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Summer 2016

Adaptive and Inclusive Recreation (AIR) • Adaptive Skate Camp... see page 5 • Bowling... see page 4 • Trips... see pages 8-12

Commissioner Amanda Fritz Director Mike Abbaté

REGISTRATION BEGINS APRIL 18, 2016

Go to PortlandParks.org, click on the Register Now tab.


EQUITY GOAL #2

EQUITY GOAL #3

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Adaptive and Inclusive Recreation 503.823.4333


Portland Parks & Recreation

Adaptive and Inclusive Recreation (AIR) 5340 N Interstate Ave. Portland, OR 97217 Telephone: 503-823-4333 FAX 503- 823-4329 Oregon Relay - 711

Hours: Monday through Friday, 9:00am-5:00pm Closed: May 30 – Memorial Day Rec. Coordinator II: Jane Doyle E-mail: Jane.Doyle@portlandoregon.gov Rec. Coordinator I: Dawn Hubbard E-mail: Dawn.Hubbard@portlandoregon.gov Rec. Leader: Madeline Jones E-mail: Madeline.Jones@portlandoregon.gov Bus Line: # 72 MAX Lines: Yellow line Parking: Accessible in parking lot. Disabled Access: Entrances: Accessible Parking: Accessible

TABLE OF CONTENTS Inclusion Services.................................................. 3 Drop-in Classes...................................................... 4 Camps.................................................................... 5 Teen Classes........................................................... 6 Adult Classes......................................................6-7 Friends, Food, & Fun............................................. 7 Adult Outings....................................................8-12 Summer Free For All Activities......................13-15 Citywide Activities..........................................16-19 Registration Information.................................20-21

INCLUSION SERVICES FOR PEOPLE WITH SPECIAL NEEDS Within the Americans with Disability Act (ADA) of 1990, Portland Parks & Recreation (PP&R) provides accommodations to individuals with disabilities/ special needs, so that they may receive an equal opportunity to participate in programs offered citywide. How it Works 1. Choose the activity you would like to participate in, and then access the PP&R site to know where the activity is being offered. 2. Register for the activity. You can do this in person at a PP&R site, or online at portlandparks.org. When registering, let the person know you will need accommodations in order to participate in the activity (online, check the box.) 3. Once registered, please contact Inclusion Services at 503-823-4333. If this is your first accommodation through Inclusion Services, you will need to do a phone intake with a staff member. At the end of the phone intake, it will be determined whether an assistant will be needed on the first day of the activity to provide on-site support. Future assistance will be provided based on need. The inclusion staff will work with the instructor on how to support you and your individual needs. Important Details A general program may be adapted using auxiliary aids and services, but the basic structure of the program remains the same. Accommodations are made as needed, and can be flexible as well as creative. Participants need to register for activities that are intended for their birth age. Personal care is provided for activities in the pre-school and youth category, up through age 12. If you have questions about Inclusion Services, please call 503-823-4333 or 711 (TRS). A minimum of 10 business days (Monday-Friday) advance notice is required. The Inclusion Services staff will do their best to accommodate each participant.

CALENDAR View and register for classes on-line at portlandparks.org or call the Customer Service Center at 503-823-2525. Summer 2016 Fall 2016 April 18 August 15 Register online at portlandparks.org

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Portland Parks & Recreation

DROP-IN CLASSES Bowling For Fun age: 10 - adult Have fun with your friends while knocking down pins. Beginners to advanced bowlers are welcomed. Bring $5 for one game or $10 for two. To accommodate bowlers who wish to play every week and don’t want to hassle with bringing money each time, we offer a 20 game punch card for $100. Shoes are free. Pre-registration is not required. Adaptive bowling equipment is available at the lanes. This is a drop-in activity. Date: Wednesdays July 6 - September 28 Time: 3:00pm - 4:30pm Cost: $5 per game

Mt. Scott Community Center 5530 SE 72nd (four blocks south of Foster Blvd.) Bus #10 and #14

Cost - $5 Age 16 - Adult

1st Friday of the month June 3rd - Elvis Have fun dancing to a DJ or a band. Socialize with friends, both new and old. Refreshments are provided. Cost for participants is $5. Facility staff and parents get in free, but donations are kindly accepted to help with the cost. Group and foster home staff must stay to assist their participants in the dance unless prior arrangements have been made with AIR by calling 503-823-4333. Due to the large number of participants who attend the dance, AIR staff is only able to supervise participants who are in the auditorium, social room or the hallway of the center. Staff is unable to provide assistance to participants who need close supervision or personal care in the restroom.

