Page 1

PROGRAM GUIDE WISCONSIN DELLS

a 58 passenger speedboat ride, a water park, a magic show & much more PAGE 19

SUMMER OVERNIGHT TRIPS

HABLAMOS ESPAÑOL WSSRA POOL PARTY (pg. 8)

A “mini” Wacky Quacky Duck Splash will be held.

Summer 2011

PAGE 10–11


WEST SUBURBAN SPECIAL RECREATION ASSOCIATION 2915 Maple Street, Franklin Park, IL 60131 847.455.2100 (voice or TTY) Office Hours: 8:30 AM - 5:00 PM Monday through Friday

Summer 2011 The West Suburban Special Recreation Association is a part of your local park district or village recreation program. We provide recreation programs for adults and children who have a physical impairment, a mental disability, or any other type of disability. Your park district or village governs the operation of the Association. The partner districts and villages and their representative to our Board of Directors are listed below:

BOARD OF DIRECTORS

Berwyn Park District ............................................................ Jeff Janda Clyde Park District ............................................................. Alex Rueda Village of Elmwood Park .......................................... John Lannefeld Park District of Forest Park .............................................. Larry Piekarz Park District of Franklin Park ............................... Joseph D. Modrich Village of Harwood Heights .................................Michael Gadzinski Hawthorne Park District ............................................. Dennis Raleigh Norridge Park District ................................................... Mark DeSalvo North Berwyn Park District ...................................... Joseph C. Vallez Park District of Oak Park ...............................................Marty Bracco River Forest Park District .................................................. Mike Sletten

BOARD MEETINGS

The Board of Directors of the Association meets on the second Tuesday of the month 8 times per year at 7:00 PM. Call the office at 847.455.2100 for the location of the meetings. The public is invited to attend.

REGISTRATION UPDATE

ALL SUMMER 2011 REGISTRATIONS TAKEN ON A FIRST-COME, FIRST-SERVED BASIS AFTER....................... April 27, 2011 SUMMER PHONE-IN REGISTRATION BEGINS................. April 27, 2011 SUMMER REGISTRATION ENDS........................................ June 3, 2011 FALL 2011 BROCHURES DISTRIBUTED................. after August 1, 2011

WSSRA STAFF

Sandra Gbur, CPRP..........................236.......................................Executive Director................................................................ sandyg@wssra.net Marianne Birko, CTRS, CPRP...........226............................ Superintendent of Recreation............................................... marianneb@wssra.net Robert A. Foster, APRP.....................238.................... Superintendent of Safety & Operations...................................................bobf@wssra.net Maryellen Bilek, MSW......................228 .................................... Outreach Specialist........................................................ maryellenb@wssra.net Sherry Scouffas.................................225..................................... Outreach Specialist.................................................................sherrys@wssra.net Gretchen Dennis, CTRS...................219...................................... Inclusion Manager.......................................................... gretchend@wssra.net Matt Barber, CPRP............................235.............................. Human Resource Manager.......................................................... mattb@wssra.net Dawn Krawiec..................................231...................................... Program Manager.................................................................dawnk@wssra.net Ahren Hoffman.................................234..................................Recreation Coordinator............................................................ahrenh@wssra.net Annie Lhotka.....................................230..................................Recreation Coordinator..............................................................anniel@wssra.net April Ryan..........................................240.................................... Recreation Specialist...................................................................aprilr@wssra.net Amy Mepham, CTRS.......................232.................................... Recreation Specialist................................................................amym@wssra.net Kristy Dacanay.................................224......................................... Lekotek Leader......................................................................kristyd@wssra.net Lisa Gershak.....................................221.......................................Finance Manager......................................................................lisag@wssra.net Noelia Hernandez............................222................................................Registrar.............................................................................nolyh@wssra.net Aileen Maldonado..........................220.................................. Administrative Assistant...........................................................aileenm@wssra.net Luz Rocha-Serrano..........................245........................................... WSSRA Driver Larry Feldt..........................................245........................................... WSSRA Driver Joe Wolfe...........................................245........................................... WSSRA Driver Mike Zych..........................................245........................................... WSSRA Driver

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Programs at a Glance T

WSSRA Transportation

PP

Transportation by Pick Up Point

$

Bring Extra Money to Program

CHILDREN SCHOOL AGE SPORTS AND FITNESS TEENS & YOUNG ADULTS ADULTS 22 YEARS & OLDER OLDER ADULTS SPECIAL EVENTS

BEAT THE PHONE RUSH

FAX your registration today at 847.455.2157. Contact your local Park District for use of their FAX machine for your WSSRA registration. Por favor llame a la oficina de WSSRA. Deje un mensaje en extension 222. Noelia Hernandez les respondera lo mas pronto posible. Tel: 847.455.2100 ext. 222. INDIVIDUALS WHO HAVE A HEARING IMPAIRMENT OR COMMUNICATION DISORDER CALL 847.455.2100 TO UTILIZE OUR TDD!

WWW.WSSRA.NET

Check out the WSSRA web site for up to date program information. E-Mail your comments to us: wssra@wssra.net

FOLLOW US ON: WSSRA’s SUMMER program session is 6 weeks in length for most programs. SUMMER programs begin June 20, 2011. Please consult each program description in this brochure for exact times and days.

7-8 9-12 13-18 19-22 20-22 23 27-28

KEY TO ABBREVIATIONS ADD: Attention Deficit Disorder ADHD: Attention Deficit Hyperactivity Disorder ALZ: Alzheimer’s AUT: Autism BD: Behaviour Disorder DD: Developmental Disability EC: Early Childhood HI: Hearing Impairment LD: Learning Disability MI: Mental Impairment MLH: Mental Health PI: Physical Impairment SL: Speech & Language Delay VI: Visual Impairment

Joshua Schoedel beats the heat at swim lessons Cover photo by David Kindler

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Program Locations BERWYN

THE CHICAGO FIRE WHEELCHAIR BASKETBALL TEAM TEAMED UP WITH THE CICERO FIRE DEPARTMENT AND CICERO POLICE DEPARTMENT on

March 24, 2011 at the Cicero Community Center in a competitive game of wheelchair basketball. This exciting night raised money for the Chicago Fire to participate in National Games in Denver, Colorado as well as additional funds for the WSSRA’s mission to support year-round recreation opportunities for persons who have disabilities. The event raised $1390 dollars! The night was filled with fun and excitement including raffle prizes, door prizes, contests, free popcorn and more! The game brought in 80 fans and supporters. We look forward to the crowd growing in the 5th Annual Wheelchair Fire versus Cicero Fire Department and Police Department basketball game next year. Thank you to all who came out to support!

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Havlicek School 6401 15th St.........................................708.795.2450 Jefferson School 7035 16th St.........................................708.795.2454 Liberty Recreation Center 6445 W. 27th Pl....................................708.795.2891 Morton West High School 2400 Home..........................................708.222.5700 North Berwyn Park District 16th & Wesley.....................................708.749.4900 PAV Berwyn YMCA 2947 S. Oak Park Ave........................708.749.0606 Proksa Park 3001 Wisconsin...................................708.795.2892 Striker Lanes 6728 16th St.........................................708.484.7831

CICERO

Cicero Community Center 2250 49th Ave.....................................708.477.6308 Cicero West School 4937 W. 23rd St...................................708.780.4487 Clyde Park District Stadium 1909 S. Laramie..................................708.652.3545 Columbus West School 5425 W. 31st........................................708.780.4482 Duck Pond Pool 5105 31st St..........................................708.863.4112 Hawthorne Park District 5200 W. 29th Pl....................................708.863.6511 Morton East High School 2423 S. Austin Blvd..............................708.222.5264 Roosevelt School 1500 S. 50th Ave.................................708.652.7833 Unity East School 2115 S. 54th Ave.................................708.863.8229 Town Hall Bowl 5025 25th St.........................................708.863.0300 Warren Park 1225 S 60th Ct.....................................708.863.2220

ELMWOOD PARK

Elmwood Park Recreation Center 2 Conti Parkway.................................708.452.3935 Elmwood Park Family Aquatic Center 2 Conti Pkwy.......................................708.452.3935

FOREST PARK

Circle Bowl 7244 Circle...........................................708.366.2810 Field Stevenson School 925 Beloit.............................................708.366.5703 Park District of Forest Park 7501 Harrison.......................................708.366.7500 Forest Park Middle School 925 Beloit.............................................708.366.5703

FRANKLIN PARK

Birch Park 2952 Birch St. Center at North Park 10040 Addison....................................847.678.4021 Enger School 10401 W Grand .................................847.455.5299 Franklin Park Community Center 9560 Franklin .......................................847.455.2852 Franklin Park Ice Arena 9711 Waveland .................................847.671.4755 Karate for Kids 10125 W. Grand ................................847.349.5425 WSSRA Office 2915 Maple St. ...................................847.455.2100

HARWOOD HEIGHTS

Harwood Heights Village Hall 7300 Wilson .........................................708.867.7200

NORRIDGE

Giles School 4251 N. Oriole.....................................708.453.4847 Norridge Park District 4631 N. Overhill ..................................708.457.1244

OAK PARK

Ascension Church 601 Van Buren....................................708.848.2703 Barrie Recreation Center Garfield & Lombard..........................708.383.6905 Carroll Recreation Center 1125 S. Kenilworth..............................708.383.6906 Field Recreation Center 935 Woodbine Ave...........................708.383.6907 Fox Recreation Center Oak Park & Jackson..........................708.383.6908 Irving School 1125 S. Cuyler Ave.............................708.524.3090 Longfellow Recreation Center Ridgeland & Adams..........................708.383.6909 Longfellow School 610 Highland.......................................708.524.3060 Mann School 921 N. Kenilworth................................708.524.3084 Oak Park River Forest High School Lake & Scoville...................................708.383.0700 Rehm Pool 515 Garfield St....................................708.848.9661 Whittier School 715 N. Harvey ....................................708.524.3080

RIVER FOREST

Concordia University Pool 7400 Augusta......................................708.209.3118

See www.wssra.net for directions.


Thank Yous WSSRA is looking for energetic & caring staff and volunteers to assist in recreation programs for individuals with disabilities. You will: • Meet new people while participating in fun recreation activities. • Enjoy personal growth. • Have a flexible schedule (morning, afternoon, evening & weekend hours available). • Gain leadership skills. • Enhance self-esteem by being part of a team that brings out the best in everyone.

