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Special Needs

Gulfarium Marine Adventure Park makes every effort to make your visit a memorable one.  If you or a family member has any special needs, please fill out this form so that we can provide assistance.

This questionnaire asks specific questions regarding the program participant’s physical and behavioral abilities.  Filling this out completely and honestly will help us to best assess our ability to satisfy your request.  In some cases, we may not be able to accommodate the desired encounter.  We apologize in advance for any inconvenience.


Participant First Name*
Participant Last Name*
Participant Age*
(if under 18)
Participant Phone
Participant Email*
Contact information for family member/attendant
Attendent Name
Attendent Phone
Attendent Email
Attendent Relationship To Participant
Encounter Program(s) Of Interest:
Date Range Of Visit
From
To
Does the participant use a wheelchair?
Does the participant have use of their upper body?
Does the participant have use of their lower body?
Does the participant follow spoken instruction readily?
Does the participant have control of their bodily functions (fecal/bladder)?
Does the participant experience spasm and or other muscular impulse behavior?
Does this participant see well?
Does the participant hear well?
Will the participant need an aide with them during the encounter?
Note: Aide must be a friend/family member of the participant, not a member of the Gulfarium staff. Aide is considered a program participant.
If so, who will that be?
Does the participant require equipment to travel with them?
(breathing apparatus, walker, etc)
Is the participant comfortable around large animals?
Is the participant comfortable around water?
Is the participant comfortable wearing a wetsuit and lifejacket?
(certain programs only)
Is there any additional information that can be provided?