Heart of Illinois Special Recreation Association FALL 2013 PROGRAMS Like us on Facebook. Just use your smartphone to click on this qr code.
REGISTRATION OPENS 8/26/13 No registrations will be processed until then.
Welcome!
Heart of Illinois Special Recreation Association (HISRA)
A cooperative extension of the Chillicothe, Morton, Peoria, and Washington Park Districts 8727 N. Pioneer Rd. • Peoria, IL 61615 • 309-691-1929 hisra@peoriaparks.org HISRA is the result of a desire on the part of your park district to provide quality recreation programs and services to individuals with disabilities and special needs. HISRA and its member districts enthusiastically support the spirit and intent of the Americans With Disabilities Act. HISRA is committed to providing opportunities for each individual to enjoy recreation activities in the least restrictive environment possible.
HISRA BOARD OF TRUSTEES
The Board meets at HISRA on the third Wednesday of the month at 5:15 p.m. Meetings are open to the public. Dick Howarth....................................... Chillicothe Kevin Yates............................................ Chillicothe Gary Watson......................................... Morton Tate Kaiser............................................. Morton Tim Cassidy........................................... Peoria Jim Hancock......................................... Peoria Doug Damery...................................... Washington Lorelei Cox............................................ Washington
HISRA VOLUNTEERS
Volunteers are special people who share their time, knowledge, and spirit with HISRA participants. HISRA would like to thank those volunteers who have devoted their time and energy to the success of our programs. If you would like to join our volunteer staff, please contact us. We’ll put your skills to great use!
ATLANTO-AXIAL SUBLUXATION
Individuals with Downs Syndrome are at risk of having a condition known as Atlanto-Axial Subluxation. HISRA must have a doctor’s written note on file stating a participant is free of the instability if he/she wishes to participate in programs that may cause undue stress upon the neck. Please take this into consideration when registering and inform staff if the condition is present.
Your HISRA Staff: Katie Hogan Van Cleve............................................. Executive Director Sarah Payne............................................................ Program Coordinator Jennifer Wahl.......................................................... Program Coordinator Corinne Wolffe....................................................... Program Coordinator Megan McCance........................................................ Program Specialist
HISRA FREQUENTLY USED PROGRAM LOCATIONS • Freedom Hall (Morton) 349 W. Birchwood, 263-7429 • Landmark Lanes (Peoria) 3225 N. Dries Lane, 686-9168 • RiverPlex (Peoria) 600 NE Water St., 282-1700 • Golf Learning Center & Academy (Peoria) 7815 N. Radnor Road • 690-7162 • Kellogg Golf Course (Peoria) 7716 N. Radnor Road • 691-0293 • Shore Acres (Chillicothe) 100 Park Blvd., 274-3409 • Willow Knolls 14 Theatre (Peoria) 4100 W. Willow Knolls Dr, 689-8463 • Landmark Cinemas (Peoria) 3225 N. Dries Ln, 682-6356 • Morton Recreation Center (Morton) 324 Detroit Street, 263-7429 • Plaza Lanes (Washington) 1500 Washington Road, 444-3059 • EastSide Center (East Peoria) 1 EastSide Drive, 698-5437 • Christian Center (Peoria) 4100 N. Brandywine Drive, 685-4218 • Franciscan Recreation Complex (W. Peoria) 908 N. Sterling Ave, 677*6705
2 – Fall 2013
– INCLUSION SERVICES –
Equal Fun ... for Everyone!
Attention residents of Peoria, Morton, Chillicothe, and Washington Park Districts: Have you seen any programs your park district offers that may be of interest to you or your child with special needs, but wondered if they could participate? Well, stop wondering and call HISRA at 691-1929! Upon reviewing the participant’s needs, HISRA’s professional staff will work to integrate participants, adapt activities, and provide additional support if appropriate so that it can be a successful inclusive setting. If you are an adult in Peoria, Morton, Chillicothe, or Washington Park Districts with special needs, you are also welcome at all programs your local park district offers. HISRA provides all inclusion services at no cost to residents of its member districts. Please contact HISRA to learn about our non-resident inclusion rates. Please give three weeks notice for all inclusion needs.
