2012 IAHPERD

State Convention

November 15—16, 2012

Pheasant Run Resort

St. Charles, Illinois

Focus on Quality Programs

Promote

Progra

m Impro

vements

Advertise the Value of Physical Activity

Educate the Community

KNOW YOUR LEGISLATOR

Illinois Association for Health, Physical Education, Recreation and Dance November 14 - 17, 2012

Pheasant Run Resort, St. Charles, Illinois

Registration and Membership Wednesday, November 14 3:00 p.m. – 8:00 p.m. Thursday, November 15 7:00 a.m. – 4:00 p.m. Friday, November 16 7:00 a.m. – NOON Exhibits and Other Displays Thursday, November 15 7:45 a.m. – 5:00 p.m. Friday, November 16 7:45 a.m. – 3:00 p.m.

GENERAL INFORMATION

DO NOT ATTEMPT TO PRE-REGISTER AFTER OCTOBER 19, 2012.

ALL MATERIALS WILL BE RETURNED TO YOU, AND YOU WILL BE REQUIRED

TO REGISTER ON-SITE. IT TAKES A LARGE AMOUNT OF TIME TO PREPARE

THE MATERIALS, BADGES, ETC., WHICH IS WHY IAHPERD MUST ADHERE TO

THE PRE-REGISTRATION CUT-OFF.

NOTICE: IAHPERD’S e-mail address, phone number and FAX.

iahperd@gmail.com

E-mail is the most effective method of communication as the IAHPERD office has only 1 full-time person.

Phone number: 217-245-6413

FAX: 217-245-5261

Wednesday, November 14 IAHPERD Executive Board 7:00 p.m.

Thursday, November 15 Council of Future Professionals Business / Social 10:45 a.m. – 11:45 a.m. IL Coalition for Adapted PE Business Meeting 10:45 a.m. – 11:45 a.m. Coalition Committee Meeting 10:45 a.m. – 11:45 a.m. Shape Up Nuts and Bolts 1:30 p.m. – 2:30 p.m. Western District Business Meeting 4:00 p.m. – 5:00 p.m. Southwestern District Business Meeting 4:00 p.m. – 5:00 p.m.

Friday, November 16 District Officers' Breakfast Meeting 7:00 a.m. – 8:00 a.m. Retirees Business Meeting / Social 9:30 a.m. – 10:30 a.m. Blue Ribbon Committee Meeting 10:45 a.m. – 11:45 a.m. IAHPERD Past President’s Meeting 10:45 a.m. – 11:45 a.m. NBCT Committee Business Meeting 12:15 p.m. – 1:15 p.m.

Shape Up Nuts and Bolts 1:30 p.m. – 2:30 p.m. Shape Up Planning Session 2:45 p.m. – 3:45 p.m.

Northeastern District Business Meeting 4:00 p.m. – 5:00 p.m. Northern District Business Meeting 4:00 p.m. – 5:00 p.m.

Chicago District Business Meeting 4:00 p.m. – 5:00 p.m. Saturday, November 17 IAHPERD Representative Assembly 8:30 a.m. IAHPERD Executive Board 11:00 a.m.

Thursday, November 15 Illinois PETE Professionals Breakfast 7:00 a.m. – 8:00 a.m. Council of Future Professionals Business / Social 10:45 a.m. – 11:45 a.m. Exhibitors Social for Attendees 4:00 p.m. – 5:00 p.m. Southwestern District Social 5:00 p.m. – 6:00 p.m. IAHPERD Awards Ceremony 8:00 p.m. All Convention Social Follows Awards Friday, November 16 Retirees Social / Business Meeting 9:30 a.m. – 10:30 a.m Jump & Hoops Meeting / Luncheon (By Invite Only) 12:15 p.m. – 1:15 p.m. Northeastern District Social 5:00 p.m. – 6:00 p.m. Northern District Social 5:00 p.m. – 6:00 p.m. Chicago District Social 5:00 p.m. – 6:00 p.m. All Convention Dance 8:30 p.m. – 12:00 midnight

BUSINESS MEETINGS

SOCIALS

Thursday, November 15, 2012

8:00 p.m.