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Adaptive and Inclusive Recreation 503.823.4333


Portland Parks & Recreation

ADAPTIVE CAMPS

Skateboarding Adaptive Skateboarding Camp ages 7-12 Set & reach new skateboarding goals while building healthy confidence on your board! This camp provides recreational opportunities for youth with disabilities, siblings and friends. Learn about skate park etiquette, safety practices, & skateboarding fundamentals. Improve balance, mechanics, riding skills & control. Get up, get excited! Let’s skate! Course #: 1047631 Location: Glenhaven Park - Skate Park 1 Dates: Monday - Friday June 27 - July 1 Time: 9:00am - 12:00pm Cost: $60 Course #: 1045880 Location: Glenhaven Park - Skate Park 1 Dates: Monday - Friday July 25 - 29 Time: 9:00am - 12:00pm Cost: $60 Course #: 1045887 Location: Sellwood Park - Tennis Court 1 A Dates: Monday - Friday August 15 - 19 Time: 9:00am - 12:00pm Cost: $60

Teen Explorer Camp ages 13-22

ter Regis Now!

This exploratory day camp is designed for teens with special needs. Every day is a different outdoor adventure around the metropolitan area. Participants will explore nature along accessible trails in Portland’s Parks & Natural Areas. Activities include games, crafts, and stewardship possibilities. Contact the Adaptive and Inclusive Recreation Office at 503-823-4333 for more information. Course #: 1045442 Dates: August 15 - 19 Time: 9:00am - 3:00pm Cost: $150 Meet: Interstate Firehouse 5340 N Interstate

Register online at portlandparks.org

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Portland Parks & Recreation

SEPTEMBER CLASSES TEENS

ADULTS

Hip Hop: Basics Feel the heat! Catch the groove & capture the irresistible beat! Adaptive class to work on technique, turns, combinations & complete dances. Increase agility & coordination while experiencing a beat that has you moving your feet! Instructor: D.J. Hawke Location: Interstate Firehouse Cultural Center 5340 N Interstate Course #: 1048742 Dates: Monday September 12 - 26 Time: 6:30pm - 7:30pm Cost: $24

TEENS & ADULTS Drum Circle Feel the Beat! Be creative, and stomp your feet. Discover drumming methods & making up beats on the spot. Appreciate the role rhythm plays and explore drumming together. Catch the rhythm and hear the beat! We meet once a month! Instructor: Connie Hill Location: Interstate Firehouse Cultural Center 5340 N Interstate Course #: 1045922 Dates: Tuesdays April 12, May 10 & June 14 Time: 5:30pm - 6:30pm Cost: $18

Strength & Movement Designed so almost anyone can participate. Gently works muscles & joints to enhance strength, range of motion, balance & circulation. Feel relaxed, refreshed & re-energized. Instructor: Carolyn Boch Location: East Portland Community Center 740 SE 106th Course #: 1048741 Dates: Tuesday September 6 - 20 Time: 4:15pm - 5:15pm Cost: $21 Cooking with Friends One part food, two parts pals create the formula for a good tasting event. Gain confidence & cooperative skills while discovering new recipes & preparing a wonderful dish to share. Smile while enjoying the fruits of your labor. Instructor: Madeline Jones Location: Alice Ott SUN Community School 12500 SE Ramona Course #: 1048745 Dates: Thursdays September 8 - 29 Time: 5:30pm - 7:00pm Cost: $40

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Adaptive and Inclusive Recreation 503.823.4333


Portland Parks & Recreation

SOCIAL SAMPLER

Register online at portlandparks.org

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Portland Parks & Recreation

TRIPS July 8th 9th 14th 16th 21st 23rd 28th 30th

August 4th 6th 11th 13th 18th 20th

FRIDAY & SATURDAY ADVENTURES AGE: 18 & UP Dinner & Dancing Fish Hatchery & Picnic Lunch Hillsboro Hops Baseball Game *Beach Trip: Fort Stevens Battery Russell Willamette River Jet Boat Ride Catch The Big One! Fun At The County Fair Portland Thorns Game Columbia Gorge Sternwheeler Coastal Primate Sanctuary A Thrilling Day At Oaks Park *Oregon Coast Scenic Railroad BBQ Lunch & Movie at Interstate Firehouse Exploring The Oregon Zoo!