Fall 2013
IN THIS ISSUE: Inclusion Services.............................................3 Focus.....................................................................4 Strikers..................................................................4 Social Programs – Adults...............................5 HISRA Center Based Events...........................6 Youth Programs................................................7 Parents Night Out.............................................7 Adapted Sports.................................................8 Special Events....................................................8 Special Olympics..............................................9 SO Medical Application............................... 10 Registration Form....................................11-12 All the Details.................................................. 13 Programs at a Glance................................... 14 Participant Calendar..................................... 15
Use Activity Code: 57658 Fall 2013 – 3
FOCUS Focus Program
Do you love hanging out with HISRA on the weekends and wish you didn’t have to wait all week? The FOCUS program is waiting for you! FOCUS is a program for dynamic adults looking for an engaging and enriching way to spend their weekdays. We are an active bunch that spend our time cooking, exploring the community, playing games, seeing friends, and having fun. This season, the FOCUS program will run Monday through Thursday, September, October, November, and December. You can register for one day per week up to all four days. Chosen days must remain consistent for the entire season. This season there will be no Focus on the following days: Monday, Sept 2nd Labor Day, Monday, November 11th Veteran’s Day, Wednesday, November 27th and Thursday, November 28th Thanksgiving Break. The Fall FOCUS program begins September 3rd and ends December 19th. Participants will need to pay for initial registration and can be billed on or about the 15th of each month for the upcoming month. Age: 18+
Code Day-Date Time Mondays 57336 M:9/9-12/16 9:00am-3:00pm Tuesdays 57337 Tu:9/3-12/17 9:00am-3:00pm Wednesdays 57338 W:9/4-12/18 9:00am-3:00pm Thursdays 57339 Th:9/5-12/19 9:00am-3:00pm
Fee-R/NR $448/$588 $512/$672 $480/$630 $480/$630
STRIKERS Strikers
If you have time to ‘SPARE’ on Tuesdays or Wednesdays, we are looking to ‘STRIKE’ up the fun at Landmark Lanes this winter. All skill levels are encouraged to participate and as always, adaptive equipment is available. On the last day we will celebrate the season with some delicious dessert at the bowling alley! Transportation to Landmark Lanes is provided as follows: Pick-up times - EP!C: 2:40pm; CWTC: 3:10pm. Please register two weeks prior to the start date of the program. All participants need to be picked up at Landmark Lanes at 5:00 PM. Due to the increasing popularity of the Strikers program, participants will only be able to register for Tuesday Strikers or Wednesday Strikers. Age: 15+ Code Day-Date Time Fee-R/NR Tuesday Strikers 57323 Tu:9/10-11/12 3:30pm-5:00pm $85/$110 Wednesday Strikers 57324 W:9/11-11/13 3:30pm-5:00pm $85/$110
The symbol next to a program indicates that transportation is provided for residents of our member districts for this program to and from CWTC and Ep!c.
4 – Fall 2013
SOCIAL PROGRAMS - ADULTS HISRA Social Programs are a series of adult programs designed to offer an exciting opportunity to hang out with friends! Fee is per program. Please note - participants will only be allowed to register for 1 program for Strikers, Pizza & Bowling, Dinner & a Movie, Hot Dogs & Wagon Rides, and Festival of Lights per session due to the popularity of these programs. Please rank your preference as first choice, second choice and (sometimes) third choice. HISRA will try to give each person their first choice, however it will depend on the number of participants registering for the program and when registration was received.
Pizza & Bowling
Let’s strike up some fun and go bowling! We’ll have some pizza and enjoy some bowling with friends! Age: 19+ Code Day-Date Time Pizza & Bowling #1 57325 Sa:9/21 6:30pm-10:00pm Pizza & Bowling #2 57326 F:10/04 6:30pm-10:00pm Pizza & Bowling #3 57327 Sa:11/02 6:30pm-10:00pm
Dinner & Movie
Hot Dogs & Wagon Rides
Fee-R/NR $35/$45 $35/$45 $35/$45
Join your friends at HISRA for dinner at a local restaurant and a movie! We will either choose a movie at one of our local theatres, or we will rent a movie and enjoy it at HISRA! Don’t forget your popcorn money! The end time of this program will be determined closer to the date of the event - based on movie times. Age: 19+ Code Day-Date Time Fee-R/NR Dinner & Movie #1 57358 Sa:9/28 5:00pm-TBA $40/$50 Dinner & Movie #2 57359 Sa:11/16 5:00pm-TBA $40/$50