AWARDS CEREMONY

Please assist IAHPERD in honoring your friends and colleagues who are receiving professional recognition by your presence at this awards ceremony.

AWARD RECOGNITIONS: Quarter Century, Service Award, Honorary Life, Teachers of the Year, Young Professionals of the Year, Student Scholarship, Honor Award, Blue Ribbon Schools, Administrator’s Award, and “Pop” Horton Award

No Dinner will be included.

All Convention Dance

Thursday

Immediately Following the Awards Ceremony

St. Charles Ballroom – Salons 2, 5 and 6

Brought to you by Western District

Exhibitors Social for Attendees

Thursday

4:00 p.m. – 5:00 p.m. Co-Sponsored by Palos Sports, the exhibitor’s social will take place in the Exhibit Hall. Make plans to visit with exhibitors and thank them for attending the convention.

Dance Gala

Thursday

4:00 p.m. – 5:00 p.m.

In conjunction with the Exhibitors Social

Because so many session topics cross several age and topic lines, the 2012 programs will be listed here by category and grade level.

TENTATIVE CONVENTION SESSIONS

MEMBERSHIP

Everyone must be a member of IAHPERD to attend the convention. Members of AAHPERD must still become members of IAHPERD.

This year’s IAHPERD Convention will have sessions exhibiting current information and innovation for PHYSICAL EDUCATION and HEALTH. Find out what has been tried and true and where you can improve your program.

Get the Information

Get the Activities

GET GOING!

Don’t wonder what’s happening – Be what’s happening!

REFUND POLICY

Refunds will be granted for convention registration only, based on requests received in writing prior to November 1, 2012, with a $20 processing fee. Refund checks will not be processed until after the 2012 convention is over and monies are reconciled. No refunds will be granted for any requests received after the November 1, 2012 deadline.

No refunds will be granted for the membership fee.

ADVENTURE CHALLENGE EDUCATION (ACE)

Achieving Fitness with Adventure Activities…It’s a New Twist on Fitness Archery in the Schools (9-12) Processing Teambuilding Activities in One Sentence or Less (9-12)

ADAPTED Systematic Observation in APE: Evidence to Support Best Practice (PK-5) Structured Dance Program for Physical Rehabilitation in Children with CP (6-8) Effective Collaboration with Paraprofessionals in APE (6-8) Paralympic Sport Opportunities in the Chicago Metro Area (9-12) Maximize Participation and Physical Activity in APE (PK-5) Goal Ball and Other Adapted Sports (6-8) Using Movement to Help Identify Learning Disabilities: Research and Practice (6-8) Issues in APE (9-12) Physical Education Curriculum for Students with Identified Special Needs (9-12) Collaborative Teaching in APE (PK-5) The Proper Environment and Power of Play for Autistic Population (6-8) The Evolution of an Inclusive Learn to Sail Program for Paralympic Eligible Youth (6-8) Fun Games for Students with Disabilities (6-8)

The sessions listed in this Pre-Convention flyer are TENTATIVE and could be subject to change at any time.

IAHPERD HAS NO CONTROL OVER CANCELLATIONS BY PRESENTERS (WITH OR WITHOUT PRIOR NOTICE INCLUDING

BEFORE OR DURING THE CONVENTION)

A complete and correct program will be available after September 1, 2012 on the IAHPERD website. (www.iahperd.org)

ADULT

Get Your Questions Answered About TRS Powerful TOOLS that will Increase Your Leadership Effectiveness Knowledge of Physical Activity Principles Amongst Diverse College Students Long Term Care Insurance Informational Sessions Teacher Performance Assessment (TPA) in Physical Education Introduction to the National Board Certification Process Movin’ On Up! Preparing for Career Advancement IAHPERD Program Enhancement Grants Putting Your Local Wellness Policy into Action