September 3rd 10th 17th 24th

*Old McDonald’s Farm *Whale Watching Big AL’s Wolf Haven

Join us on a

Van Excursion! 8

Adaptive and Inclusive Recreation 503.823.4333

Friday!

Dinner & Dancing Friday night Dance Party! Meet new people & dance at Vancouver Park & Recreation, Access to Recreation Dance. Dine out and enjoy dinner before moving to the music! Bring $7 for admission into the dance and dinner. Course #: 1049918 Instructor: Richard Riess Date: Friday July 8 Time: 4:00pm - 8:30pm Cost: $25 Bonneville Fish Hatchery & Dam Did you know that the sturgeon is a “prehistoric” fish and appeared millions of years ago in the Jurassic period? Come check out the fish hatchery as we walk around learning new things. After a sack lunch we will be off to visit the Bonneville Dam, seeing fish jumping over the fish ladders, learn history & see boats go through the locks. Bring a sack lunch and $15 for spending money & ice cream. Course #: 1050973 Date: Saturday July 9 Time: 9:00am - 3:30pm Cost: $35


Portland Parks & Recreation

THURSDAY & SATURDAY ADVENTURES AGE: 18 & UP

New van trips departure location: Interstate Fire house 5340 N Interstate Ave Max Line: Yellow Bus Number: #72

Hillsboro Hops Baseball Game Come join us to cheer on the Hillsboro Hops while they take on the Spokane Indians. Hillsboro’s newest Minor league baseball team. Bring money for lunch. Bring $16 for ticket & $ 15 for dinner Course #: 1048733 Date: Thursday July 14 Time: 5:45pm - 10:45pm Cost: $28

Willamette River Jet Boat Ride Travel at a high speed with the wind flying through your hair. Feel the spray of the water as you travel through the city, having a wonderful day. This is a way to see the sights differently. Learn about the history of the area that we live in. Bring $31 for the Jet boats and $10 for lunch. Course #: 1048734 Date: Thursday July 21 Time: 3:30pm - 8:30pm Cost: $28 Catch The Big One! Do you like fresh trout? Experience the sensation of catching & eating your own dinner. Improve fishing skills & hook a ‘whopper’ from a stocked pond located in a natural setting. Imagine the fun you’ll have sharing personal fish stories that will surprise friends & family. Bring a sack lunch and $20 for fish cleaning. Course #: 1048735 Date: Saturday July 23 Time: 10:00am - 4:00pm Cost: $30

*Day at the Beach Spend the after in the sand and exploring Fort Stevens in Warrington, Or., while making new friends. Join us for a picnic lunch at Coffenbury Lake, followed by an afternoon playing in the sand. Next stop will be at Battery Russell. Explore this old Battery used in World War II. This is a non-accessible trip. Bring $5 for ice cream on the way home. Course #: 1049923 Date: Saturday July 16 Time: 9:00am - 6:00pm Cost: $45

Register online at portlandparks.org

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Portland Parks & Recreation

THURSDAY & SATURDAY ADVENTURES AGE: 18 & UP

Fun At The County Fair Escape from the ordinary with an unforgettable ‘down home’ experience. Develop a life-long love for an old-fashioned American tradition. From farm animals & crafts to games & rides, nothing compares to the scents, sounds & memories you’ll remember for years! Bring $10 for lunch at Burgerville and money for spending at the fair. Course #: 1048736 Date: Thursday July 28 Time: 10:30am - 5:00pm Cost: $34 Portland Thorns Game Come cheer on the Portland Thorns as the play against the Seattle Reign. This will be an exciting day to make new friends, yell loudly as we support our team. Bring $20 for dinner. We will be meeting at Providence Park 1844 SW Morrison, by the face. Price of trip includes the ticket to the game. Course #: 1050827 Date: Saturday July 30 Time: 6:45pm - 10:45pm Cost: $52