Join us as we head over to Sommer Park for an evening of outdoor fun! You will get to ride on a wagon through the park and then we will roast hot dogs over a campfire! This popular outing is sure to fill up, so be sure to sign up early! Please Note: the wagon ride is not accessible. The Management Team will determine whether or not staff can safely transfer participants on the wagon ride. Age: 19+ Code Day-Date Time Fee-R/NR Hot Dogs & Wagon Ride #1 57360 F:10/18 6:30-10:00pm $27/$34 Hot Dogs & Wagon Ride #2 57361 Sa:10/19 6:30-10:00pm $27/$34
Festival of Lights
Join us for a trip to East Peoria for the Festival of Lights! We will light up your evening as we check out more than 40 floats with over two million lights on them! After our trip through the festival we will enjoy some delicious dessert! Age: 19+ Code Day-Date Time Festival of Lights #1 57356 F:12/06 6:30-10:00pm Festival of Lights #2 57357 Sa:12/07 5:30-10:00pm
Fee-R/NR $30/$40 $30/$40
The symbol next to a program indicates that transportation is provided for residents of our member districts for this program to and from Chillicothe (Shore Acres Park), Morton (Morton Freedom Hall) and Washington (St. Claire’s Crossing). Fall 2013 – 5
HISRA CENTER BASED EVENTS BINGO
Snacks and great prizes are a couple of good reasons to get registered for this program B-4 it fills up! We will meet at HISRA and play a variety of Bingo games with the opportunity to win some great prizes! Age: 15+ Code Day-Date Time Fee-R/NR 57328 Su:9/22 2:00pm-4:00pm $10/$15 57329 Su:10/20 2:00pm-4:00pm $10/$15 57330 Su:11/17 2:00pm-4:00pm $10/$15 57331 Su:12/08 2:00pm-4:00pm $10/$15
Wii Mania @ HISRA
Get ready for an evening of fun! Wii will spend the night playing Wii and enjoying some snacks here at HISRA! Age: 15+ Code Day-Date Time Fee-R/NR 57367 F:09/27 7:00pm-9:00pm $15/$20
Dinner & Games @ HISRA
Come spend an evening at HISRA as we enjoy dinner and then spend the rest of the evening playing games at HISRA! Age: 15+ Code Day-Date Time Fee-R/NR 57365 F:11/08 6:30pm-10:00pm $20/$25
Karaoke @ HISRA
Tighten up those vocals! Spend the evening with your friends at HISRA as we sing the night away! We will enjoy some refreshments while everyone picks and sings their favorite hits! Age: 15+ Code Day-Date Time Fee-R/NR 57364 F:11/15 7:00pm-9:00pm $15/$20
Dinner & Movies @ HISRA
Come spend an evening at HISRA as we enjoy dinner and then spend the rest of the evening watching movies at HISRA! Age: 15+ Code Day-Date Time Fee-R/NR 57366 F:10/11 6:30pm-10:00pm $20/$25
Halloween Dance
Don’t miss this spooky night at HISRA! Dress in your favorite costume and be ready for music, dancing, snacks and most of all FUN! Register early! This hair raising night fills up fast!! Come if you dare! Age: 15+ Code Day-Date Time 57363 Sa:10/26 7:00pm-9:00pm
Holiday Dance @ HISRA
Fee-R/NR $15/$20
‘Yule’ enjoy dancing the night away at this festive end of the year celebration. Come and enjoy music, snacks, visiting with friends and meeting new ones at HISRA! Age: 15+ Code Day-Date Time Fee-R/NR 57362 F:12/13 7:00pm-9:00pm $15/$20
The symbol next to a program indicates that transportation is provided for residents of our member districts for this program to and from Chillicothe (Shore Acres Park), Morton (Morton Freedom Hall) and Washington (St. Claire’s Crossing). 6 – Fall 2013
YOUTH PROGRAMS HISRA After School Program
Are you in need of after school care? Why not bring your child to the HISRA After School Program! Activities and snacks will be provided daily. The HISRA After School Program follows the Peoria District 150 school schedule, when District 150 does not have school - there will be no After School Program. Please note, District 150 Early Release days are built into program fees. Transportation is not provided for this program, please drop off and pick up at HISRA. This is not a drop-in program and registration is required for the entire season. Age: 4+ Code Day-Date Time Fee-R/NR ASP - Mondays 57340 M:8/19-12/16 2:45pm-6:00pm $180/$270 ASP - Tuesdays 57341 Tu:8/20-12/17 2:45pm-6:00pm $216/$324 ASP - Wednesdays 57342 W:8/21-12/18 2:45pm-6:00pm $228/$342 ASP - Thursdays 57343 Th:8/22-12/19 2:45pm-6:00pm $204/$306 ASP - Fridays 57344 F:8/23-12/19 2:45pm-6:00pm $204/$306
Holiday Camp
Looking for a fun way to spend your holiday break? HISRA’s Holiday Camp is the answer! Register for single days - or all 4! We will be doing arts and crafts, games, and field trips! We offer a close staff to camper ratio for children with severe and multiple disabilities. HISRA will provide snacks each day, campers need to bring a sack lunch and drink. Please register for Holiday Camp AS SOON AS POSSIBLE, this camp fills up fast! Age: 4+ Code Day-Date Time Fee-R/NR 57345 Th:12/26 8:30am-4:00pm $35/$42 57346 F:12/27 8:30am-4:00pm $35/$42 57347 Th:1/2/14 8:30am-4:00pm $35/$42 57348 F:1/3/14 8:30am-4:00pm $35/$42
Kids Korner