BLUE RIBBON Simply the Best…Blue Ribbon Evaluator Training (K-12) How We Were Awarded the Blue Ribbon Twice (6-8) How to Make Your School a Blue Ribbon Award Winner (9-12) It’s Time to Get Your Health Blue Ribbon (9-12)

COUNCIL OF FUTURE PROFESSIONALS Jeopardy I Jeopardy II Super Stars I've completed my student teaching. Now What? Tool Kit for Teachers Student Poster Session

CPDU’S

There will be a CPDU packet in the materials you receive at convention. In your packet, you will find an information sheet, a record of sessions page and an Illinois State Board of Education evaluation form. When you turn in the completed ISBE evaluation form, IAHPERD will furnish you with an evidence of completion certificate. Do not discard your program book, some ROE’s are requiring to

see it, and IAHPERD does not have extras.

CHILDREN (PK - 5th Grade) Fun Fitness Activities and Wellness Workouts Large Group, Little or No Equipment…What Do I Do? Physical Development and Brain Development in Early Childhood The Impact of Content Integration on Student Academic Achievement Catch the Cross Curricular Craze Moving with the Movies Joliet Partners for Healthy Families Core Strength Development for Kids and Adults There are NO Such Things as Girl Push-ups! A Little Bit of This GPS for Curriculum Mapping Got Game? No, Get Game! FUNctional Fitness: Join the Movement Common Assessments – How?! Juggling Skills Progression Moving Generations: Maximizing Leaning Tips Skillastics: Character is Cool Change a Game Adding Literacy to Your PE Program Without Sacrificing Movement Time Promoting Motor Competence in the Early Years: Thematic Ideas from Project SKIP Rookie Rugby for PE Classes The COREMatters Project Developing Aquatic Readiness and Water Competence ExSTEMing Scientific Minds through Physical Activities

DANCE Jump into Jazz Dance (9-12) What Do I Teach in My Beginning PE Ballroom Dance Class? (6-8) Tae Kwon Dance (6-8) We’re Dancing and We Know It! (PK-5) Dancing with the Stars – Shine Up Your Dance Unit (6-8) Middle Eastern Dance as Fitness for Teens (9-12) Designing a High School Dance Program in Your PE Department (9-12) Strategies for Teaching Modern Dance (9-12) Hip Hop is for Everyone! (9-12) Tap Away with Technique (9-12) Learn the Thriller (9-12) Structured Dance Program for Physical Rehabilitation in Children with CP (6-8)

HEALTH Stevenson’s Path to Wellness Part I (9-12) Stevenson’s Path to Wellness Part II (9-12) Teaching Students to Use Their Inner Wisdom (9-12) Power Up with Chocolate Milk (9-12) Teaching Modern Nutrition (9-12) Mindfulness in Undergraduate Students (adult) Teaching Health in a 21st Century (9-12) Utilizing Student Projects to Enhance Your Health Curriculum (9-12) Weighing the Risks and Benefits of Exercise (adult) Rape Trauma Syndrome (college) Mission Nutrition: Engaging Lesson Ideas to Help Students Make Healthy Choices (9-12) Healthy Kids Club: An After School Community Partnership to Address Obesity (9-12) What You Thought You Knew About Breast Self-Exam (adult) Increasing Engagement in the Health Classroom (9-12) Everything I Teach I Stole from the Convention…and a few of my own! (9-12) Synthetic Drugs 101 (9-12) Cooling Down Your Classroom: Just 1,2,3 Breathe (PK-5) Coordinated Approach to Child Health (CATCH): Creating Successful After School Programs for Elementary Schools (PK-5) The Missing Defensive Game Plan (9-12) Rethink Your Drink (adult) CPR Training in the Classroom – An Easy Solution for an Important Lesson (9-12) Handling Sensitive Health Topics Comfortably (9-12) Assessment Show and Tell (9-12) Innovative Health Projects (9-12) Introduction to Nutrigram (PK-5) Leading the Way to School Wellness (6-8) Applying the CHES Competencies: Health Education Senior Projects (college) Health Teachers – Getting Your Students’ Attention and Keeping It (9-12) Technology Driven Health Curriculum in a 1:1 Computing Environment (9-12) Putting Your Local Wellness Policy into Action (adult)

MEMBERSHIP PAYMENT

You may pay membership at the same time you pre-register for convention, or, if your school district is paying the pre-registration, make sure you send IAHPERD your

membership FIRST.

