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2. Title II Compliance

   In accordance with the requirements of Title II of the Americans with Disabilities Act (“ADA”) of 1990, the Fair Employment & Housing Act (“FEHA”), the Rehabilitation Act of 1973 (as amended), Government Code section 11135 and other applicable codes, the City of Modesto (“City”) will not discriminate against individuals on the basis of disability in the City’s services, programs, or activities. For more information, please visit the City of Modesto website.

4. First Name*
5. Last Name*
7. Phone Number*
8. Email Address*
10. Street Address*
12. City*
13. State*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
14. Zip Code*
16. Number of Adults Volunteering*
17. Number of Minors Volunteering*
19. Age Requirements*

    1. I am over 18 years old
    2. I am under 18 years old
20. Age Requirement Note
    If under the age of 16, you must be accompanied by an adult or legal guardian.
22. Select one

    1. Yes, I am participating with a Service Group.
    2. No, I am not participating with a Service Group
23. If so, what service group are you with?
25. Which holiday event would you like to volunteer at?*
    -- Select One --Celebration of Lights Holiday Parade- Saturday, December 2Spirit of Giving 5K Fun Run- Saturday December 9I would like to volunteer at both holiday events

    Choose an option.

27. Parade Volunteer Time Preference *

    This event has two shifts available. What time would you like to volunteer for this event?

    1. 2PM - 8PM
    2. 4PM - 8PM
29. Spirit of Giving 5K Run Volunteer Time *

    1. I agree to volunteer from 7:00 AM until 11:00 AM - If you are registering after 12:00PM. You may not receive a confirmation email, but you are welcome to join us. Check-in begins at 6:45 AM
    2. I don't agree
31. Contact

    For more information please contact Shane Silva at 209-577-5346 or ssilva@modestogov.com

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33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field