For more information call 847.455.2100 or visit www.wssra.net.

NEW MEMBERS

THANK YOU VOLUNTEERS & STAFF

The WSSRF welcomes new members. Please consider joining! No one on the Foundation is asked to do more than they can handle, yet by working together, WSSRF raises $20,000 each year to support WSSRA programs. At each meeting, Foundation members have the opportunity to give input and ideas about program offerings. So come join the fun and help WSSRF improve and expand programs for persons of all ages with disabilities. Call Sherry Scouffas at 847.455.2100 ext. 225 to learn more.

We thank all of WSSRA’s spring volunteers & staff. Programs could not run without them! Tania Andrade Nedum Aniemeka JoAnn Barber Nick Barnes Arturo Barragan Carly Baylian Anthony Becker Karen Bellafiore Alex Brunet Karina Carrera Emily Clark-Mchale Angie Coleman Kristen Corna Camille Danolko Heather Delagarza Bertha Diaz Nicole Dipaola

Sheila Donoghue Lauren Farmer Ken Filip Sarah Forte Megan Foster Nancy Giangrasse Kurt Grahnke Erin Grimes Tim Hanley Elliot Henry Nina Iannotta Patty Iannotta Trisha Iannotta Brittany Jackson Ankica Jedry Danielle Jirsa Laura Kelly

Jamee Kenny Megan Kopacz David Kordesh Kelli Krueger Sarah Kuhr Andrew Lee Sarah Liebreich Jaclyn Lima Carlos Marroquin Amelia Martinez Meghan Matthews Teegan Mcfeely Kaitlin Mcnulty Natalie Meza Christine O’Connor Anel Olivares Annie Oliver

Ted Orphan Japes Palles Anisa Pashaj Amanda Raimondi Anne Ralenkotter Maria Ramirez Bryan Rasche Jill Record Junior Rodriguez Tom Ryan Judy Saucedo Darryl Scott Jeanne Simons Maurissa Storck Irene Talavera Kathleen Tardella John Vicars Mike Vinci

The WSSRF needs you!

BEAT THE PHONE RUSH

FAX your registration today at 847.455.2157. Contact your local Park District for use of their FAX machine for your WSSRA registration. Por favor llame a la oficina de WSSRA. Deje un mensaje en extension 222. Noelia Hernandez les respondera lo mas pronto posible. Tel: 847.455.2100 ext. 222. INDIVIDUALS WHO HAVE A HEARING IMPAIRMENT OR COMMUNICATION DISORDER CALL 847.455.2100 TO UTILIZE OUR TDD!

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SPECIAL EVENTS

KIDS NIGHT OUT Chicago Fire Saturday, DATE TBA Game time: 7:00pm Toyota Park 7773 S. Harlem Ave, Bridgeview

ITRS B & C SOFTBALL SSSRA & WSSRA Sunday, July 10

SO DISTRICT SOFTBALL B&C Team Sunday, July 24

ISO BOWLING TOURNAMENT Saturday, July 16 8:00am – 4:00pm Stardust Bowl, Addison

GOLF OUTING Saturday, July 16 6:30 – 2:00pm SRSNLC

GOLF SKILLS QUALIFIER Monday, August 1

WSSRA POOL PARTY Tuesday, July 12 Rain date: July 19 8:15 – 10:15pm Park District of Forest Park Pool

BERWYN CARNIVAL OF FUN Saturday, July 16 2:00 – 6:00pm Proksa Park, Berwyn

SUMMER TRIPS

BRADFORD WOODS CAMP August 6 – 10

THE GREAT OUTDOORS ADVENTURE August 10 – 12

OVERNIGHT ADVENTURE August 6 – 8

WISCONSIN DELLS August 22 – 25

BROADWAY TOUR Beaty and the Beast June 28 – July 10

WALK-N-DINE

ENCHANTED SUMMER DAY

SWIM LESSONS TI

August 23

GALOS CAVE

August 16

10:00 – 11:30am Village of Harwood Heights Session 1: June 28 – July 26 Session 2: August 9 – Sept. 13

YOGA

9:30am – 12:30pm Weekly location varies

TUESDAY

WILD CARD WEDNESDAYS

CSI CHICAGO

SEADOGS

SWIM LESSONS

HIT THE GREENS 5:45 – 7:15pm Location varies

4:00 – 5:15pm 2 sessions of M&W lessons Rehm Pool, Oak Park

September 7

August 31

MOVIE GOERS

August 17

KOHLS CHILDREN’S MUSEUM & SEADOGGIN’!

August 3

9:30am – 12:30pm PDFRP

WEDNESDAY

August 4

FRIDAY

TOWERS SOCIAL 12:30 – 2:30PM Franklin Towers

August 5

LIFE’S A BEACH

RIVERS CASINO August 26

SWIM LESSONS 4:15 – 4:45PM 4:50 – 5:20pm 5:25 – 5:55pm PAV YMCA, Berwyn

6:30 – 9:15pm Barrie Center, Oak Park

FOOD CRITICS time TBA Bushwood, Forest Park

FRIDAY SHOW TIME

Barrie Center, Oak Park

6:45 – 8:15PM White Pines Golf Course, Bensenville

INTRO TO GOLF

SUMER IN THE CITY 7:00 – 10:00pm Location varies

JUNIOR GOLFERS

August 18

GRILLS, CHILLS & THRILLS!

GIDDY UP!

THURSDAY

7:00 – 10:00pm varies weekly

SOCIALITES CARROLL MOONLIGHTERS BARRIE

7:00 – 10:00pm varies weekly

HOT SHOTS CARROLL CITY SLICKERS BARRIE

1:00 – 3:00pm Circle Bowl, Forest Park

SATURDAY BOWLING LEAGUE

12:15 – 2:45pm Carroll Center, Oak Park

SUPER SATURDAYS

varies weekly Segwick Park, East Avenue & 49th

CHALLENGER BALL

10:00 – noon varies weekly

BOCCIA NATIONALS

9:30am – 12:30pm Park District of Forest Park Bldg #4

OUTDOOR ADVENTURES

9:00 – 11:30am Carroll Center, Oak Park

SATURDAY FUN CLUB

9:00 – 11:30am Norridge Park District

SENSATIONAL SATURDAYS

SATURDAY

Calendar of Events - Summer 2011 MONDAY

HEALTHY START

10:00 – 11:30am Franklin Park Community Center

SWIM LESSONS

4:00 – 5:15pm 2 sessions of M&W lessons Rehm Pool, Oak Park

SWIM LESSONS

4:00 – 4:40pm 4:45 – 5:25pm Duck Pond Pool, Cicero

BLEACHERS BUMS

June 13&20, July 11

5:00 – 5:30pm 5:30 – 6:00pm Elmwood Park Aquatics Center

BOBCATS SOFTBALL

6:30 – 8:00pm Fox & Longfellow Park, Oak Park, North & Birch Park, Franklin Park

TEEN/ADULT AQUA EXERCISE & STINGRAY SWIM TEAM

5:45 – 6:30pm Park District of Forest Park

BOBCATS VOLLEYBALL TEAM GAME SEASON

6:30 – 8:00pm Ascension School gym, Oak Park

BOBCATS VOLLEYBALL PRACTICE SEASON

5:30 – 6:30pm 6:40 – 7:40pm Ascension School gym, Oak Park

WEEKLY WORKOUT

7:00 – 8:15pm Franklin Park Community Center

TAE KWON DO

7:15 – 8:00pm Karate for Kids 10125 W. Grand in Fr. Park


WSSRA Program Policies REGISTRATION

Any cancellations for SUMMER programs will be accepted through June 3, 2011 and credit will be issued. Any cancellations after June 3, 2011 participants will be charged full program fee. Any unpaid balance will restrict participation in future programs.

CLOSED PROGRAMS

If a program closes because we have reached maximum enrolment, you will be put on a waiting list and contacted if additional space is available.

CANCELLED PROGRAMS

A. If four participants or less register, a program may be cancelled. A program reimbursement or credit will be issued. B. If a program is cancelled because of unforeseen circumstances you will be contacted at the soonest possible time. C. A program credit will not be issued for weather related cancellations. No programs will be made up unless otherwise specified.

REFUNDS

Refunds will only be issued when the registrant cannot participate for extended medical reasons and/or hospitalization verified by a physician. For the majority of the season the refund/credit will be prorated. Call for more information. 847.455.2100.

PAYMENT POLICY

Payment of program fees is due upon registration unless other arrangements are made. Statements are mailed out the first week of the program season (4 times per year). Call the Finance Manager to arrange a payment plan, Monday through Thursday, 8:30 AM to noon. A participant cannot register for the next season until balance from previous season is paid.

RETURNED CHECK POLICY

A $20.00 fee will be charged for any checks returned to WSSRA. The $20.00 fee, as well as the balance, will need to be paid before registering for future programs.

SCHOLARSHIP REQUEST

WSSRA is in a position to offer scholarships to WSSRA residents for a percentage of fees for two programs each season. Persons requesting a scholarship must complete a scholarship application, which will be mailed to you upon request. Scholarship applications need to be filled out once a year. If you are interested in a scholarship, check the box on the registration form: Request Scholarship. All scholarship applications must be completed and in the WSSRA office by June 3, 2011.

NON-RESIDENT POLICY

WSSRA programs are limited to people who live in the WSSRA partner districts and villages. If you live outside the WSSRA communities and are interested in participating in a special recreation program, call your park district or village recreation department. Call the WSSRA Outreach Specialists for more information.

PARTICIPANT ABSENCE

If you or your child are not going to attend a recreation program that you are registered for, please notify WSSRA office 847.455.2100 AS SOON AS POSSIBLE! Please leave a message on Voice Mail after hours.

PARTICIPANT ILLNESS

For the protection of all the participants in programs, you/your child must be kept at home or will be sent home if he/she shows any of the following symptoms: • A temperature of over 100.3. • Stomach ache accompanied by diarrhoea or vomiting. • Any undiagnosed rash. • Sore or discharging eyes or ears. • Profuse nasal discharge (green or yellow). Please keep children with active colds home. • Have a highly contagious condition such as chicken pox, measles, lice, etc.

MEDICATION

It is the parent/guardian and participant’s responsibility to inform WSSRA of any medication a participant is taking. This information is very important in case of an emergency. Medication information should be noted on the registration forms, as well as the Annual Information Form. Any changes in medication should be communicated to WSSRA.