School’s out but HISRA is in session! Join us for games, arts & crafts and other fun activities at HISRA! In addition to games and arts & crafts, we have special activities planned for each date! Don’t forget a sack lunch and drink. Fee is per date, choose one or all three! Please register two weeks prior to each program date. Ages: 4-21 Code Day-Date Time Fee-R/NR 57351 M:10/14 8:30am-4:00pm $35/$42 57352 F:10/25 8:30am-4:00pm $35/$42 57353 M:11/11 8:30am-4:00pm $35/$42
Parents Night Out
If you need a night out, this is for you! Drop your kids off at HISRA and enjoy an evening out! All children in the family are welcome to attend. Each additional child is only $7! During Parents Night Out, participants will enjoy dinner, play games, make crafts, and more! SPACE IS LIMITED! PLEASE REGISTER AT LEAST 2 WEEKS IN ADVANCE FOR STAFFING PURPOSES. Fee is per program. Choose as many as you like! NOTE TIME CHANGE! Age: 2+ Code Day-Date Time Fee-R/NR/Sib 57332 Sa:9/7 5:00pm-10:00pm $27/$37/$7 57333 Sa:10/12 5:00pm-10:00pm $27/$37/$7 57334 Sa:11/9 5:00pm-10:00pm $27/$37/$7 57335 Sa:12/14 5:00pm-10:00pm $27/$37/$7
The symbol next to a program indicates that transportation is provided for residents of our member districts for this program to and from Chillicothe (Shore Acres Park), Morton (Morton Freedom Hall) and Washington (St. Claire’s Crossing). Fall 2013 – 7
ADAPTED SPORTS Peoria Wildcats Wheelchair Basketball
To be eligible for play in adapted sports, a player must have an irreversible lower extremity disability, such as paralysis, amputation, radiological evidence of limb shortening, partial to full joint alkalosis or joint replacement, which consistently interferes with functional mobility. The team travels to games and tournaments around Illinois and surrounding states. During the 2011/2012 season, the Peoria Wildcats placed 9th at the National Tournament in Colorado Springs, Colorado! Game and tournament times for the 2013/2014 season are TBA Age: 5-21 Code Day-Date Time Fee-R/NR 57368 TBA TBA $60
SPECIAL EVENTS The Peoria Park District presents
PEORIA’S 1st Annual
Register @8:00 am; Walk begins @ 9:30 am Registration Costs: $15 per participant with T-shirt / $5 per participant without T-shirt $5/participant with Down Syndrome (FREE T-shirt) You can register up to and including the day of the walk. Register by September 5 to be guaranteed a t-shirt. Games, activities, fun, and breakfast items starting at 8:00 am. Visit www.firstgiving.com/hoidsa to register. Questions? call (309)712-4852
Saturday, October 5, 2013 • 11 am-3 pm Glen Oak Park, Peoria IL
Family Friendly, Fun-Filled Activities! Performance by Julie K PNC Mobile Learning Adventure Air National Guard Band • Planks and the PlayHouse Peoria Zoo discount admission • ELITE Drumline Touch A Truck • Children’s Resource Fair Storytime • and more! www.peoriaparks.org/WWDOP Like the Peoria Park District on Facebook for updates!
8 – Fall 2013
SPECIAL OLYMPICS Special Olympics competition will be available if you are eligible and wish to participate. All Special Olympics athletes must have a valid medical application on file for the entire length of the season. Athletes must register for Special Olympics sports at least two weeks prior to the start of the program.
Special Olympics Basketball Team
Its time to move indoors and get back on the basketball court! Our basketball program will begin with a mandatory informational meeting and basketball clinic October 7th and 8th. You must attend one night of the clinic to be considered for team placement. Team assignments and season calendars will be mailed to athletes following the basketball clinics. We will begin the season learning the fundamentals of basketball and honing our skills. Beginning in November, we will attend games and tournaments with local teams. There will be no practice on Monday, October 14, Monday November 11, the weeks of November 25th, the week of December 23rd and December 30th. REGISTRATION WILL NOT BE ACCEPTED AFTER SEPTEMBER 23rd. Ages: 12+ Code Day-Date Time Fee-R/NR 57354 Begins 10/07 TBD $41/$52
Special Olympics Bocce Ball
Come out to HISRA and practice the ancient sport of Bocce! Bocce is an outdoor sport that many compare to “lawn bowling.” It is a great combination of sport and leisure that makes it the perfect sport for many athletes. Please note the change in season: Athletes must participate in the fall league to compete in the district competition in the spring 2014. Bocce is a unified sport, meaning your sibling, friend, or parent plays alongside you as your teammate. Unified partners must register prior to participating, although we offer this program FREE for unified partners. NOTE: NEW TIME OF YEAR Ages: 8+ Code Day-Date Time Fee-R/NR 58139 M: 9/9-9/30/13 5:30-7:00pm $36/$45* Unified Partner 58140 M:9/9-9/30/13 5:30-7:00pm $0/$0 *Fee includes practice nights in spring as well as the district competition. Eligibility to participate on team sports is contingent on athlete commitment to attend all tournaments and game days. See Special Olympics Handbook for details.
