sociales is invalid\" aria-describedby=\"frm_desc_field_ab5n72\"   \/> Prefiere estar acompa\u00f1ada(o)<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_503-448-6\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[503][]\" id=\"field_ab5n72-6\" value=\"Prefiere mantenerse sola(o)\"  data-sectionid=\"448\"  data-invmsg=\"Habilidades Sociales is invalid\" aria-describedby=\"frm_desc_field_ab5n72\"   \/> Prefiere mantenerse sola(o)<\/label><\/div>\n<\/div>\r\n    <div id=\"frm_desc_field_ab5n72\" class=\"frm_description\">(Check all that apply)<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_504_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio frm_other_container\">\r\n    <label  class=\"frm_primary_label\">Supervisi\u00f3n (La mayor\u00eda de los programas y actividades utilizan una proporci\u00f3n de 1:10 para determinar la participaci\u00f3n de personal)\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_504-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[504][]\" id=\"field_jq4yv2-0\" value=\"No se requiere supervisi\u00f3n adicional \"  data-sectionid=\"448\"  data-invmsg=\"Supervisi\u00f3n (La mayor\u00eda de los programas y actividades utilizan una proporci\u00f3n de 1:10 para determinar la participaci\u00f3n de personal) is invalid\"   \/> No se requiere supervisi\u00f3n adicional <\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_504-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[504][]\" id=\"field_jq4yv2-1\" value=\"Se requiere un poco de supervisi\u00f3n adicional \"  data-sectionid=\"448\"  data-invmsg=\"Supervisi\u00f3n (La mayor\u00eda de los programas y actividades utilizan una proporci\u00f3n de 1:10 para determinar la participaci\u00f3n de personal) is invalid\"   \/> Se requiere un poco de supervisi\u00f3n adicional <\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_504-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[504][]\" id=\"field_jq4yv2-2\" value=\"Se requiere constante supervisi\u00f3n adicional \"  data-sectionid=\"448\"  data-invmsg=\"Supervisi\u00f3n (La mayor\u00eda de los programas y actividades utilizan una proporci\u00f3n de 1:10 para determinar la participaci\u00f3n de personal) is invalid\"   \/> Se requiere constante supervisi\u00f3n adicional <\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_504-448-other_3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[504][other_3]\" id=\"field_jq4yv2-other_3\" value=\"Other\"  data-sectionid=\"448\"  data-invmsg=\"Supervisi\u00f3n (La mayor\u00eda de los programas y actividades utilizan una proporci\u00f3n de 1:10 para determinar la participaci\u00f3n de personal) is invalid\"   \/> Other<\/label><label for=\"field_jq4yv2-other_3-otext\" class=\"frm_screen_reader frm_hidden\">Other<\/label><input type=\"text\" id=\"field_jq4yv2-other_3-otext\" class=\"frm_other_input frm_pos_none\" name=\"item_meta[other][504][other_3]\" value=\"\" \/><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_505_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_6yemv2\" class=\"frm_primary_label\">Que t\u00e9cnicas funcionan mejor para motivar, redirigir, y \/ o mantener la participaci\u00f3n del participante en las actividades?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[505]\" id=\"field_6yemv2\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"Que t\u00e9cnicas funcionan mejor para motivar, redirigir, y \/ o mantener la participaci\u00f3n del participante en las actividades? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_506_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_6i0nc2\" class=\"frm_primary_label\">Que t\u00e9cnicas funcionan mejor para facilitar las transiciones y \/ o cambios en la rutina?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[506]\" id=\"field_6i0nc2\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"Que t\u00e9cnicas funcionan mejor para facilitar las transiciones y \/ o cambios en la rutina? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_507_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_kcx9l2\" class=\"frm_primary_label\">\u00bfQue causa que el participante se altere o se estimule demasiado (es decir, ruidos fuertes, contacto, perder un juego)?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[507]\" id=\"field_kcx9l2\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfQue causa que el participante se altere o se estimule demasiado (es decir, ruidos fuertes, contacto, perder un juego)? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_508_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o)\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-0\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-0\" value=\"Ninguno\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Ninguno<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-1\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-1\" value=\"Se auto estimula\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Se auto estimula<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-2\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-2\" value=\"Llora\/Grita\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Llora\/Grita<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-3\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-3\" value=\"Se enfada\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Se enfada<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-4\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-4\" value=\"Se frustra\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Se frustra<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-5\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-5\" value=\"Discute\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Discute<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-6\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-6\" value=\"Es desafiante\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Es desafiante<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-7\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-7\" value=\"Se apaga, no responde, se retira\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Se apaga, no responde, se retira<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-8\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-8\" value=\"Destruye o tira cosas\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Destruye o tira cosas<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-10\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-10\" value=\"Golpea, tira pu\u00f1etazos, Tira patadas, Muerde, Rasgu\u00f1a, Pellizca, Tira saliva\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Golpea, tira pu\u00f1etazos, Tira patadas, Muerde, Rasgu\u00f1a, Pellizca, Tira saliva<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-11\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-11\" value=\"Hace da\u00f1o a si mismo\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Hace da\u00f1o a si mismo<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_508-448-12\">\t\t\t<label >\n\t\t\t<input type=\"checkbox\" name=\"item_meta[508][]\" id=\"field_qqpns2-12\" value=\"Hay riesgo que huya\"  data-sectionid=\"448\"  data-invmsg=\"Qu\u00e9 tipo de comportamiento demuestra el participante cuando esta alterado o sobre estimulada(o) is invalid\"   \/> Hay riesgo que huya<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_509_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_a2mgz2\" class=\"frm_primary_label\">\u00bfEl participante demuestra comportamientos comunes el cual personal deber\u00eda saber?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[509]\" id=\"field_a2mgz2\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"\u00bfEl participante demuestra comportamientos comunes el cual personal deber\u00eda saber? is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_510_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_d19o52\" class=\"frm_primary_label\">Cu\u00e1l es la medida m\u00e1s efectiva cuando un participante se molesta o se sobre estimula (tiempo en silencio, hablar calmadamente, o ausentarse del \u00e1rea de actividad)\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[510]\" id=\"field_d19o52\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"Cu\u00e1l es la medida m\u00e1s efectiva cuando un participante se molesta o se sobre estimula (tiempo en silencio, hablar calmadamente, o ausentarse del \u00e1rea de actividad) is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_511_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_juqhe2\" class=\"frm_primary_label\">Por favor comparta cualquier otra informaci\u00f3n que usted cree que sea importante saber sobre el participante.\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[511]\" id=\"field_juqhe2\" rows=\"5\"  data-sectionid=\"448\"  data-invmsg=\"Por favor comparta cualquier otra informaci\u00f3n que usted cree que sea importante saber sobre el participante. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_767_container\" class=\"frm_form_field form-field  frm_none_container mt-3\"><div  id=\"field_9gkg5\" class=\"frm-cf-turnstile\" data-sitekey=\"0x4AAAAAAB_HL2zd2-s-LYbv\" data-language=\"en-US\" data-size=\"normal\" data-theme=\"light\"><\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_766_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_793_container\">\n\t\t\t<label for=\"field_s4ak6\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_s4ak6\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[793]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"iFtBTJtgbONr57qGwbVO+2ntRu38AzXLebXBKtsXi\/wDll3Y6gibeb79k69xt4m+\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_2\" name=\"ak_js\" value=\"40\"\/><script>\ndocument.getElementById( \"ak_js_2\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><\/form>\n<\/div>\n[\/vc_column_text][\/vc_tta_section][vc_tta_section title=\"Adult Adaptive Recreation\" tab_id=\"adult-adaptive-recreation\"][vc_column_text]<\/p>\n<h4 class=\"card-header-primary\">Adult Adaptive Recreation<\/h4>\n<p>Adult adaptive recreation classes and excursions offer adults with intellectual and developmental disabilities the opportunity to develop social skills, interact with peers, discover talents and interests, and explore the local community.<\/p>\n<p>For more information about current offerings, check out the Adaptive Recreation information in the Adult section of the\u00a0<a href=\"https:\/\/www.cityofpasadena.net\/humanservices\/recreation-guide\/\">City of Pasadena Recreation Guide<\/a>.<\/p>\n<p><strong><u>Classes<\/u><\/strong><\/p>\n<p><u>Interact<\/u><\/p>\n<p><em>Saturdays, 10:00-11:30 AM @ Victory Park<\/em><\/p>\n<p>Join us for arts and crafts, games, and music for adults with disabilities. The purpose of this program is to encourage peer relationships, increase self-esteem and further independence through recreational activities.<\/p>\n<p><u>Pioneer<\/u><\/p>\n<p><em>Tuesdays, 6:00-8:00 PM @ Victory Park<\/em><\/p>\n<p>Are you a planner who loves new experiences? This class offers adults with disabilities the opportunity to plan and implement various recreational projects, trips, and activities for themselves. Fees for specific trips and activities may be required in addition to the class registration fee.<\/p>\n<p><u>Adaptive Art<\/u><\/p>\n<p><em>Wednesdays 6:00-7:30 PM @ Victory Park<\/em><\/p>\n<p>Express yourself! This class provides opportunities for adults with disabilities to express themselves through art. Instructors include an experienced art specialist and an instructor assistant. Participants will explore their artistic skills through drawing and writing. Materials and supplies are included in the fee.<\/p>\n<p><strong><u>Excursions<\/u><\/strong><\/p>\n<p>Excursions provide exciting opportunities to explore the local community by attending events and visiting attractions throughout the year. Previous excursions have included the Mayor\u2019s Annual Holiday Tree Lighting, Black History Festival, and Parks After Dark.<\/p>\n<p>Excursions are typically 2-4 hours in duration and take place within the geographic area that Dial-A-Ride operates. Transportation is arranged on behalf of participants who take Dial-A-Ride, so long as registration is received by the deadline. The staff to participant ratio ranges from 1:6 to 1:10, depending on the nature of the excursion.<\/p>\n<p>More information about upcoming excursions is available in the Adaptive Recreation portion of the Adult section of the\u00a0<a href=\"https:\/\/www.cityofpasadena.net\/humanservices\/recreation-guide\/\">City of Pasadena Recreation Guide<\/a>.[\/vc_column_text][\/vc_tta_section][\/vc_tta_tabs][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column width=\"1\/3\"][vc_column_text][\/vc_column_text][\/vc_column][vc_column width=\"2\/3\"][vc_tta_tabs style=\"outline\" color=\"sky\" spacing=\"10\" gap=\"10\" alignment=\"center\" active_section=\"1\"][vc_tta_section title=\"Inclusion Services\" tab_id=\"inclusion-services\"][vc_column_text] Inclusion Services [\/vc_column_text][\/vc_tta_section][vc_tta_section title=\"Servicios de Inclusi\u00f3n\" tab_id=\"servicios-de-inclusi\u00f3n\"][vc_column_text] Servicios de Inclusi\u00f3n [\/vc_column_text][\/vc_tta_section][vc_tta_section title=\"Adult Adaptive Recreation\" tab_id=\"adult-adaptive-recreation\"][vc_column_text] Adult Adaptive Recreation [&hellip;]<\/p>\n","protected":false},"author":17,"featured_media":0,"parent":0,"menu_order":7,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"class_list":["post-45","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-json\/wp\/v2\/pages\/45","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-json\/wp\/v2\/comments?post=45"}],"version-history":[{"count":1,"href":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-json\/wp\/v2\/pages\/45\/revisions"}],"predecessor-version":[{"id":14676,"href":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-json\/wp\/v2\/pages\/45\/revisions\/14676"}],"wp:attachment":[{"href":"https:\/\/www.cityofpasadena.net\/parks-and-rec\/wp-json\/wp\/v2\/media?parent=45"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}