SPECIALIZED RECREATION RESPITE REGISTRATION

Participant First Name *

Participant Last Name *

Phone Number *

Primary Email Address *

Thurston County Specialized Recreation is contracted to accept Developmental Disabilities Administration (DDA) Respite Funds.

I have checked with my Case Resource Manager and have funds to use for activity registration

*

Yes

No

Check all that apply:
December 2024

Check all that apply:
January 2025

Check all that apply:
February 2025

Check all that apply:
March 2025