Special Olympics Basketball Skills
The basketball skills program is for athletes interested in learning and practicing the fundamentals of basketball without being on a team. This program is most appropriate for athletes focusing on skill acquisition and for those individuals not able or interested in team participation. Athletes compete in the district skills competition in January. There will be no practice on Monday November 11, November 25th, the week of December 23rd and December 30th. REGISTRATION WILL NOT BE ACCEPTED AFTER OCTOBER 21st. Ages: 8+ Code Day-Date Time Fee-R/NR 57355 Begins 11/04 5:30pm-6:30pm $32/$40
Important Special Olympics Dates 8/24 9/9 9/14-15 9/19 9/23 10/7 10/12 10/14 10/21 10/21 11/4 11/11 11/25 11/27 12/7 12/23 12/25 12/30 1/1 1/6 1/29
District Bowling Tournament Bocce Ball begins Fall Outdoor Festival SO Banquet (must RSVP) Basketball Team Registration Deadline Basketball Team begins Bowling Sectionals No Basketball Basketball Skills Registration Deadline Medical Apps due for Basketball Basketball Skills begins No Basketball No Basketball No Basketball State Bowling Tournament No Basketball No Basketball No Basketball No Basketball No Basketball Basketball Team District Competition
Fall 2013 – 9
SAVE THE
DATE
Special Olympics Banquet September 19 at Weaver Ridge Invitations will be sent to all athletes and volunteers. Look for them in your mailbox!
10 – Fall 2013
Heart of Illinois Special Recreation Association HIS RA REG I ST R A T I O N FORM
Name of Participant:
PROGRAMS FOCUS
CODE
BEGINS
Focus Mondays
57336
M:9/9
CIRCLE: FEE: R/NR $448/$588
Focus Tuesdays
57337
Tu:9/3
Focus Wednesdays
57338
Focus Thursdays
CIRCLE:
X Transp?
CIRCLE: FEE: R/NR $85/$110
CIRCLE:
X Transp?
STRIKERS
CODE
BEGINS
N/A
Strikers Tuesday
57323
Tu:9/10
$512/$672
N/A
Strikers Wednesday
57324
W:9/11
W:9/4
$480/$630
N/A
57339
Th:9/5
YOUTH PROGRAMS
CODE
DATE/BEGINS
After School Program - Monday
57340
M:8/19
$480/$630 CIRCLE: FEE: R/NR $180/$270
N/A CIRCLE: Transp? N/A
Pizza & Bowling #1
57325
Sa:9/21
$35/$45
MCW
After School Program - Tuesday
57341
Tu:8/20
$216/$324
N/A
Dinner & Movie #1
57358
Sa:9/28
$40/$50
MCW
After School Program - Wednesday 57342
W:8/21
$228/$342
N/A
Pizza & Bowling #2
57327
F:10/4
$35/$45
MCW
After School Program - Thursday
57343
Th:8/22
$204/$306
N/A
Hot Dogs & Wagon Rides #1
57360
F:10/18
$27/$34
MCW
After School Program - Friday
57344
F:8/23
$204/$306
N/A
Hot Dogs & Wagon Rides #2
57361
Sa: 10/19
$27/$34
MCW
Kids Korner
57351
M:10/14
$35/$42
MCW
Pizza & Bowling #3
57327
Sa:11/2
$35/$45
MCW
Kids Korner
57352
F:10/25
$35/$42
MCW
Dinner & Movie #2
57359
Sa:11/16
$40/$50
MCW
Kids Korner
57353
M:11/11
$35/$42
MCW
Festival of Lights #1
57356
F:12/6
$30/$40
MCW
Holiday Camp
57345
Th:12/26
$35/$42
MCW
Festival of Lights #2
57357
Sa: 12/7
Holiday Camp
57346
F:12/27
$35/$42
MCW
HISRA CENTER BASED EVENTS
CODE
DATES
Holiday Camp
57347
Th:1/2/14
$35/$42
MCW
BINGO #1
57328
Su:9/22
$30/$40 CIRCLE: FEE: R/NR $10/$15
MCW CIRCLE: Transp? N/A
Holiday Camp
57348
F:1/3/14
57367
F:9/27
$15/$20
MCW
CODE
DATE
Dinner & Movies @ HISRA
57366
F:10/11
$20/$25
MCW
Parents Night Out
57332
Sa:9/7
MCW CIRCLE: Transp? N/A
Wii Mania @ HISRA
PARENTS NIGHT OUT
$35/$42 CIRCLE: FEE: R/NR $27/$37/$7
BINGO #2
57329
Su:10/20
$10/$15
N/A
Parents Night Out
57333
Sa:10/12
$27/$37/$7
N/A
Halloween Dance
57363
Sa:10/26
$15/$20
MCW
Parents Night Out
57334
Sa:11/9
$27/$37/$7
N/A
Dinner & Games @ HISRA
57365
F:11/8
$20/$25
MCW
Parents Night Out
57335
Sa:12/14
57364
F:11/15
$15/$20
MCW
CODE
BEGINS
BINGO #3
57330
Su:11/17
$10/$15
N/A
SO Basketball Team
57354
10/7
N/A CIRCLE: Transp? N/A
Karaoke @ HISRA
SPECIAL OLYMPICS