JUMP ROPE FOR HEART / HOOPS FOR HEART (AHA) One School, One Heart (9-12) Money for Your Programs (6-8) Jump Start Your Jump Event (PK-5) Jump and Hoops for Heart Coordinators: How You’ve Changed the World! (PK-5) JRFH Grant Recipients Research Presentations (adult)

TECHNOLOGY iPad and iPhone Tech for Functional Use in PE (9-12) iPads and iPods in PE (PK-5) Enhancing Your Health Education Curriculum with Technology (6-8) Integrating Technology within the Health Curriculum (9-12) Using Fitnessgram Software Mad for iPad? Don’t be a Sap. Know Your Apps! Technology Driven Health Curriculum in a 1:1 Computing Environment Did You Meet Your Objectives? Using Excel Data to Check Success and Improve Performance

TEENAGE YOUTH (6TH - 8TH grade)

Fire Up—Push Up—Stack Up! Fitness Stacking with Speed Stacks 12 Minutes to Fitness: Simple Activities that Yield Complex Results Program Coordinator Non Contact Lacrosse Balance to the Core FITStep Pro Pedometers – Quickly Upload Pedometer Data Can’t Participate in PE? Think Again! Teach Bowling in Your School Middle School Cardio Connections: Linking Fitness Activities with Popular Culture Snapshot of Skills: Lead-up Games and iPads Using Fitnessgram Software Ins and Outs of Sport Education Tchoukball – A Team Sport for All Create a Healthy School Environment with Fuel Up to Play 60 Limited PE Budget? Ideas for Repurposing Equipment for PE Activities Middle School PE and Teacher Preparation: Building a Partnership Physical Education Without Balls The Struggle for Ethics and Health in a World of Steroids and Supplements Sport Education, Multi-activity and Fitness Model – Which is most effective and why? Learn the Game of GAGA BALL

TEENAGE YOUTH (9TH - 12TH grade)

Structuring a Mini-Triathlon for a 45 minute PE Class Sports Medicine and Athletic Training Course for High School Students Shooting Ourselves in the Foot Differentiation in the Fitness Center Impact of the IHSA Multiplier on Illinois High School Athletics Eclipse Ball Co-ed Games Relationship Between Adult BMI and Sport Participation Differentiation in Health and PE Small School, Big Success Coaching a Special Olympics Team Can Unify Your School Kayaking at St. Charles East and St. Charles North High Schools How PE, Health and Driver’s Ed Fit into the PLC Structure Gymstick: A Systematic Approach to Strength Training Supporting Secondary STEM through Physical Activity Learning Readiness PE Fit Strike Kickboxing/MMA Fitness Instructor training Bullying in PE: Creating a Safe Environment for ALL Learners Change for the Better/We Can! Bring Up the Next Generation of Coaches Mad for iPad? Don’t be a Sap. Know Your Apps! Hip Hop Aerobics in the High School Classroom Assessments Made Easy Nitroball Cardio Games

Due to the increasing costs involved with using the United State Postal

Service, IAHPERD will be increasing its use of an electronic means of

communication to deliver information to members.

The "On The Move" newsletter has moved to a monthly electronic format

starting in September, 2012. You will receive an email notifying you that the

newsletter is ready for your viewing. IAHPERD must have a good email

address for you. It has been discovered that many of the IAHPERD

publications will not go through school district email filters. Please be sure

you have notified IAHPERD of a good email address, so you will continue to receive notification of this newsletter.