INSURANCE

The Association takes every reasonable precaution to prevent injuries and accidents from occurring. However, if an accident does occur or if you or your child is injured, you are solely responsible for any costs incurred or caused by an injury that happens in an Association program.

SAFETY PRECAUTIONS

Some participants in WSSRA programs and special events may be carriers of infectious disease(s). Staff and volunteers have been provided in-service training concerning proper hygienic procedures. WSSRA seeks to provide a safe environment for all of our participants, staff volunteers and the public. If you have any specific questions, please call the WSSRA Executive Director or Superintendent of Safety & Operations at 847.455.2100.

REVISED LATE PICK-UP/ DROP-OFF POLICY

In order to be fair to our participants, program staff and drivers, WSSRA has enacted a Late Pick-up/Drop-off Policy. Many of our program staff and drivers need to get to a program immediately after the program your child is in. We ask that you make sure you are on time picking up your child from program, as well as home to greet your child when the WSSRA van drops them off. A $10.00 fee will be charged for every 15 minutes or portion thereof, a participant is picked up late, or a van is delayed, after a 10 minute grace period. A notice will be sent to you indicating the fee being charged to your account. Also, participants must be dropped off on time for programs that are travelling, including over night trips. Vans will not wait more than 5 minutes for participants who are late for the program. Saturday morning programs - Parents must drop off their child by 9:30 AM or call the emergency phone. If the program is travelling, the van will not wait longer than 5 minutes past the program start time.

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Children SATURDAY FUN CLUB

Age: 3-6 years Time: 9:00-11:30 AM Location: Carroll Recreation Center Fee: $10.40 week / $41.60 season

Date: SATURDAY FUN CLUB: June 25 .............................................304-01 July 9.................................................. 304-02 July 23................................................304-03 July 30 ...............................................304-04

SENSATIONAL SATURDAYS

Age: 3-11 years Time: 9:00-11:30 AM Location: Norridge Park District Fee: $10.40 week / $41.60 season

SENSATIONAL SATURDAYS: ......................................................................305-01 ......................................................................305-02 ......................................................................305-03 ......................................................................305-04

SUPER SATURDAYS

Age: 7-11 years Time: 12:15-2:45 PM Location: Carroll Recreation Center Fee: $10.40 week / $41.60 season

SUPER SATURDAYS: ................................................................. 306-01 ................................................................. 306-02 ................................................................. 306-03 ................................................................. 306-04

ALL ABILITIES Participants will enjoy Saturdays filled with music, games, crafts and much more. Register for one or all four weeks. An activity schedule will be sent the first week of program. Dress for indoor & outdoor play.

WSSRA POOL PARTY LEKOTEK

ALL ABILITIES WSSRA’s Lekotek is a toy lending library and resource for family play. Families meet for a one hour play session each month guided by a certified Lekotek leader. Families have the opportunity to borrow from our inventory of over 2,000 toys including adapted toys which makes play possible for all kids. Lekotek offers: • Relaxing, guided play sessions. • Home loan of up to six toys monthly. • Opportunities to focus on the abilities of children. • Positive parent/child interactions that increase skills. • Self-esteem building. • Sibling play and fun. Monthly play sessions take place at the WSSRA office or North Berwyn Park District. Call Kristy or Ahren at 847.455.2100 for details and to schedule your first play session. Schedule now for play sessions beginning in September. Age: birth to 6 years Fee: $6.00 per visit (including toy check out) Registration Number: 300

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A “MINI” WACKY QUACKY DUCK SPLASH WILL BE HELD. Refreshments will be available for purchase. Each attendee will be assigned a duck number upon their arrival. Our cute little rubber ducks will be sent down the water slide into a chute. The top 5 finishers will win a duck to be entered into the Wacky Quacky Duck Splash on Saturday, July 16. DON’T LIKE TO SWIM? DON’T WANT TO BE SEEN IN A SWIMSUIT? COME SOCIALIZE & MEET OTHER FAMILIES. Date: Tuesday, July 12 Time: 8:15 – 10:00pm Fee: FREE Location: Park District of Forest Park Aquatic Center 7501 Harrison St., Forest Park Limited transportation for persons with VI, PI Trans: $6.05 If it looks like rain, call 847.455.2100 x236 after 7:30 p.m. If we cancel due to inclement weather our rain date is Tuesday, July 19. This is a family event. All children/teens must attend with an adult. No RSVP required.


School-Aged SWIM LESSONS

ALL ABILITIES WSSRA Swim Lessons are based on a skill development program through the American Red Cross. All skills will be taught in a progression. Bring suit and towel. Parents are responsible for changing child before and after lesson. Participants are limited to one half hour lesson per season. Lessons are designed to be appropriate for specific age groups as well as skill level. PLEASE NOTE: ANYONE WITH POSSIBLE INCONTINENCE MUST WEAR PROTECTIVE PANTS UNDERNEATH THEIR SWIMSUITS. This is for everyone’s health & safety. If your child is wearing a swim diaper, the public health code requires them to wear rubber pants in addition to the diaper. Any problems in this area with your child could risk your child’s ability to participate in this program. If you have any questions, please contact us at 847.455.2100. Thank you for your attention and support. Age: 3 years & older, Preschoolers are welcome! REGISTRATION NUMBER

DAY

TIME

DATES

AGE

FEE

DUCK POND POOL, CICERO 351-01

Mondays

4:00-4:40 PM

June 20 - Juy 25 (No program July 4)

all ages

$28.00 (5 weeks)

351-02

Mondays

4:45-5:25 PM

June 20 - July25 (No program July 4)

all ages

$28.00 (5 weeks)

REHM POOL, OAK PARK 351-03

Mondays & Wednesdays

4:30-5:15 PM

June 20 - July 6 (No program July 4)

all ages

$29.00 (3 weeks) - 5 sessions

351-04

Mondays & Wednesdays

4:30-5:15 PM

July 11 - July 27

all ages

$32.00 (3 weeks) - 6 sessions

ELMWOOD PARK AQUATICS CENTER, ELMWOOD PARK 351-05

Tuesdays

5:00-5:30 PM

June 21 - July 26

all ages

$26.25 (6 weeks)

351-06

Tuesdays

5:30-6:00 PM

June 21 - July 26

all ages

$26.25 (6 weeks)

351-07

Fridays

4:15-4:45 PM

June 24 - July 29

6 yrs & under

$26.25 (6 weeks)

351-08

Fridays

4:50-5:20 PM

June 24 - July 29

6 yrs & under

$26.25 (6 weeks)

351-09

Fridays

5:25-5:55 PM

June 24 - July 29

7 yrs & up

$26.25 (6 weeks)

PAV YMCA, BERWYN

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School-Aged EMERGENCY

PHONE The purpose of this phone number is to allow access to WSSRA for emergencies only during non-office hours. 1. The phone may be called Monday through Friday, from 5:00 PM to 11:00 PM, Saturday, 7:00 AM to 11:00 PM when programs are in session only. 2. Leave a message with your phone number at 847.833.9611 and a WSSRA staff will return your call. 3. The emergency phone should not be a substitute for calling the office for non-emergency questions, such as pick up times.

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OVERNIGHT ADVENTURE: BRADFORD WOODS

SP, MH, AUT, TMI Join us on an Overnight Adventure to Bradford Woods! Bradford Woods is Indiana University’s learning and outdoor education centre situated on more than 2,500 acres of pristine forest which includes a 140 acre lake and over 10 miles of hiking trails. All facilities at Bradford Woods are fully accessible in accordance with the Americans with Disabilities Act (ADA) and air conditioned. WSSRA is very excited to have the opportunity to attend this camp and we hope you will join us! www.bradwoods.org Call Ahren or Amy with any questions about this overnight camp. Check out all of the activities we can do at Bradford Woods: • Swimming pool and lake • Hiking Trails • Archery • Canoeing • Pontoon Boat Rides • Fishing • Campfires • Sports Pavilion

KIDS NIGHT OUT WITH THE FIRE!

Enjoy FREE tickets to see the Chicago Fire Major League Soccer team play. (Date to be announced.) Tickets are limited to persons who have a disability and three family members. We will hold your tickets for pick up at your child’s program or day camp or at the WSSRA office. WSSRA will not have a staff person in attendance. You must supervise your own children. Tickets are available on a first-come, firstserved, basis. Just call our office to reserve your tickets, 847.455.2100. Limited tickets available. You must get to the game on your own. Game date and time to be announced. Location: Toyota Park (Chicago Fire’s new stadium) 7773 S. Harlem Ave., Bridgeview, IL Fee: FREE Registration Number: 311

THE GREAT OUTDOORS

LD, BD Pitch your tent, gather around the fire and enjoy a few days of wilderness fun! Participants will experience the following: • Boating Appropriate sleeping arrangements will be • Horseback Riding made and special diets taken into account. • Theme parks Round trip transportation provided from • Water parks WSSRA office for the four hour drive to Bradford • Camping Woods. • Hiking Due to the popularity of this trip it will be offered as a lottery. All participants interested in attending this trip must register by June 6, 2011. The lottery will be pulled on June 6, 2011. We will contact you by June 10, 2011. Age: 11-22 years Date: August 6-8, 2011 Location: Bradford Woods, Martinsville, Indiana Participant Ratio: 1:1 to 3:1 assistance Fee: $293 Registration Number: 340

PP

Please contact April Ryan with questions at 847.455.2100 ext. 240. Age: 10-15 years Location: Mt. Olympus Resort, WI Dells Date: August 10, 11 & 12 Fee: $180 Registration Number: 339


School-Aged CHALLENGER BALL

ALL ABILITIES Did you forget to sign up for Challenger Ball? Registration is always open. Sign up today!