$27/$37/$7 CIRCLE: FEE: R/NR $41/$52
BINGO #4
57331
Su:12/8
$10/$15
N/A
SO Basketball Skills
57355
11/4
$32/$40
N/A
Holiday Dance @ HISRA
57362
F:12/13
$15/$20
MCW
SO Bocce Ball
58139
9/9
$36/$45
N/A
SO Bocce Ball-Unified Partner
58140
9/9
57658
$0/TBD
N/A
CODE
BEGINS
Wildcats Wheelchair Basketball
57368
TBA
N/A CIRCLE: Transp? N/A
Inclusion Services
ADAPTED SPORTS
$0 CIRCLE: FEE: R/NR $60
TRANSPORTATION: M= Morton Freedom Hall C= Shore Acres in Chillicothe W= St. Claire’s Crossing in Washington
X
X
X
X
E=EP!C T=Community Workshop/Trng Ctr
ET
$85/$110 ET CIRCLE: CIRCLE: ADULT SOCIAL PROGRAMS CODE DATES X Transp? FEE: R/NR Adult Social Program participants will only be allowed to attend one session per type of program. For example: Choose either Strikers Tues OR Wed, but not both. Please RANK your 1st and 2nd (sometimes 3rd) choice for each.
X
Fees Add the program fees: SUBTOTAL $
Must complete the registration form on back
Fall 2013 – 11
HISR A R E G I S T R A T I O N FORM – continued from front Full Name of Participant: Birthdate:
/
/
Age:
Male/Female (CIRCLE)
Parent/Guardian Full Name: Address: City, State, ZIP: Phone: Disability: E-mail: ALL registrations MUST be signed and accompanied by payment in order to be processed.
WAIVER (MUST be signed for participation) As a participant, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, including death, damages, or loss which I may sustain as a result of participating in any and all activities connected with or associated with such program. I agree to waive and relinquish all claims I may have as a result of participating in the program against the Heart of Illinois Special Recreation Association and its officers, agents, servants, and employees. I do hereby fully release and discharge the Heart of Illinois Special Recreation Association and its officers, agents, servants, and employees from any and all claims from injuries, including death, damage, or loss which I may have or which may accrue to me on account of my participation in the program. I further understand and agree that the terms such as “participating,” “programs,” and “activities,” referred to in the Agreement, include all exercises and physical movements of any nature while I am participating in these programs and further include the provision of or failure to provide proper instructions or supervision, the use and adjustment of any and all machinery, equipment, and apparatus, and anything related to my use of the services, facilities, or premises involved in these programs, and transportation to and from any events. I authorize HISRA staff to dispense prescribed medications in their original container or accompanied by a copy of a signed prescription to me/my child. I understand the nature of these programs for which I am registering, and fully understand this Waiver, Release, and Hold Harmless Agreement. I further understand that any advisements or warnings of the particular risks of these programs that I subsequently receive will be incorporated by reference into and become a part of this Agreement. Additionally, in order that the Heart of Illinois Special Recreation Association may better serve the interests of myself/my child, I hereby grant permission for Special Recreation staff to access relevant education and/or medical records. I hereby consent to the use of my/my child’s photograph in the Heart of Illinois SRA brochures, publications, or promotional materials.
DON’T FORGET!
Signature of Participant or Parent/Guardian
Date
PAYMENT
Check Cash Master Card Visa Discover
Requesting Scholarship Third-Party Payor Payment Plan for balances over $200
Please contact HISRA if payment plan options are needed.