ON THE MOVE HAS GONE TO ELECTRONIC

COMMUNICATION

TECHNOLOGY CENTER

To enable IAHPERD Convention Attendees to have the opportunity to

become familiar with the technological advances in the profession, the

Convention will host the 7th Technology Center. The Center is now

located by the indoor pool with the waterfall. These sessions are

located in the Marsalis Rooms as they are equipped to handle internet

connections.

Below are sessions currently scheduled:

iPad and iPhone Tech for Functional Use in PE (9-12)

iPads and iPods in PE (PK-5)

Enhancing Your Health Education Curriculum with Technology (6-8)

Integrating Technology within the Health Curriculum (9-12)

Using Fitnessgram Software

Mad for iPad? Don’t be a Sap. Know Your Apps!

Technology Driven Health Curriculum in a 1:1 Computing Environment

Did You Meet Your Objectives? Using Excel Data to Check Success and

Improve Performance

IAHPERD ATTENDEES

YOU ARE INVITED TO

ATTEND

'MOTOR DEVELOPMENT

RESEARCH CONSORTIUM'

SESSIONS AT CONVENTION ON FRIDAY!

Title: Physical development and Brain Development in Early Childhood Presenter: Clersida Garcia Description: This presentation will address the importance of physical development in early childhood

and its benefits for brain function, brain development, and cognitive function.

Friday at 8:15 in St. Charles II

Physical Education - Children

Title: Promoting Motor Competence in the Early Years: Thematic Ideas from Project SKIP Presenter: Jacqueline D. Goodway Description: Project SKIP, Successful Kinesthetic Instruction for Preschoolers, is an evidence based

motor skill program that meets the `Active Start` guidelines. It is designed to promote fundamental motor skill competence and physical activity in children from diverse and disadvantaged backgrounds. This presentation will share the evidence-based findings of SKIP and demonstrate a variety of thematic SKIP activities that are developmentally appropriate, promote moderate to vigorous physical activity, and enhance fundamental motor skill competence.

Friday at 9:30 in SC II

Physical Education - Children

'MOTOR DEVELOPMENT

RESEARCH CONSORTIUM'

Title: Using movement to help identify learning disabilities: Research and practice. Presenter: Nancy Getchell Description: Within the United States, an estimated 15 – 20% of the population have some form of

learning disability (LD), with dyslexia being the most common sub-type. Children must begin to show discrepancies between academic performance and intellectual performance in order to be identified with an LD. The National Center for Learning Disabilities lists both gross and fine motor coordination issues (e.g. clumsiness) as early signs of LD; however, movement is rarely used as diagnostic criteria for learning disabilities. Can early movement differences be used to more systematically screen for children at risk for LD? With this in mind, my research has focused on understanding and quantifying the notion of ‘clumsiness’ in children with different learning disabilities. I will review research on children with learning disabilities, focusing on gross motor coordination during a dual motor task (clapping while walking). After discussing this research, I will offer some practical ways in which movement practitioners can help identify children who may be at risk for LD.

Friday at 10:45 in SC II

Adapted

Title: Developing Aquatic Readiness and Water Competence Presenter: Steven Langendorfer Description: This presentation illustrates a unique developmental perspective applied to the acquisition

of aquatic skills. Instead of a traditional teacher-centered learn-to-swim process that teaches formal strokes, this hands-on presentation describes individualizing the development of water competence for drowning prevention. The in-pool presentation invites participants to “take the plunge” and explore ideas and activities using the 4-P and constraints models to optimize water competence including changing buoyancy, breath control, and water locomotion.

: Friday at 10:45 in the pool

Physical Education - Children

SESSION HANDOUTS SESSION HANDOUTS

This year all card carrying members of IAHPERD, who pay to attend the 2012 State

Convention, will have the ability to compile their own resource guide based on the

session handouts. Members will use their membership number and last name to access

a “members only” section on the IAHPERD website to obtain the handouts. Your

membership number and expiration date are on the mailing label of materials you

receive from IAHPERD.

Check your membership card or JOURNAL for the information regarding your

membership number and expiration date.