Columbia Gorge Sternwheeler Board from Marine Park at Cascade Locks, in the heart of the Columbia River Gorge National Scenic Area. Enjoy a riverboat cruise on an authentic triple-deck paddle wheeler, providing 360 degrees of breathtaking vistas. Step on board for a unique afternoon on the river. Fee includes cruise, non-refundable after 6/30. Bring $15 for box lunch and $5 for ice cream afterwards. Course #: 1050905 Date: Thursday August 4 Time: 9:15am - 3:15pm Cost: $64 Coastal Primate Sanctuary Come explore the beautiful 28 acre sanctuary where the monkey’s live amongst the trees, birds and deer. Their mission is to take in unwanted monkey’s that need a place to stay and provide life time care. Bring a sack lunch and $10 cash for admission. Course #: 1048732 Date: Saturday August 6 Time: 9:00am - 2:00pm Cost: $28 A Thrilling Day At Oaks Park What is your favorite amusement attraction? Hang on tight as you spin, dip & roll your way to adventure. Develop friendships & a lifelong love for excitement, sure to create great memories & put a smile on your face. Bring a sack lunch and $10 for a ride bracelet. Course #: 1048739 Date: Thursday August 11 Time: 11:15am - 4:00pm Cost: $26

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Adaptive and Inclusive Recreation 503.823.4333


Portland Parks & Recreation

THURSDAY & SATURDAY ADVENTURES AGE: 18 & UP

*Oregon Coast Scenic Railroad Join us on a train ride between Garibaldi and Rockaway Beach and back. This train goes along the Tillamook Bay with views of many different types of wildlife. Afterwards we will be stopping for ice cream. Please bring $20 for the train ticket and $5 for ice cream afterwards. Please bring a sack lunch to eat at a Bayside ark in Garibaldi. The train is not accessible. Course #: 1048737 Date: Saturday August 13 Time: 9:15am - 6:30pm Cost: $45

It’s Happening At The Oregon Zoo! Sea lions & otters romp for your enjoyment in underwater viewing areas! Insects, amphibians, birds & mammals await your discovery! Explore different environments, including tundra, desert & marine life gaining knowledge of animals from around the world. Bring $ 26.50 for lunch & admission. Meet in the Lobby. Course #: 1050974 Date: Saturday August 20 Time: 8:30am - 2:30pm Cost: $32

BBQ Lunch & Movie at Interstate Firehouse Spend the day with new and old friends. Watch as we BBQ your burger on the grill, in Patton Park. Play some games in the park. We will go inside to enjoy a movie in our theater. Price of trip includes your BBQ’d lunch and the movie, followed by and ice cream treat. Meet at the Theater. Course #: 1048738 Date: Thursday August 18 Time: 11:30am - 3:30pm Cost: $35

Scholarships:

City of Portland residents and non-residents, regardless of age, who require financial assistance can apply for partial scholarships for AIR activities. Contact AIR at 503-823-4333.

*Old McDonald’s Farm Adventure out to the farm as we learn how to feed all types of livestock. Spend the morning with chickens, pigs, goat, horses and cows in their own farm habitat. Bring $20 for admission and lunch. This is a non- accessible trip. Meet in the Lobby. Course #: 1050981 Date: Saturday September 3 Time: 8:45am - 2:00pm Cost: $30 Register online at portlandparks.org 11


Portland Parks & Recreation

THURSDAY & SATURDAY ADVENTURES AGE: 18 & UP

*Whale Watching Join us on The Samson, a fifty foot wheelchair accessible vessel. As we board we will be greeted by Lars and the deck hand James, who will make us feel like a part of the crew and right at home as we adventure out on our 1 hour trip to look for whales. This trip is weather dependent. Bring snacks, jacket and $35 for the excursion and lunch. Meet in the Lobby. Course #: 1050985 Date: Saturday September 10 Time: 8:15am - 6:00pm Cost: $50 Big AL’s Games! Games! Games! There is a lot to do on your day at the arcade. Try to beat your score on your choice of games. Cheer your friends on or try something new! Bring $15 for lunch and $15 for games. Meet in the Lobby. Course #: 1050990 Date: Saturday September 17 Time: 10:30am - 2:30pm Cost: $25

WITHDRAWAL & REFUND INFORMATION

WITHDRAWALS & REFUNDS: Please notify us at least seven (7) days, unless otherwise specified, before the start of your program so that we can refund or credit your account for the registration fee. Pre-paid materials and admission tickets cannot be refunded. Participants needing to withdraw after the program has begun are offered a prorated credit or refund based upon when the request is made. 12