SUBTOTAL from front Donations TOTAL
$ $ $
Credit Card Number (no dashes or spaces)
Expiration Date:
Amount: $
Authorized Signature: for credit card use only
RETURN WITH HISRA, 8727 N. Pioneer Rd., Peoria, IL 61615 PAYMENT TO: Fax: 309-691-4383 (credit card payments only)
12 – Fall 2013
/
Heart of Illinois Special Recreation Association 8727 N. Pioneer Rd. Peoria, IL 61615
ALL THE DETAILS Program Registration
On 8/26/13 HISRA will begin taking registrations for Fall 2013 programs. Please note: any registrations for Fall 2013 programs received prior to 8/26/13 will be placed, unopened, into a container at the front desk. On 8/26/13, HISRA staff will begin to randomly enter registrations from the container. Beginning 8/26/13, walk-in registrations will be processed as they come in. THE FOLLOWING PAPERWORK MUST BE COMPLETED IN ORDER FOR REGISTRATION TO BE ACCEPTED AND PROCESSED: 1. Registration Form 2. 2013 Annual Information Form 3. Payment Arrangements
REGISTRATION INFORMATION
• Registration forms (with payment) can be mailed to the HISRA Office at 8727 N. Pioneer Road, Peoria, IL 61615. • Walk-in registrations (with payment) will be accepted at HISRA during regular business hours (Monday-Thursday: 8:30 am-12:00 pm and 1:00 pm-4:30 pm; Friday: 8:30 am-12:00 pm). After hours registrations and payments can be deposited in the drop box at the front of the HISRA building. • Faxed registrations will ONLY be accepted for credit card payments. • Staff WILL NOT accept payments or registration forms at programs. A locked dropbox is available in the lobby or outside the front door. • Registration forms must be filled out COMPLETELY and the waiver at the bottom of each registration form MUST be signed each time a participant registers. • Payment must accompany all registration forms. Registrations will not be entered into the system until payment is received. • Payment plans are available for balances over $200. Please request a copy of the Payment Plan Policy. • YOU MAY NOT REGISTER FOR ANY PROGRAM IF YOU HAVE A REMAINING BALANCE FROM ANY PAST SEASON. THERE ARE NO EXCEPTIONS TO THIS POLICY! • Persons living outside the Chillicothe Park District, Morton Park District, Peoria Park District, and Washington Park District must pay the second fee listed (NR = Non-Resident). • There are no pro-rated fees for camps, programs or activities. • Due to limited space, registrations are taken on a first-come, first-served basis, when received with payment. No phone registrations will be accepted. • If a program is full, you will be placed on the waiting list. If space becomes available, you will be called and payment will be needed immediately. • An Annual Information Form must be completed once per year. All questions must be answered or marked N/A, if not applicable. For safety reasons, an individual without a completed Annual Information Form on file for the current year will not be permitted to participate in any HISRA program. • Participants must register for all programs, camps and Special Olympics sports at least two weeks prior to the start date.
All forms are available online at http://www.peoriaparks.org/heart-of-illinois-special-recreation Fall 2013 – 13
PROGRAMS AT A GLANCE August 2013 8/19/13 8/20/13 8/21/13 8/22/13 8/23/13 8/24/13
ASP - Mondays ASP - Tuesdays ASP - Wednesdays ASP - Thursdays ASP - Fridays SO Bowling District Tournament
September 2013 9/2/13 9/2/13 9/2/13 9/3/13 9/4/13 9/5/13 9/7/13 9/9/13 9/9/13 9/10/13 9/11/13 9/14-15/13 9/19/13 9/21/13 9/22/13 9/23/13 9/25/13 9/27/13 9/28/13
HISRA CLOSED NO ASP NO FOCUS FOCUS - Tuesdays FOCUS - Wednesdays FOCUS - Thursdays Parents Night Out #1 FOCUS - Mondays SO Bocce Ball Begins Tuesday Strikers Wednesday Strikers SO Fall Outdoor Festival SO Banquet (must RSVP) Pizza & Bowling #1 Bingo #1 SO Basketball Team Registration Deadline ASP 1/2 Day Wii Mania Dinner & Movie #1
October 2013 10/4/13 10/5/13 10/7/13 10/11/13 10/12/13 10/12/13 10/14/13 10/14/13 10/14/13 10/18/13 10/19/13 10/20/13 10/21/13 10/21/13 10/25/13 10/25/13 10/26/13 10/30/13