Each week players will have the opportunity to practice for 20 minutes followed by a 40 minute game. Each player will be teamed with a volunteer peer buddy who will assist them throughout the game. Participants have the choice of t-ball or coach pitch. Beginner? Intermidiate? Advanced? All are welcome to play. Saturdays: Sunday: May 7 – 12:30 PM-2:30 PM **June 5 – 1:00 PM-3:00 PM May 14 – 11:00 AM-1:00 PM May 21 – 11:00 AM-1:00 PM *June 11 – 7:30 PM-9:00 PM June 18 – 11:00 AM-1:00 PM *Night Game June 25 – 11:00 AM-1:00 PM **Picture Day Time: 10:00-12:00 PM Fee: $35.00 (includes baseball shirt and hat) Trans: $16.50 Pick up Point: Irving School, Oak Park Game Location: Sedgwick Park in La Grange, 48th & East Ave. Registration Number: 239

TAE KWON DO

ALL ABILITIES This introductory class is designed to captivate the interest of our youngest student. Karate for Kids teaches the American Tae Kwon Do Association curriculum. It is based on the concepts of positive mental attitude and high goal setting. Building blocks for this system include the following: •Goals •Self-control •Courtesy •Integrity •Friendship •Confidence •Self-awareness •Self-Esteem •Perseverance •Self Improvement •Respect •Dedication A uniform is required for all new students. (Additional one time fee of $40 for uniform)

Age: 9-14 years Date: Tuesdays, June 21 - July 26, 2011 Time: 7:15-8:00 PM Location: Karate for Kids 10125 W. Grand Avenue, Franklin Park Pick up Point: North Berwyn Park District Drop off time: 6:30 PM Pick up time: 8:30 PM Fee: $60.00 Pick up Point Trans: $22.00 Registration Number: 313

BRADFORD WOODS 5-DAY ADVENTURE

EMI, TMI, DD Join us on a 5-day Adventure to Bradford Woods! Bradford Woods is Indiana University’s learning and outdoor education centre situated on more than 2,500 acres of pristine forest which includes a 140 acre lake and over 10 miles of hiking trails. All facilities at Bradford Woods are fully accessible in accordance with the Americans with Disabilities Act (ADA) and air conditioned. WSSRA is very excited to have the opportunity to attend this camp and we hope you will join us! www.bradwoods.org Call Annie with any questions about this overnight camp at extension 230. Check out all of the activities we can do at Bradford Woods: • Swimming pool and lake • Hiking Trails • Archery • Canoeing • Pontoon Boat Rides • Fishing • Campfires • Sports Pavilion Appropriate sleeping arrangements will be made and special diets taken into account. Round trip transportation provided from WSSRA office for the four hour drive to Bradford Woods. This camp experience is designed for pre-teens to adults who have a mental impairment. Participants attending this camp must be: • Toiled trained • Responsible for independent personal care including feeding, dressing & toileting • Devoid of emotional outbursts that require 1:1 staffing • Successful socially within 1 staff person per 4 participant staffing ratio If your son/daughter meets the eligibility criteria listed above, don’t wait to register as there are limited registration openings available. For more information call us at 847.455.2100. Age: 12 years & older Date: August 6-10, 2011 Location: Bradford Woods, Martinsville, Indiana Fee: $487 Registration Number: 338

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School-Aged OUTDOOR ADVENTURES

Registration Number: MI, DD, LD, VI Join us for a Saturday morning of thrills and excitement as we explore our communities with a special focus on our environment! Register for one or all 5 exciting events. Van will not wait longer than 5 minutes past start time for travelling programs. Age: 12-22 years Date: Saturdays Time: 9:30-12:30 PM Location: Park District of Forest Park Building #4 REGISTRATION NUMBER

DATE

DROP OFF & PICK UP TIMES

ACTIVITY

DESTINATION

FEE

331-01

06/25

9:30am12:30pm

Rah! Rah! Sis Boom Bah!- Let’s celebrate Independence day a little early with a musical parade! We will make our own musical instruments and decorate the sidewalks with chalk for our own parade at the Park District of Forest Park.

Forest Park Building #4

$13.70

Forest Park Aquatics Center

$13.70

Special Notes: Dress for the weather. 331-02

07/09

9:30am12:30pm

Aqua Adventures- Let’s take a dip, dive or slide into the water at the Park District of Forest Park Pool! Special Notes: Bring bathing suit and towel.

331-03

07/23

9:30am12:30pm

iO Theatre, Chicago Storytown- From superheroes to undersea adventures, princesses to dinosaurs, Storytown takes you on an interactive, fully improvised adventure!

331-04

07/30

9:30am12:30pm

You don’t have to beg!- Today Animal Assisted Therapy is bringing dogs to Outdoor Adventures. The group will get to learn about the dogs, pet them, and even make them do tricks!

$13.70

Special Notes: iO Theatre not accessible . Forest Park Building #4

$13.70

Special Notes: Note any allergies to dogs.

WSSRA WISH LIST

Many of the items listed below represent needs that cannot be totally funded within WSSRA’s budget. Should you be in a position to make a donation of money or product, we would be most appreciative. We welcome donations from individuals, community organizations, businesses, and clubs and foundations. Thank you for your consideration! • Adopt-a-program • Braille playing cards • Office Supplies • Portable movie screen • Water coolers/Ice chests • Day camp prizes

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• Arts & Crafts materials • Team Uniforms • Scholarship Funds • Juice boxes for programs • Raffle prizes • T-shirt sponsors

• Printing Costs • Busses or Minivans • Flat screen TV for training • I pods • Sporting equipment & supplies


Adaptive Sports BOCCIA

PI Boccia is one of the fastest growing Paralympic In-door sports! This season we will compete in a local competition as well as the regional and national boccia games. Participants will compete in boccia against athletes with similar level of ability. Sign up for one, two or all three events. WSSRA will provide all the equipment.

WSSRA

I love “WSSRA

Age: 6-22 years

Boccia National Games

Date: July 27-31, 2011 Times and location TBD Fee: $100.00 ($75.00 registration fee and $25.00 for BlazeSports membership) Trans: $6.05 (Scholarships may be available) Registration Number: 350-02

basketball, softball and bowling – I am really just a sports person

Door to door transportation to and from each event is available. Pick-up point transportation will be provided from the Liberty Center in Berwyn. Please call April Ryan if you have any questions 847.455.2100.

Ricky Smith

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Sports & Fitness SPECIAL OLYMPICS

Illinois Special Olympics provides year round sports training in a variety of Olympic-type sports for children and adults with mental impairments or closely related developmental disabilities who are 8 years of age or older. The program gives athletes opportunities to develop physical fitness, demonstrate courage, experience joy and participate in the sharing of skills and friendship with their families and other athletes. WSSRA supports the mission of Special Olympics through the participation in the following sports: Track & Field, Softball, Aquatics, Basketball, Bowling, Volleyball, and Golf

CRITERIA FOR PARTICIPATION

All Special Olympic athletes must have a current, completed Application for Participation in Illinois Special Olympics form on file with the Special Olympic coordinator at WSSRA. This form contains four sections: 1. Athlete Information 2. Parent and/or Guardian Authorization & Medical Authorization 3. Health Insurance and Emergency Information 4. Medical Clearance (This MUST be completed by a physician). Applications for Participation in Illinois Special Olympics are valid for 2 years based on the earliest signed date on the medical application form. We can FAX the medical application form to you today. Anyone interested in participating, starting a new sport, or volunteering, please contact: WSSRA Special Olympics Coordinator, 2915 Maple Street, Franklin Park, IL 60131, 847.455.2100.

TEEN & ADULT AQUA ATHLETICS

MLH, MI, AUT, DD Enjoy one of the greatest modes of exercise. Through water, participants can increase their: • cardiovascular system • strength • flexibility • mobility • range of motion All while having fun in the pool with friends. Age: 15 years & older Date: Mondays, June 20 - July 25, 2011 (No Program July 4) Time: 5:45 - 6:30 PM Location: Forest Park Aquatics Center Fee: $29.00 Trans: $30.25 Registration Number: 348

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HEALTHY START

ALL ABILITIES Get your week off to a great start with a healthy exercise class on Monday mornings! If you need a special type of exercise, this program is for you. We’ll emphasize: • stretching and flexibility exercise • moderate aerobics • use of exercise equipment All exercise routines will be closely monitored by staff to meet your individual needs. Age: 21 years & older Date: Mondays, June 20 - July 25, 2011 (No Program July 4) Time: 10:00 - 11:30 AM Location: Franklin Park Community Center Fee: $27.00 Trans: $30.25 Registration Number: 345

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WSSRA STINGRAY SWIM TEAM

Stingray Swim Team is a training program for participants who are comfortable in the water. Participants will be expected to swim consecutive laps throughout a majority of the program. Those wishing to compete in Special Olympics can receive their training in the program but are not obligated to compete with WSSRA. Bring a suit and towel. Transportation is available on a limited basis. Please Note: Due to the limited swim lessons available, swim team members are not eligible for swim lessons. Date: Mondays, June 20 - July 25, 2011 (No Program July 4) Time: 5:45 - 6:30 PM (Pool time 7:05-8:10) Location: Forest Park Aquatics Center Fee: $29.00 Trans: $30.25 Registration Number: 341

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Sports & Fitness BOBCATS SOFTBALL

MI, AUT, DD All teens and adults who are interested in joining the WSSRA Bobcats Softball Team, register now! Practices and games will be held on Tuesday evenings. During the SUMMER season participants will practice and prepare for the game season which begins at the end of May and goes through the beginning of August. All participants must participate in the practice season in order to be a part of the game season.

Bobcat Softball Philosophy: In establishing the Bobcat’s softball program, the WSSRA has set criteria the program will follow. WSSRA will emphasize teamwork, good sportsmanship, and giving one’s best in a safe and healthy environment. Competitiveness will come from the game itself and not from emphasis on the score. Each player will: • Learn the fundamentals of softball and have fun doing so. • Be a part of a team and learn the importance of teamwork. • Learn and play different positions. More information about the game schedule and locations will be available upon registration. Up to 3 teams and 3 locations will be announced at the beginning of the season. New players must purchase a uniform before being able to compete on the Bobcats softball team. Must have registered in spring to compete this summer. Age: 15 years & older Date: Tuesdays, April 12 - August 2, 2011 Games: 6:45-8:00 PM Practice Fields: Longfellow Park, Oak Park, North Park/Birch Park, Franklin Park, Fox Park, Oak Park Game locations: Check the website: WSSRA.net or contact Annie Lhotka for up to date game information 847-455-2100 Fee: $121.00 for Session (includes practice & games) Registration Number: 399 PP

WEEKLY WORKOUT

MI, AUT, DD, MLH Let’s work out! It’s a great way to end your day and improve your physical condition through: • exercise stations • light weight lifting • low impact aerobics WSSRA will provide door to door transportation. Age: 13 years & older Date: Tuesdays, June 21 - July 26, 2011 Time: 7:00-8:15 PM Location: Franklin Park Community Center Fee: $27.00 Trans: $36.30 Registration Number: 347

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GOOD SPORTSMANSHIP

WSSRA encourages parents and families to attend games and tournaments and cheer the teens/young adults on! We expect coaches, players and parents to demonstrate good sportsmanship during these events. This includes respect and support of coaching staff and officials who are working on behalf of your player. Any person not demonstrating good sportsmanship including behavior outbursts towards a player or coaching staff and/or officials, that is deemed threatening, will not be tolerated. You may be asked to leave and your future participation and attendance at events will be in jeopardy. By registering your son/daughter/dependent for these programs you are agreeing to follow these guidelines as written. Please refer any concerns or questions to the Superintendent of Recreation. We look forward to a safe and successful season.