Adaptive and Inclusive Recreation 503.823.4333

Wolf Haven The sanctuary in Tenino, WA has provided rescue for displaced, captive-born wolves, a few coyotes, foxes & wolf-dog hybrids. They promote wolf restoration & educate the public about the value of all wildlife. Tour the outdoor animal living areas & grounds. This is a 1 hour walking tour on hard packed gravel, followed by an indoor movie “World of Wolves”. Bring a snack, $15 for lunch at Don Juan’s Mexican Restaurant. Trip fees includes admission. Dress for weather. Meet in the Lobby. Course #: 1050991 Date: Saturday September 24 Time: 9:00am - 5:45pm Cost: $56


MONDAYS

TUESDAYS

                 

          

WEDNESDAYS

 


WEDNESDAYS

THURSDAYS

FRIDAYS


DATE DATE


Portland Parks & Recreation

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Adaptive and Inclusive Recreation 503.823.4333


Portland Parks & Recreation

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Portland Parks & Recreation

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Adaptive and Inclusive Recreation 503.823.4333


Portland Parks & Recreation

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REGISTRATION

NOTICE OF NON-DISCRIMINATION

Receipt of full payment is required for registration, unless otherwise arranged. Please call if you receive a returned check or declined bank card notice, either of which void registration.

PP&R programs and services reflect the cultural diversity of our community. We do not discriminate on the basis of religion, race, color, gender, national origin, sexual orientation, age or ability.

RESIDENT / NON-RESIDENT

SPECIAL NEEDS

A resident is:

Within the American with Disability Act (ADA), a person with a disability or special need who desires assistance with registration and/or participation in general PP&R programs can contact Inclusion Services at please call 503-823-4333 or 711 (TRS). If you request assistance through Inclusion Services, a minimum of 10 business days (Monday-Friday) advance notice is required.

• anyone who occupies a permanent residence inside the city limits of Portland. At the discretion of a Community Center Director, proof of home address may be required. Acceptable address verification may include a 1) drivers license, 2) Oregon ID card, 3) property tax statement, 4) utility bill or lease agreement with current home address.

Registration Information

• any child living within the school boundaries of the Reynolds and Centennial School Districts who is attending a SUN Community School. Through a partnership between the City and County, a child attending a SUN Community School is eligible to register for programs at any SUN Community School location without paying a non-resident surcharge. Anyone else is considered a non-resident (NR) and will be assessed a 40% surcharge (rounded to the next highest quarter (.25)). NR surcharges do not apply to drop-in activities. Non-residents who wish to register for PP&R activities may choose one of these options: • Pay the additional 40% NR fee. • Purchase a NR fee discount pass as either an individual or family for a period of three, six or nine months from the date of purchase. The NR discount pass takes 25% off the NR fee for the activity. Inquire about this option at time of registration. These passes are not refundable. Non-resident Pass Prices 3-month pass: Individual $25 Family $50 6-month pass: Individual $45 Family $90 9-month pass: Individual $65 Family $130 A family denotes a couple (married or domestic) or a single parent and their legal dependents living in the same residence.

CLASS ENROLLMENT Our classes must meet minimum and maximum enrollment standards. Classes may fill quickly or be canceled due to low enrollment.

WITHDRAWAL & REFUNDS Please notify us at least seven (7) days, unless otherwise specified, before the start of your program so that we can refund or credit your account for the registration fee. Prepaid materials and admission tickets cannot be refunded. Participants needing to withdraw after the program has begun are offered a prorated credit or refund based upon when the request is made.

SCHOLARSHIPS City of Portland residents, regardless of age, who require financial assistance may apply for partial scholarships. Contact individual centers for information.

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Adaptive and Inclusive Recreation 503.823.4333

If you need a sign language interpreter or FM loop amplifier, please contact please call 503-823-4333 or 711 (TRS), at least five business days in advance of the activity or class. Information about programs and services is available online for those needing a voice synthesis; visit our website at www.PortlandParks.org. For additional ADA information, call 503-823-2223.

PHOTO POLICY Portland Parks & Recreation (PP&R) reserves the right, and may give permission to the media, to photograph classes, programs, and participants at any of our facilities and properties or any sponsored activity. Please be aware that these photos are for promotional purposes and may be used in future publications and media communications in any format. If you do not wish to be photographed, please inform staff and we will make reasonable efforts to honor your request. If you see staff taking pictures, and you do not wish to be photographed, please let us know. If you see a photo of yourself or a family member that causes you concern, please notify us. As a courtesy, we will make every reasonable effort to dispose of the image, and will not use it in future publications. However, we will not be able to retrieve, destroy or discontinue existing printed publications in which the photograph may have been included.

