ADA Accessibility Grievance Form

If you prefer to complete the form and mail it to us, you may

First Name*:

Last Name*:

Address*:

City*:

State*:

Zip*:

Phone*:

Email:

Is it okay to contact you via email?*:

Yes No

Please provide a complete description of your grievance.*:

Did you notify park staff or other CCPRC employee of your grievance?*:

Yes No

If yes, were they responsive to your needs?:

Yes No

Please state what you think should be done to resolve the grievance:

Please attach additional documentation if necessary.:

I agree to the Privacy Policy*:

Yes No

* Indicates a required field.

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