BOBCAT VOLLEYBALL

MI, AUT, DD Come out for WSSRA’s third volleyball season. Participants will focus on developing the following skills during practice season: • serving • passing • hitting • setting Participants will be given a practice session time once registration is complete. In August the teams will compete with other local Special Recreation Association teams. Age: 15 years & older Practice Season: Wednesdays, July 13 - August 3, 2011 Time: 5:30 - 6:30 PM or 6:40 - 7:40 PM Game Season: Tuesdays, August 9 - September 27, 2011 Time: 6:15 - 8:15 PM Fee: $54.00 Registration Number: 359

ISO BOWLING TOURNAMENT

If a participant is signed up for WSSRA Saturday Bowling, he or she may choose to compete in the ISO Tournament. REGISTRATION DEADLINE IS JUNE 1, SIGN UP TODAY! Transportation provided from pick up points to be announced. Date: Saturday, July 16, 2011 Time: 8:00AM - 4:00 PM Location: Stardust Bowl, Addison Fee: $20.00 Trans: $2.75 Registration Number: 342

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Sports & Fitness INTRODUCTION TO GOLF

TMH, AUT, DD, MH, MLH The Chicago District Golfing Foundation, CDGF, is sponsoring this golf program opportunity. Learn the basics of the game of golf from a professional. The CDGF will provide the equipment and a golf professional. Participants will be introduced to the following skills: • Stance • Swing • Basic principals of woods, irons, chipping & putting • Proper golf etiquette and rules Limited registration available. Don’t miss out on this wonderful opportunity.

CHALLENGER BALL DATES: Saturdays May 7: 12:30 PM-2:30 PM May 14 : 11:00 AM-1:00 PM May 21: 11:00 AM-1:00 PM *June 11: 7:30 PM-9:00 PM June 18: 11:00 AM-1:00 PM June 25: 11:00 AM-1:00 PM Sunday **June 5: 1:00 PM-3:00 PM *Night Game **Picture Day

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Age: 12 years and older Date: Thursdays, June 23 – July 28 Time: 6:45-8:15 PM Location: White Pines Golf Course, Bensenville Fee: $18 Trans: $36.30 Registration Number: 333

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JUNIOR GOLFERS

TMH, AUT, DD, MH, MLH The Chicago District Golfing Foundation, CDGF, is sponsoring this golf program opportunity. Parents join your child in this! Learn the basics of the game of golf from a professional. The CDGF will provide the equipment and a golf professional. Participants will be introduced to the following skills: • Stance • Swing • Proper golf etiquette and rules • Basic principals of woods, irons, chipping & putting Limited registration available. Don’t miss out on this wonderful opportunity to participate with your child. Age: 6–12 years Date: Thursdays, June 23 – July 28 Time: TBA Location: Bushwood Golf, Forest Park Fee: $18 Trans: $36.30 Registration Number: 335

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HIT THE GREENS

ADVANCE GOLFERS ONLY EMH, TMH, AUT, DD, MH, MLH Advanced Golf season is over but we can help you keep your golf game in check. Sign up for one or all three golfing opportunities. You will have the opportunity to play 3-9 holes. Game time is restricted. We’ll play as long as time allows. Locations & times may vary. Participants must have been Advanced Golf program to participate. Age: 15 years and older Date: Wednesdays Time: 5:30 PM 334-01: June 22 334-02: July 6 334-03: July 27 Fee: $11/per week Trans: $6.05/per week Registration Number: 334

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SPECIAL OLYMPIC GOLF QUALIFIER

ALL CURRENT WSSRA ADVANCE GOLFERS WELCOME

Any WSSRA Advanced golfer is welcome to test their skills in the Special Olympic Golf Qualifier. The event held in August at a location to be announced. Participants must have the following information completed to participate: • Current Special Olympic Medical form on record through September 5, 2011 • 3 signed score cards from regulation par 5 golf courses • All participants must register with WSSRA by Friday, July 1, 2011 Transportation available by pick-up point. Date: Monday, August 1, 2011 Time and location to be announced. Fee: $10 Trans: $2.75 PP Registration Number: 321


Sports & Fitness BLEACHERS BUMS

DD Spend your Monday evenings this summer at the ball park with WSSRA. We’re going to check out minor league games throughout Chicagoland. Register for one, two or all three games. We recommend bringing $10-15 for concessions & souvenirs.

Due to unpredictable length of the game, return times are to be announced. WSSRA stays for the whole game, including delays & extra innings. In the event of excessive delay, staff decides when they will return. If the group will be more than 15 minutes late, we will contact families with an updated return time. Age: 19 years and older Date: Mondays Fee: $25 each game Trans Pick-up Point: $2.75 per game Special Notes: Bring $ for concessions and/or souvenirs

$

REGISTRATION NUMBER

DATE

DROP OFF & PICK UP TIMES

ACTIVITY

DESTINATION

362-01

06/13

5:15pm Office 5:45pm Fox Park Pick up TBA

Windy City Thunderbolts vs. Kalamazoo Kings

Crestwood

362-02

06/20

5:00pm Office 5:30pm Fox Park Pick up TBA

The Fielders vs. Rockford River Hawks

Zion

362-03

07/11

4:30pm Office 5:00pm Fox Park

Kane County Cougars vs. Burlington Bees

Geneva

SATURDAY BOWLING LEAGUE

MI, AUT, DD, SP, MH Spend your Saturdays with friends while sharpening your bowling skills through practice and instruction. An adaptive ball and bowling ramp will be available. Age: 13 years & older Location/Pick Up/Drop off: WSSRA Office, Franklin Park/11:55 AM/3:55 PM Harwood Heights Village Halll/12:10 PM/3:15 PM Elmwood Park Recreation Center/12:30 PM/ 3:20 PM McDonalds, 5500 Cermak, Cicero/12:30 PM/ 3:20 PM Date: Saturdays, June 25 – July 30, 2011 (No program July 2) Time: 1:00-3:00 PM Location: Circle Lanes, Forest Park Fee: $47.50 Pick up Point Trans: $18.75 Registration Number: 310 PP

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My sons “ can’t wait for swim day! They love going to the pool

GOLF OUTING

ALL CURRENT WSSRA GOLFERS WELCOME Any WSSRA golfer is welcome to test their skills in the SRSNLC Golf Tournament. The event held on Saturday, July 16, 2011 at the Shiloh Golf course in Zion from 8:00 – noon. Participants will be registered for the 9 hole event or the 4 hole event. All participants must register with WSSRA by June 10, 2011 to participate. Transportation available by pick-up point. Date: Saturday, July 16 Time: 6:30 AM – 1:30 PM approximately Fee: $25.00 Trans: $2.75 Registration Number: 320

Guadalupe Ramirez (mom)

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Valid Application for Participation is mandatory for all competitors 605 E. Willow St.  Normal, IL 61761-2682  309-888-2551

Zip Code

-

Y

Y

SO ILL Rev. 8-1-10 D

Sex (M or F)

Birthdate M M D

APPLICATION FOR PARTICIPATION IN SPECIAL OLYMPICS ILLINOIS ATHLETE INFORMATION

Athlete Name (last name, space, first name)

Agency Name

State

-

Parent’s/Guardian’s (Please Circle One) Home Address

Zip Code

Parent’s/Guardian’s Home Telephone

-

Athlete’s Mailing Address

Asian

Parent’s/Guardian’s City

Black/African American Other

Emergency Contact Phone (

)

Athlete’s City

State

Ethnicity

White Hispanic/Latino

Person to be contacted in case of emergency

Policy Number

HEALTH INSURANCE & EMERGENCY INFORMATION (Required for Processing) Medical Insurance Company

PARENT AND/OR GUARDIAN AUTHORIZATION AND MEDIA RELEASE

Date

Parent’s Email Address

Signature of Parent and/or Legal Guardian (Check appropriate box) Print Name

Date

I, on my own behalf or as the undersigned parent and/or legal guardian of the above named applicant (hereafter referred to as the “Entrant”), hereby request permission for the Entrant to participate in Special Olympics programs. I acknowledge that Special Olympics will screen all entrants using the Sex Offender Public Registry and the Child Murder and Violent Offender Against Youth Registry and understand that entrants listed on either Registry will be denied participation. I affirm that this Entrant has never been on said Registries or, if Entrant was listed on either Registry but has since been removed, I will contact Special Olympics Illinois for instructions before submitting this application. I represent and warrant to you that the Entrant is physically and mentally able to participate in Special Olympics, and I submit herewith a subscribed medical certificate. I understand that if the athlete has Down Syndrome, he/she cannot participate in sports or events which, by their nature result in hyper-extension, radical flexion or direct pressure on the neck or upper spine unless a full radiological examination establishes the absence of Atlantoaxial Instability. I am aware that the sports and events for which this radiological examination is required are equestrian sports, artistic gymnastics, diving, pentathlon, high jump, alpine skiing, soccer, soccer skills, powerlifting squat and butterfly stroke and diving starts in swimming. On behalf of the Entrant and myself, I acknowledge that the Entrant will be using facilities at his/her own risk and I, on my own behalf, herby release, discharge and indemnify Special Olympics from all liability for injury to person or damage to property of myself and Entrant. In permitting the Entrant to participate, I am specifically granting permission to Special Olympics Illinois to use the likeness, voice and words of the Entrant in television, radio, films, newspapers, magazines and other media, and in any form not heretofore described, for the purpose of advertising or communicating the purposes and activities of Special Olympics and in appealing for funds to support such activities. I understand that by signing below I consent for the Entrant to participate in the Special Olympics Healthy Athletes Program that provides individual screening assessments of health status and health care needs. The Entrant has no obligation to participate and I understand the Entrant should seek his/her own medical advice and assistance and Special Olympics is not responsible for the Entrant’s health. If I am not personally present at Special Olympics activities in which the Entrant is to compete, so as to be consulted in case of necessity, you are authorized on my behalf and at my account to take such measures and arrange for such medical and hospital treatment as you may deem advisable for the health and well-being of the Entrant. I, THE UNDERSIGNED ADULT ENTRANT, have read and fully understand the I, THE UNDERSIGNED PARENT AND/OR GUARDIAN of the above specified provisions of the above release and/or have had them explained. I hereby agree that I Entrant, have read and fully understand the provisions of the above release and have will be bound thereby and I shall defend Special Olympics Illinois and hold it harmless explained them to said Entrant. I hereby agree that I and said minor will be bound from disaffirmation thereof. thereby, and I shall defend Special Olympics Illinois and hold it harmless from any disaffirmation thereof by said minor. Entrant Witness