CUSTOMER SATISFACTION Your satisfaction is our goal! Portland Parks & Recreation strives for 100% customer satisfaction. If you are not satisfied with a recreation program or service, please let us know.

INFORMATION HOTLINE For information on other PP&R services & programs, call our Information Hotline at 503-823-PLAY (7529), MondayFriday, 8:30am-5pm.

INCLEMENT WEATHER If the City of Portland public school districts (Portland Public, Parkrose, David Douglas, Reynolds, and Centennial) are closed because of weather conditions, PP&R classes and youth basketball in those school districts are cancelled. However, some sites may be open for drop-in activities. Call the specific PP&R facility for information and opening/ closing times. If inclement weather is forecast on weekends or holidays, call the PP&R facility or program for operating hours and activity cancellations.


Register Now – One of Five Ways ONLINE at PortlandParks.org – Click on the “Register Now!” top tab. Search for classes by age, category, location or keyword – or narrow your search by specific activity or course number. PHONE – Complete this registration form and call any PP&R site using the phone numbers on the map pages. You may also phone in your registration to the PP&R Customer Service Hotline at 503-823-2525, MondayFriday, 8:30am-5:15pm. Only Visa, MasterCard or American Express accepted with phone-in registration. MAIL – Mail your completed registration form to the program center address. Include full payment using your Visa, MasterCard, American Express or check payable to the City of Portland. Mail-in registration is also received at the PP&R Customer Service Center, 1120 SW Fifth Ave, Suite 1302, Portland, OR 97204. FAX – Complete the registration form and fax it to 503-823-2515 with full payment using your Visa, MasterCard or American Express. Faxes are accepted 24 hours a day, seven days a week, but are processed during regular business hours. IN PERSON – Any PP&R facility is able to process your registration, including the Customer Service Center located in the lobby of the Portland Building at 1120 SW Fifth Ave. All Community Centers are open for walk-in registration during business hours. CHECK ONE:

 New Customer

 Taken class with PP&R before  My account information has changed

Main Contact Name _______________________________________________________________________ Birthdate ___________________________ M_____ F_____ African Immigrant White

American Indian/Alaska Native Slavic/Eastern European Immigrant

Black/African American Asian

Hispanic/Latino Multi-Racial

Native Hawaiian/Pacific Islander Other

Home Address ________________________________________________________________________ City/St/Zip _______________________________________________ Home Phone ( _________)________________________________________________ Work Phone ( _________)_________________________________________________ Cell Phone ( _________)_____________________________________________ Email Address _______________________________________________________________ Emergency Contact Name & Phone Number ___________________________________________________________________________________________________ Portland Parks & Recreation welcomes individuals with disabilities and special needs into programs. Please describe any accommodations needed for successful inclusion: _____________________________________________________________________________________________ PARTICIPANT INFORMATION Name (last, first)

Birthdate

M/F

Class Title

Course #

Class Location

NON-RESIDENTS of the City of Portland pay a 40% surcharge. Or you may purchase a non-resident pass at the amounts listed below. List pass price or 40% surcharge in column at right and add to your total.

I already have a non-resident pass. Duration ______-month Purchase date ______/______/______ Passholder name ________________________________________________________________________________________________

 I need a pass. Circle one: 3-month | 6-month | 9-month

Circle one: Individual | Family Name of person(s) needing pass ______________________________________________________________________________ 3-month pass: individual $25; family $50 | 6-month pass: individual $45; family $90 9-month pass: individual $65; family $130

Start Date

Cost

Subtotal 40% non-resident surcharge or pass price

TOTAL

 I do not want a pass. I choose to pay the 40% surcharge.

PAYMENT INFORMATION

 CHECK

Check number_____________________

 CREDIT CARD Account #

(make check payable to the City of Portland)

Information

____ ____ ____ ____

-

____ ____ ____ ____

- ____

____ ____ ____

Cardholder’s Name_____________________________________________________ Please print

- ____

____ ____ ____

Expires ____________________________________

Signature______________________________________________________________

 VISA  MasterCard  Amex

Registration Information

CIRCLE ONE:


Adaptive and Inclusive Recreation 5340 N Interstate Ave. Portland, OR 97217


Adaptive and Inclusive Recreation (AIR) Summer activities 2016