If you are planning on using this service,

please read the materials in the convention

packet, as the detailed instructions on

accessing the session handouts will be

included in those materials.

t

EARN GRADUATE CREDIT AT CONVENTION

Overview: 1 semester Hour Graduate Credit per course. Cost is $TBD per credit hour.

Course Title: HS 5988.80 – Workshop in Health and Safety HS 5995.80 – Seminar in Health and Safety

PE 5950.80 – Continuing Professional Development PE 5980.80 – Workshop in P. E.

PE 5990.80 – Seminar in P. E.

Course Requirements: Attend six (6) sessions per course and submit written critiques by the assigned deadline. More information will be provided to you by CSU upon registration.

Registration (2 options): You may register for graduate credit once the cost per credit hour has been determined. Please call the IAHPERD Office for cost.

Option #1 - You may pre-register* by completing the form below and sending it, along with your credit card, check, or money order payment, made payable to IAHPERD to:

IAHPERD P. O. Box 1326

Jacksonville, IL 62651 Option #2 - You may register on-site by submitting a check or money order payment, made payable to IAHPERD/CSU to the CSU registration table. We cannot accept credit cards for on-site registration.

*You must be a current member and pre-registered for the convention to pre-register for graduate credit(s).

All pre-registered and onsite-registered members must check-in at the CSU

Registration table to complete their graduate credit course(s) registration on Thursday, Nov. 15th or Friday, Nov. 16th between 8:00 a.m. and Noon.

The grade you receive for this course will be for spring semester 2013. For more information, contact Dr. Justy Reed at ereed@csu.edu or (773) 995-3646. NAME __________________________________ H (______) ________________ Address _________________________________ W (______) ________________ City ________________________ State ______ Zip _________________ e-mail address: _______________________________________________________

Last Day to pre-register for graduate credit(s) is: OCTOBER 19th All Graduate Credit(s) Course Registrants must check-in at the:

REGISTRATION TABLE, located outside the

St. Charles Ballroom at breezeway to the Mega Center.

If you have never before attended an IAHPERD

convention, please keep these things in mind:

There are over 200 sessions to choose from

You do not have to pre-

register, you may register on-site. There is always room for you.

118 exhibit booth spaces on

site

Time to socialize and meet with old friends as well as make new ones

Membership in IAHPERD

works for a stronger profession

Know the current information –

Be current

Eclipse Ball, Inc. Baggo, Inc. A & M Partnership Gen Move PE Tees Brain In A Bag EKHO Heart Rate Monitors Great Lakes Sports American Heart Association Siddell & Ray Foundation, Children's Health Market Wilmot Mountain ETR Associates Coaches Choice Omnikin, Inc. Minerva Sportswear Hergert Sports Toledo P. E. Supply Empower Training Systems Camp Manitoqua Human Kinetics Publishers Spark Program Fitness Wear Inc. BRAX Spirit Cups Playworld Preferred Palos Sports Wolverine Sports Shield, Inc. IL Bowling Proprietors Foundational Fitness Speed Stacks, Inc. Pickle Ball, Inc. Mindful Practices Bigger Faster Stronger Creative Health Products Skatetime GAGA Ball Pits Pick A Paddle U. S. Games B. R. Sports, Inc. NASCO Fitness Fundamentals St. Louis Dairy Council Litania Sports Group Tchoukball Mixed Bag Designs Crown Gym Mats, Inc. Midwest Dairy Council IL Youth Rugby Association American Sportswear, Inc. Gopher Sport Skillastics Cirque Amongus Inner Strength Solutions Rocky Mountain Pedometer CORE Matters Project Vertical Endeavors US Anti Doping Agency (True Sport)

Take a look at the list of exhibitors that will be at the 2012 IAHPERD Convention. You will have the opportunity to search for “that special item”, purchase products, or comparison shop between companies, as well as talk to various company representatives. Nowhere else in the State of Illinois will you find this

opportunity.

What is your motivation to go

to school/work everyday?

What are you doing to

increase your competence?