Athlete’s Email Address

SO ILL OFFICE ONLY

MEDICAL CLEARANCE

PLEASE CHECK MEDICAL INFORMATION

Does athlete have Down Syndrome? Yes No If yes, have x-rays of the C1-C2 vertebrae been taken and examined? Yes No Date of x-ray Is the athlete clear of Atlantoaxial Instability? Yes No

No No No No No No

Dosage

Does the athlete have or is the athlete: Heart Problems Yes Diabetic Yes Epileptic/Seizures Yes Blind Yes Deaf Yes Hepatitis Yes Other

Current Medication

Allergies to medication, if any:

Date of last Tetanus shot:

State

Zip

I have examined the above-named Entrant and, in my opinion, there is no mental or physical reason why he or she should not participate in the Special Olympics sports training and competition program. Further information will be forwarded if required. Current medication, if any, is specified with dosage on this application.

Examination Date

)

Doctor’s Signature

Print Name

Address

City

Phone (

Original parent/guardian and doctor signatures are required by the office of Special Olympics Illinois. Faxed signatures will not be accepted.


Teens & Young Adults WISCONSIN DELLS

PI, EMI, TMI, DD Come with us on our trip to the Wisconsin Dells. We’ll enjoy all the Dells has to offer including: • a 58 passenger speedboat ride, • a water park, • a magic show, and much more. The trip will include transportation, hotel and three meals per day, as well as, admission to all activities on the trip. Participants will need to provide their own spending money. Age: 15 years and older Location: Wisconsin Dells, WI Date: August 22 – August 25, 2011 Fee: $745 for this vacation trip (excluding spending money) Price may vary by $100 based on group size. A $250 non-refundable deposit is due upon registration. Refunds will be considered if a physicians note prohibiting travel accompanies your request for refund or another WSSRA participant is able to go on late notice. NO SCHOLARSHIPS ARE AVAILABLE FOR THIS TRIP.

Eligible Participants: • Participants who are responsible for independent personal care including feeding, dressing & toileting • Participants who are independent in mobility either walking or wheeling • Participants who are successful socially at a 4:1 participant staffing ratio • Participants who are devoid of emotional oubursts that require 1:1 staffing • Participants who have had a successful overnight trip with WSSRA in the past (this includes a Special Olympic overnight trip experience) • Call Marianne Birko with questions concerning eligibility (WSSRA reserves the right to determine if this trip is appropriate for an individual) TO REGISTER: Call the office. The program is limited and registration will be accepted on a first-come, first-served basis. If you need more information we will be happy to provide it for you. Call us at 847.455.2100 and ask for Annie Lhotka or Ahren Hoffman. Registration Number: 363

WSSRA staff: WSSRA will provide a minimum of a 4:1 participant to stffing ratio. A minimum of 1 full time staff will be in attendance.

“ WSSRA is good

because they are good! Yeahh!

Andrew Effgen

ATTENTION! WSSRA IS GOING TO DISNEY! WHERE DREAMS COME TRUE...

Start saving NOW! WSSRA is looking to plan a trip to Disneyworld in January 2012. Please look for more details coming in our Fall brochure. Age: 22 years and older

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Teens & Young Adults HOT SHOTS & SOCIALITES: Program Location: Carroll Center, 1125 S Kenilworth, Oak Park

Pick Up Point: WSSRA Office, 2915 Maple Street, Franklin Park or McDonalds, 5500 Cermak (West of Laramie), Cicero Pick up Point Transportation: $2.75 per week Ability Group: DDMI Age: 15 years and older

HOT SHOTS:

SOCIALITES:

pick up & drop off @Carroll Center

pick up & drop off @Carroll Center

NORTHLAKE DAYS

Come get a taste of Northlake! Enjoy a night of food, carnival games, and live music. Bring $15-20 for rides, food and games. Date: 6/25/11 Time: 6:00 – 9:00pm Registration Number: 373-01 Destination: Northlake Fee: $12.00

LUAU POOL PARTY & BBQ

The smoothies are frozen, the theme is set, we’are having a luau that you’ll never forget! Bring bathing suit and towel. MEET AT PARK DISTRICT OF FOREST PARK. Date: 7/9/11 Time: 6:00 – 9:00pm Registration Number: 373-02 Destination: Park District of Forest Park Fee: $15.00

SPORTS & GAMES

Tonight we’ll have a kickball tournament and compete in some games from your favorite TV shows. Date: 7/23/11 Time: 6:00 – 9:00pm Registration Number: 373-03 Destination: Carroll Center, Oak Park Fee: $12.00

SHORELINE ARCHITECTURE TOUR

Come experience a thrill ride on a boat! Learn about Chicago’s history, landmarks and architecture as we tour the Chicago River. Dress for the weather. Date: 7/30/11 Time: 6:00 – 9:00pm Registration Number: 373-04 Destination: Navy Pier, Chicago Fee: $20.00

CHICAGO ETHNIC TOUR

Get a taste of Chicago as we travel on a trolley to Chinatown, Greektown and Little Italy. A lite dinner included. Don’t miss out on this voyage! FRIDAY EVENT. SPACE IS LIMITED. Date: 8/5/11 Time: 6:00 – 9:00pm Registration Number: 373-05 Destination: Trolley Tour Fee: $25.00

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TEACHING OLD DOGS NEW TRICKS

Tonight we’ll have special guests from Rainbow Animal Assisted Therapy. Come meet some therapeutic dogs and learn how to teach new tricks. Date: 6/25/11 Time: 6:00 – 9:00pm Registration Number: 376-01 Destination: Barrie Center, Oak Park Fee: $12.00

LUAU POOL PARTY & BBQ

The smoothies are frozen, the theme is set, we’re having a luau that you’ll never forget! Bring bathing suit and towel. MEET AT PARK DISTRICT OF FOREST PARK. Date: 7/9/11 Time: 6:00 – 9:00pm Registration Number: 376-02 Destination: Park District of Forest Park Fee: $15.00

CHICAGO RUSH

Cheer on the Chicago Rush arena football team as they defeat the Milwaukee Mustangs! Bring money for snacks. Date: 7/23/11 Time: 6:00 – 9:00pm Fee: $20.00 Destination: Allstate Arena, Rosemont Registration Number: 376-03

ZUMBA IN THE PARK

ZUMBA is a fusion of Latin and International music. Join us as an instructor leads us with energetic and easy to follow dance moves! Wear comfortable clothing. Date: 7/30/11 Time: 6:00 – 9:00pm Registration Number: 376-04 Destination: Barrie Center Fee: $16.00

CHICAGO ETHNIC TOUR

Get a taste of Chicago as we travel on a trolley to Chinatown, Greektown and Little Italy. A lite dinner included. Don’t miss out on this voyage! FRIDAY EVENT. SPACE IS LIMITED. Date: 8/5/11 Time: 6:00 – 9:00pm Registration Number: 376-05 Destination: Trolley Tour Fee: $25.00


CITY SLICKERS & MOONLIGHTERS: Program Location: Barrie Center, Garfield & Lombard, Oak Park Pick Up Point: WSSRA Office, 2915 Maple Street, Franklin Park or

NEW TO SATURDAY NIGHTS? – CALL THE OFFICE FOR GROUP PLACEMENT 847.455.2100

McDonalds, 5500 Cermak (West of Laramie), Cicero Pick up Point Transportation: $2.75 per week Ability Group: DD, MI Age: 15 years and older

CITY SLICKERS:

MOONLIGHTERS:

pick up & drop off @Barrie Center

pick up & drop off @Barrie Center

NORTHLAKE DAYS

Come get a taste of Northlake! Enjoy a night of food, carnival games, and live music. Bring $15-20 for rides, food and games. Date: 6/25/11 Time: 6:00 – 9:00pm Registration Number: 374-01 Destination: Northlake Fee: $12.00

LUAU POOL PARTY & BBQ

The smoothies are frozen, the theme is set, we’re having a luau that you’ll never forget! Bring bathing suit and towel. MEET AT PARK DISTRICT OF FOREST PARK. Date: 7/9/11 Time: 6:00 – 9:00pm Registration Number: 374-02 Destination: Park District of Forest Park Fee: $15.00

TEACHING OLD DOGS NEW TRICKS

Tonight we’ll have special guests from Rainbow Animal Assisted Therapy. Come meet some therapeutic dogs and learn how to teach new tricks. Date: 6/25/11 Time: 6:00 – 9:00pm Registration Number: 374-03 Destination: Barrie Center, Oak Park Fee: $12.00

SHORELINE ARCHITECTURE TOUR

Come experience a thrill ride on a boat! Learn about Chicago’s history, landmarks and architecture as we tour the Chicago River. Dress for the weather. Date: 7/30/11 Time: 6:00 – 9:00pm Registration Number: 374-04 Destination: Navy Pier, Chicago Fee: $20.00

CHICAGO ETHNIC TOUR

Get a taste of Chicago as we travel on a trolley to Chinatown, Greektown and Little Italy. A lite dinner included. Don’t miss out on this voyage! FRIDAY EVENT. SPACE IS LIMITED. Date: 8/5/11 Time: 6:00 – 9:00pm Registration Number: 374-05 Destination: Trolley Tour Fee: $25.00

TEACHING OLD DOGS NEW TRICKS

Tonight we’ll have special guests from Rainbow Animal Assisted Therapy. Come meet some therapeutic dogs and learn how to teach new tricks. Date: 6/25/11 Time: 6:00 – 9:00pm Registration Number: 375-01 Destination: Barrie Center, Oak Park Fee: $12.00