Pizza & Bowling #2 World Wide Day of Play SO Basketball Team Begins Dinner & Movies @ HISRA SO Bowling Sectionals Parents Night Out #2 Kids Korner #1 NO ASP NO SO Basketball Hot Dogs & Wagon Rides #1 Hot Dogs & Wagon Rides #2 Bingo #2 SO Basketball Skills Registration Deadline Medical Apps due for SO Basketball Kids Korner #2 NO ASP Halloween Dance ASP 1/2 Day
*please remember that registration closes two weeks prior to each program. 14 – Fall 2013
November 2013 11/2/13 11/4/13 11/8/13 11/9/13 11/11/13 11/11/13 11/11/13 11/11/13 11/11/13 11/12/13 11/13/13 11/15/13 11/16/13 11/17/13 11/25/13 11/27/13 11/27/13 11/27/13 11/27/13 11/28/13 11/28/13 11/28/13 11/29/13 11/29/13 11/29/13
Pizza & Bowling #3 SO Basketball Skills Dinner & Games @ HISRA Parents Night Out #3 Kids Korner #3 HISRA CLOSED NO ASP NO FOCUS NO SO Basketball Last Day of Tuesday Strikers Last Day of Wednesday Strikers Karaoke @ HISRA Dinner & Movie #2 Bingo #3 NO SO Basketball HISRA CLOSED NO ASP NO FOCUS NO SO Basketball HISRA CLOSED NO ASP NO FOCUS HISRA CLOSED NO ASP NO FOCUS
December 2013 12/6/13 12/7/13 12/7/13 12/8/13 12/13/13 12/14/13 12/19/13 12/20/13 12/23/13 12/23/13 12/24/13 12/25/13 12/25/13 12/26/13 12/27/13 12/30/13 12/30/13 12/31/13
Festival of Lights #1 Festival of Lights #2 SO State Bowling Tournament Bingo #4 Holiday Dance Parents Night Out #4 Last Day of FOCUS ASP 1 hour early release HISRA OFFICE CLOSED NO SO Basketball HISRA OFFICE CLOSED HISRA OFFICE CLOSED NO SO Basketball Holiday Camp - Thursday #1 Holiday Camp - Friday #1 HISRA OFFICE CLOSED NO SO Basketball HISRA OFFICE CLOSED
January 2014 1/1/14 1/1/14 1/2/14
HISRA OFFICE CLOSED NO SO Basketball Holiday Camp - Thursday #2
1/3/14 1/6/14 1/29/14
Holiday Camp - Friday #2 NO SO Basketball SO Basketball Team District Competition
September 2013
Sun Mon 1 2
Tue Wed 3 4
Thu 5
Fri
Sat
Sun
6
7
13
14
October 2013
Mon
Tue Wed 1 2
Thu 3
Fri
Sat 4
5
ce Offi sed Clo
8
15
22
29
Sun
3
10
17
24
9
10
16
17
23
24
11
18
25
12
19
26
20
27
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
21
28
30
November 2013
Mon
Tue
Wed
Thu
Fri
December 2013
Sat 1
2
Sun Mon 1 2
Tue Wed 3 4
Thu 5
Fri
Sat 6
7
4
5
6
7
8
9
8
9
10
11
12
13
14
11
12
13
14
15
16
15
16
17
18
19
20
21
18
19
20
21
22
23
22
23
24
25
26
27
28
ce Offi sed Clo
ce Offi sed Clo
ce Offi sed Clo
30
31
1/1
1/2
1/3
1/4
ce Offi sed Clo
ce Offi sed Clo
ce Offi sed Clo
ce Offi sed Clo
25
26
27
PROGRAM CALENDAR Name of Participant:
28
29
ce Offi sed Clo
ce Offi sed Clo
30
29
Fill in this calendar to help keep track of the dates/times of programs or special events for you or your child. Fall 2013 – 15
PRSRT STD U.S. Postage PAID Permit No. 247 Peoria, IL
Heart of Illinois Special Recreation Association 8727 N. Pioneer Rd. Peoria, IL 61615 REGISTRATION OPENS 8/26/13 AND CLOSES 2 WEEKS PRIOR TO EACH PROGRAM START DATE! Call 691-1929 or Fax 691-4383 www.peoriaparks.org/heart-of-illinois-special-recreation OFFICE HOURS Mon - Th, 8:30 am-12:00 pm & 1:00 pm-4:30 pm; Fri, 8:30 am-12:00 pm Closed 9/2, 11/11, 11/28-29, 12/23-25, 12/30-31, 1/1/14
1/13 ing 9/ ce n n i g Be ffi SRA O the HI e at noon os will cl idays. on Fr
OR CURRENT RESIDENT h to er wis ure? g n o l No och our br e v i e c re ISRA Call H 29 -19 at 691
• After School Programs
• Special Olympics
• Parents Night Out
• Adapted Sports
• Spring Break & Holiday Camps
• Kids Korner
• Summer Camps
• And More!
Heart of Illinois Special Recreation Association (HISRA) A cooperative extension of the Chillicothe, Morton, Peoria, and Washington Park Districts 8727 N. Pioneer Road, Peoria, IL 61615 Phone: (309) 691-1929 http://peoriaparks.org/heart-of-illinois-special-recreation
HISRA provides quality recreation programs and services to individuals with disabilities and special needs. We support the spirit and intent of the Americans With Disabilities Act. HISRA is committed to providing opportunities for each individual to enjoy recreation activities in the least restrictive environment possible.