School Districts are looking

hard at their teacher's

contribution to the school

and community

Show your District you are

staying current

Attend the IAHPERD

State Convention

1. Everyone (professional/student/retired) must be a current member of IAHPERD in order to attend the convention.

2. In order to pre-register, membership must be current through

12/31/2012. If you are completing the membership application or renewing your membership, you may also complete pre-registration at the same time. Check YOUR membership card to see when your membership expires or e-mail us at iahperd@gmail.com.

3. Student members are those who are full-time undergraduate or full-time

graduate students who do not have full or part-time employment in the field. If you are currently teaching or coaching in the field while attending graduate school, you are a professional.

4. If your School District doesn't pay your membership, make sure you send in

your membership monies BEFORE the School District sends in the pre-registration check.

5. ATTENTION!!! You know that some School Districts don't adhere to

deadlines --- check with them to make sure your material gets sent in on time! It is your responsibility to get your request in to your School District office to give them ample time to meet deadline dates.

6. Please pay attention to the Deadline Dates included in this Pre-Convention

Flyer.

7. DO NOT SEND PRE-REGISTRATION AFTER OCTOBER 19, 2012.

WALK IN ATTENDANCE IS ALWAYS WELCOMED!

REGISTRATION AT THE DOOR WILL BE:

Professional Members $145.00 Full time student members 45.00 Non member professionals 195.00

Non member Students 65.00

HOW TO REGISTER

2012 PREREGISTRATION APPLICATION DO NOT MAIL THIS Pre-registration AFTER October 19

th.

All sections must be filled out so we may properly complete your information in the IAHPERD database.

1 Badge Information (Print Clearly)

NAME ____________________________________________

SCHOOL/ORG. ___________________________________ CITY ____________________________ STATE ________ COUNTY ________________________________________

2 Home Address (Print Clearly)

STREET ___________________________________________________ CITY ___________________________ STATE ________ ZIP _________________ COUNTY___________________________ PHONE __________________________

3 PAYMENT Member Registration See Below ________

Student Registration See Below ________ Retired Registration $10 ________ Non Members Registration See Below ________

Total Payment Enclosed ________

Method of Payment: Check Payable to IAHPERD

Circle one: VISA MasterCard Discover ________________________________________________ Print Name of Card Holder as it appears on card ____________________________________ ___________________ _______________ Credit Card # Expiration Date Security Code

____________________________________________________ Signature

IAHPERD DOES NOT ACCEPT PURCHASE ORDERS!!!

Please provide IAHPERD your e-mail address so you may be quickly contacted if any questions arise.

_________________________________________________________ Print Carefully

MAIL APPLICATION TO:

IAHPERD

P. O. Box 1326

Jacksonville, IL 62651

Membership must be

current through

12/31/2012

2012 REGISTRATION FEE & TIMELINES

Current Professional Members Non Members Must Be Current Through 12/31/2012 Early Bird Registration Until September 30

th $96.00 $146.00

Pre-Registration October 1st

– October 20th

$120.00 $170.00 On-Site Registration $145.00 $195.00 Current Student Members Student Non Current/Non Member Must Be Current Through 12/31/2012 Pre-Registration $25.00 $45.00 On Site Registration $45.00 $65.00

HOTEL RESERVATION FORM Pheasant Run Resort and Convention Center 4051 East Main Street St. Charles, Illinois 60174 Phone 800-999-3320 www.pheasantrun.com CALL NOW Reservations must be made by October 14

th.

Special Rate of $120 per night plus taxes. Any cancellations after October 14

th may be assessed a $50

cancellation fee by the Hotel. Reservations may be accepted after

the 14th

of October if there are rooms available in the room block.

Pheasant Run Resort is

located on Route 64 (North

Avenue). It is west of Route 59 and east of the city of St.

Charles.

ILLINOIS ASSOCIATION FOR HEALTH, PHYSICAL EDUCATION, RECREATION & DANCE P. O. Box 1326 - Jacksonville, IL 62651 (217) 245-6413 iahperd@gmail.com

FAX (217) 245-5261