LUAU POOL PARTY & BBQ

The smoothies are frozen, the theme is set, we’re having a luau that you’ll never forget! Bring bathing suit and towel. MEET AT PARK DISTRICT OF FOREST PARK. Date: 7/9/11 Time: 6:00 – 9:00pm Registration Number: 375-02 Destination: Park District of Forest Park Fee: $15.00

CHICAGO RUSH

Cheer on the Chicago Rush arena football team as they defeat the Milwaukee Mustangs! Bring money for snacks. Date: 7/23/11 Time: 6:00 – 9:00pm Fee: $20.00 Destination: Allstate Arena, Rosemont Registration Number: 375-03

ZUMBA IN THE PARK

ZUMBA is a fusion of Latin and International music. Join us as an instructor leads us with energetic and easy to follow dance moves! Wear comfortable clothing. Date: 7/30/11 Time: 6:00 – 9:00pm Registration Number: 375-04 Destination: Barrie Center Fee: $16.00

CHICAGO ETHNIC TOUR

Get a taste of Chicago as we travel on a trolley to Chinatown, Greektown and Little Italy. A lite dinner included. Don’t miss out on this voyage! FRIDAY EVENT. SPACE IS LIMITED. Date: 8/5/11 Time: 6:00 – 9:00pm Registration Number: 375-05 Destination: Trolley Tour Fee: $25.00


Teens & Young Adults SHOW TIME

MI, AUT, DD Enjoy a night at the movies with friends. Participants need to bring $20.00 to pay for the show and snacks. Meeting time will be based on local show schedule. Call the office the Wednesday before program for information on show time. Participants need to be able to focus on a movie two hours in length with limited breaks. This is to minimize the disturbance of other audience members. Participants will see movies rated: G, PG & PG13. Age: 15 years & older Barrie Recreation Center, Oak Park locations only Pick up Points available: WSSRA Office: 5:15 PM, 10:00 PM Cicero McDonalds: 6:15 PM, 9:15 PM Registration Number: 360-01 Friday, July 1, 2011 Fee: $12.50 Trans: $2.75 Registration Number: 360-02 Friday, July 22, 2011 Fee: $12.50 Trans: $2.75

Age: 15 years and up

FOOD CRITICS

Age: 15 years & older Date: Fridays, June 24, July 8, 15, 29, 2011 Time: 6:30-9:15 PM Location: Barrie Center, Oak Park Fee: $12.00 per week Transportation: $2.75 per week/ $11.00 for 4 weeks Pick up points: WSSRA Office: 5:15 PM, 10:00 PM Cicero McDonalds: 6:15 PM, 9:15 PM Date Restaurant June 24 Russells BBQ July 8 Skrine Chops July 15 Famous Daves July 29 Robinsons

Location Elmwood Park Forest Park North Riverside Oak Park

PP

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381

6/28/11 – 7/10/11

Beauty and the Beast Experience the romance and enchantment of DISNEY’S BEAUTY AND THE BEAST!

Ford Center/ Oriental Theatre, Chicago

481

11/13/11

The Sound of Music Experience the enchanting story of Maria & the 7 Von Trapp children.

$40.00 Drury Lane Theatre, Oak Brook Terrace

PP

MLH, MI, AUT, DD Come help us decide who we will crown “Pitmaster” as we compare the tastes and surroundings of four local BBQ spots. Lively discussions about what we liked best each week will be part of the fun. Bring $20 to cover your food and share of the tip. Participants need to be able to sit for a meal with minimal interruptions to others.

Regist # 361-01 361-02 361-03 361-04

BROADWAY TOUR

HI, VI, PI MLH, DD Do you enjoy live theatre? Join us in our very own Broadway Tour. Registered participants will be notified of the actual show dates once WSSRA is able to secure tickets after the ticket release date. Once you are notified of the actual show date and time you are obligated to pay for the ticket. Ticket prices may vary from list below: Participants need to be able to focus on a 2+ hour performance with minimal interruptions. This is to minimize the disturbance of other audience members.

$40.00


Older Adults WILD CARD WEDNESDAYS

HI, VI, PI, MLH Join us for an early morning of socializing and card shuffling fun! Light & healthy refreshments will be served. Participants can register for one or all of the weeks. Time: 9:30 AM-12:30 PM Location: Franklin Park Community Center Fee: $62.40 / 6 weeks ($10.40 per week) Trans: $36.30 / 6 weeks ($6.05 per week) Date: Wednesdays 365-01: June 22 365-02: June 29 365-03: July 6 365-04: July 13 365-05: July 20 365-06: July 27

T

SUMMER IN THE CITY

HI, VI, PI, MLH Join us for a night of socializing, and laughter. We enjoy two local dining establishments.

366-02 7/21

Date: Tuesdays Time: 9:30 AM-12:30 PM Location: Varies Fee: $11.00 week / $66.00 6 weeks Trans: $6.05 week / $36.30 6 weeks Program Number: Date/Outdoor Location/Indoor Location 367-01: June 21/Commons Park, North Riverside/ North Riverside Mall 367-02: June 28/Proksa Park, Berwyn/North Riverside Mall 367-03: July 5/Lindberg Park, Oak Park/Harlem Irving Plaza 367-04: July 12/Center at North Park, Franklin Park/ Harlem Irving Plaza 367-05: July 19/Lakefront Tour/North Riverside Mall 367-06: July 26/Dominican University, River Forest/ North Riverside Mall

T

Date: Thursdays Time: 6:00-8:00 PM Location: WSSRA Office, Franklin Park Fee: $7.50 per week / $15.00 2 weeks Trans: $6.05 per week / $12.10 2 weeks 366-01 6/30

WALK N DINE

HI, VI, PI, MLH Join the WSSRA Walking Club and get walking to a healthier heart while enjoying friends too! The group will walk or wheel at different locations. Afterwards, join us for an enjoyable, light, healthy lunch together at different local restaurants. Participants will be responsible for buying their own lunch. Participants must be independent in mobility. Sign up for the weeks that fit your schedule!

T

Join us for dinner in Elmwood Park. We’ll enjoy excellent Chinese food.

Bring $20 for dinner.

New Star, Elmwood Park

Join us for some Mayan cuisine while dinning in the outdoors with good friends.

Bring $25 for dinner. Dress for weather.

Maya Del Sol, Oak Park

TOWERS SOCIAL

PI VI, MLH Join us for socializing, games/trivia, and a light snack with your coffee while we play cards, “Garbage” style. Location: Community Room, Franklin Towers, Franklin Park Fee: $5.00/week Trans: $6.05/week Time: 12:30-2:30 PM 379-01, Friday, June 24, 2011 379-02, Friday, July 22, 2011 379-03, Friday, August 12, 2011

T

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WSSRA TRANSPORTATION

1. Door to door transportation is available for all programs noted with the transportation symbol. This extra service is available if you pay a $6.05 per round trip fee, for each day the program meets. 2. Transportation to programs from designated pick up points is available for a fee of $2.75 per round trip, for each day the program meets. You must pay at time of registration. 3. All participants being transported in WSSRA vehicles must abide by WSSRA guidelines. Failure to do so will result in suspension from transportation. Repeat offenders will not be transported by WSSRA. 4. Parents or participants must notify the Association in regard to any change in transportation. 5. If an Association vehicle cannot complete a route and family members must pick up riders, a credit will be issued for the participant’s later use. 6. Any registration received after June 3, 2011 may result in a late program start or no transportation. 7. Parents are requested to notify their child’s school on days students are being picked up by a WSSRA van. 8. A participant under the age of 16 must be taken off the van by a responsible person over 12 years old.

PLAYING IT SAFE

Due to new state legislation, car seats or booster seats must be provided for all children ages seven and under. For more information contact Bob Foster.

WAIVER OF LIABILITY

WSSRA is insured through a self insurance pool with other Special Recreation Associations and Park Districts. Our pool is known as the Park District Risk Management Agency (PDRMA). As a loss prevention measure, PDRMA is requiring participants to execute a release of liability for programs. The reverse side of the registration forms contains the WSSRA waiver release form. This must be signed and returned to the WSSRA office before participants can be in programs. Since we do not carry medical or accident insurance for program participants, the release of liability is necessary. The cost of such coverage would make our program fees too high for most to afford. Please review your personal health plan to be certain that you and your family have coverage in instances like these. Our objective is to offer a high quality program at a reasonable cost. The use of a release of liability when appropriate is but one way we are trying to meet that objective. If you have any questions, call Sandra Gbur at 847.455.2100. We appreciate your continued involvement and support.

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WALK-IN OR MAIL-IN OR FAXED REGISTRATION PROCEDURES

1. Complete the enclosed registration form with correct program selection, day, program fee, transportation and payment option. 2. Contact your local park district or village for use of their fax machine to fax your registration. 3. All signed registration forms received by June 3, 2011 will be processed by the WSSRA Registrar and approved for program and transportation information. 4. All registrations will be accepted on a first-come, first served basis until we reach our maximum enrolment for each program. 5. Mail-in or walk-in registrations received AFTER 5:00 PM June 3, 2011 may result in a late program start and transportation may not be available. 6. If a program closes, you will be put on a waiting list and contacted if openings are available. 7. Recreation Specialists MAY NOT accept program payment or registration forms at programs. This must be done by mail or at the office only. 8. Anyone registering MUST have a working phone number. 9. A participant cannot register for the next season until balance from previous season is paid.

PHONE-IN REGISTRATION PROCEDURES ONLY

1. Phone-in registration begins April 27, 2011 and will be accepted until June 3, 2011. Any mail-in and faxed registrations received prior to April 27, 2011 will be processed in the order they are received). 2. Calls will be accepted Monday through Friday from 9:00 until 4:30 PM. 3. The WSSRA Registrar will assist you in completing the registration form. She will be sure the programs selected are age and ability appropriate. 4. A confirmation letter will be sent to you. Sign the attached waiver form and return to WSSRA by June 3, 2011 . 5. The registration will be on hold until we receive the signed registration form. No participation can take place without this signature. 6. Phone-in registration WILL NOT BE ACCEPTED after March 25, 2011 . 7. Faxed, mail-in or walk-in registrations will be accepted after June 3, 2011 but may result in a late program start and transportation may not be available. 8. All registrations will be accepted on a first-come, first-served basis until we reach our maximum enrolment for each program. 9. If a program closes, you will be put on a waiting list and contacted if openings are available. 10. Recreation Specialists MAY NOT accept program payment or registration forms at programs. This must be done by mail or at the office only. We can accept credit card payments over the phone during business hours. 11. Anyone registering MUST have a working phone number. 12. A participant cannot register for the next season until balance from previous season is paid.


SUMMER 2011 REGISTRATION FORM

MAIL TO: WSSRA, 2915 Maple Street, Franklin Park, IL 60131 FAX TO: 847.455.2157 SIGNED REGISTRATION MUST BE RECEIVED BY JUNE 3, 2011

Participant’s Name:___________________________________________ Birth Date:___________________ Address:___________________________________________ City/State:_______________________ /________ Zip:________________________ Park District/Village:_________________________________________ Home Phone:________________________________________________ Parent Or Guardian Name:_______________________________________________________________________________________________ e-mail address: Parent/Guardian Work Phone:___________________________________ Parent/Guardian Cell Phone:__________________________________ Who Should We Contact If Parent/Guardian Is Unavailable? Name:___________________________________ Phone:_______________________ Doctor’s Name: ____________________________________________ Doctor’s Phone:_______________________________________________ Present School/ Workshop/Other:_________________________________________________________________________________________ Teacher/Supervisor Name:______________________________________ Dismissal Time:____________________________________________ Participant’s Disability:_________________________________________________________________________________________________ Can Participant Transfer? □Yes □No Does Participant Use Wheelchair/Walker? Specify:______________________________________________ Is Participant Subject To Seizures: □Yes □No List Any Medication:_______________________________________________________________ Is Medication Taken At Program? □Yes □No List Any Allergies:_____________________________________________________________________________________________________ Does Participant Have A Communicable Disease? □Yes □No If Yes, Please Explain__________________________________________________ ___________________________________________________________________________________________________________________ Program #

Program Name

Day

Fee

Transp

Subtotal Program & Transport FEES

TOTAL DUE:

FEE PAYMENT OPTION - CHECK ONE

□ Total Payment Enclosed □ Total Payment to Follow (if FAXED) □ Request Scholarship □ Payment Plan – Arranged with Finance Manager □ Credit Card □ Visa □ Master Card □ Discover Exp. Date: ____________

Card Number:

I have read the Waiver Release of All Claims and Hold Harmless Agreement on the reverse and unless I have checked NO under the three authorizations, I approve them. ___________________________________________________

Parent/Participant/Guardian Signature

____________________________

Date

HOLD HARMLESS RELEASE ON REVERSE SIDE


West Suburban Special Recreation Association

WAIVER RELEASE OF ALL CLAIMS AND HOLD HARMLESS AGREEMENT (Read Carefully)

Please read this form carefully and be aware that in signing up and participating in West Suburban Special Recreation Association programs, you will be waiving and releasing all claims for injuries arising out of these programs that you or the named participant might sustain. The terms “I”, “me” and “my” also refer to parents or guardians as well as participants in the programs. In registering for these programs, you are agreeing as follows: As a participant in these programs, I recognize and acknowledge that there are certain risks of physical injury, and I agree to assume the full risk of any injuries, damages or loss which I may sustain as a result of participating in any manner, in any and all activities connected with or associated with such activities and involve substantial risks of injury. I agree to waive and relinquish any and all claims I may have as a result of participating in these programs against the West Suburban Special Recreation Association, any and all participating governmental units, any and all independent contractors, officers, agents, servants and employees of the governmental bodies and independent contractors, and any and all other persons and entities of whatever nature that might be directly or indirectly liable for any injuries, that I might sustain while participating in these programs. I do hereby fully release and discharge the West Suburban Special Recreation Association and the other released parties from any and all claims for injuries, damages or loss, which I may have or which may accrue to me on account of my participation in these programs.

I further agree to indemnify, hold harmless and defend, the West Suburban Special Recreation Association and any and all other parties from any and all claims resulting from injuries, damages and losses sustained by anyone, and arising out of, connected with, or in any way associated with my conduct and the activities of these programs. I further understand and agree that the terms such as “participation”, and “activities”, referred to in this 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 events. I understand the nature of these programs for which I am registering, and have read and fully understand this Waiver, Release and Hold Harmless Agreement. I further understand that any advisement 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. In case of emergency, I give my permission for the participant to receive any first aid, transportation or medical attention that may be required. You may return this waiver and release of all claims by mail or fax. You may mail this release to 2915 Maple St., Franklin Park, IL 60131 or send by facsimile transmission to 847.455.2157. When forwarding by fax, it is mutually understood that the facsimile document shall substitute for and have the same legal effect as the original form.

To Communicate with School/Health Care Personnel*

I authorize counsellors, teachers, case workers, therapists, or physicians to communicate with WSSRA about the participant’s needs as they relate to WSSRA’s provision of recreation services to the participant. WSSRA will keep confidential all information obtained through such communications.

□ yes □ no

To Disclose Information to WSSRA Member Partners*

WSSRA may disclose to my home park district or municipality information about the participant’s and my involvement in WSSRA programs or activities, including our names, telephone number, address, program registrations, and the participant’s age and disability, provided that my home park district or municipality shall not redisclose that information without my express written consent.

□ yes □ no

To Release Information for Publicity Purposes*

I authorize the use of photographs or descriptions of the participant or of me in publicity materials about WSSRA programs and services, which may appear in newspapers, member partner brochures, video presentations, web sites and other similar mediums or displays.

□ yes □ no

*I understand that I can change my decisions regarding the statements above at any time for any reason by delivering a written notice to WSSRA, prohibiting further disclosure information.

COMMENT SHEET – WE WELCOME YOUR INPUT!

We invite you to share with us your program ideas and comments about our services: _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ You can also send us an email at wssra@wssra.net

Support WSSRA by following us on


Special Events HOT SUMMER DAYS

Registrati ALL ABILITIES (SEE EACH EVENT FOR AGES) Day Camp may be over, but the fun isn’t! Have your child join us for any one or all of the “Hot Summer Days” activities in August. • Limited spaces - so register today! • In the case of rain, alternate activities will be planned to visit an indoor location. • All events will leave from the WSSRA office and a central location to be announced. • Specific details will be available after registration • Please send a sack lunch for each event • WSSRA will provide a beverage • Door to door transportation will be available for $6.05 for each event REGISTRATION NUMBER/AGE

DATE

DROP OFF & PICK UP TIMES

ACTIVITY

DESTINATION

FEE

315-01/6-22

08/03

9:00am3:00pm

CSI CHICAGO Put on your detective hat because we’re heading downtown for a scavenger hunt in Millennium Park! We’ll have a picnic lunch and finish the day by cooling off in the fountain.

Millennium Park

$21.00

315-02/6-22

08/04

9:00am3:00pm

GIDDY UP! We’re heading to Equestrian Connection for an afternoon of horseback riding, art therapy and fishing.

600 N. Bradley Rd., Lake Forest, 60045

$28.00

315-03/6-22

08/05

10:00am4:00pm

LIFE’S A BEACH We’ll spend the day maxin’ and relaxin’ at Centennial Beach in Naperville. Bring your swimming gear and lunch.

500 W. Jackson, Naperville

$21.00

315-04/3-22

08/16

10:00am4:00pm

ENCHANTED SUMMER DAY We’re heading to Enchanted Castle for an action-packed day of bumper cars, mini-golf, laser tag and pizza!

1103 S. Main St., Lombard

$25.00

315-05/3-10

08/17

9:00am3:00pm

KOHLS CHILDREN’S MUSEUM Join us for an exciting day of exploration at Kohls Children’s Museum!

2100 Patriot Blvd., Glenview

$21.00

315-06/11-22

08/17

9:00am3:00pm

SEADOGGIN’! Hold on to your hats and buckle up! We’ll be cruising Lake Michigan on the Seadog. After the boat ride we’ll enjoy a picnic lunch in Grant Park.

600 E. Grand Ave., $25.00 Chicago - Navy Pier

315-06/3-22

08/18

10:00am4:00pm

GRILLS, CHILLS & THRILLS! A bounce house, a BBQ and 7500 W. Harrison, Forest Park an afternoon of swimming. What more could you want? Wrap up the summer with an afternoon of fun!

$21.00

JUST THIS ONCE SERIES – ADULTS

PI, VI, HI, MLH Enjoy one or all of our Just This Once Series. Door to door transportation for each event: $6.05 REGISTRATION NUMBER

DATE

DROP OFF & PICK UP TIMES

ACTIVITY

DESTINATION

FEE

375-01

08/23

10:00am2:00pm

GALOS CAVE Revitalize yourself with the healing power of Crimean salt from the Dead Sea. We’ll enjoy lunch after a rejuvenating 45 minute session at the caves.

6501 W. Irving Park Rd., Chicago

$25.00

375-02

08/26

9:00am3:00pm

RIVERS CASINO Who’s gonna be the first person to break the bank at Illinois’ brand new casino?

Des Plaines River Rd. & Devon

$25.00

375-03

08/31

11:00am5:00pm

MOVIE GOERS We’ll check out a descriptive movie at a Chicagoland movie theater. Bring $ for lunch.

TBA

$20.00

375-04

09/07

9:00am3:00pm

SEADOGS We’re heading to Navy Pier for a ride on the Seadog on an architectural tour along the Chicago River. We’ll wrap up the day with lunch downtown.

Navy Pier, Chicago

$25.00

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West Suburban Special Recreation Association

PRSRT STD U.S. POSTAGE PAID COMPLETE MAILING SVC, IL

2915 Maple Street | Franklin Park, Il 60131 P 847.455.2100 | F 847.455.2157 www.wssra.net

POSTMASTER Dated Material Please DO NOT HOLD

BRING THE WHOLE FAMILY! r Ca

nival

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Proceeds from this event support WSSRA & the Berwyn Park District recreation programs.

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• CARNIVAL GAMES • FREE CHILDREN’S CRAFTS • DUCK RACE • REFRESHMENTS • ADOPT A DUCK FOR A CHANCE TO WIN $500

Qu a c k y d

GREAT AMERICAN DUCK RACES®

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WACKY QUACKY DUCK SPLASH & CARNIVAL OF FUN

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SATURDAY JULY 16, 2011 2:00 TO 6:00 PM 3001 WISCONSIN, PROKSA PARK IN BERWYN Sponsored by

Summer 2011 Brochure  

Summer 2011 brochure

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