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WSSRAWSSRA
West Suburban Special Recreation Foundation The West Suburban Special Recreation Foundation (WSSRF) is an Illinois not-for-profit corporation that exists to raise funds for WSSRA. The funds raised by the WSSRF help expand programming and support additional needs of WSSRA when necessary. To learn more about WSSRF, call Marianne Birko at the WSSRA office. The WSSRF needs you!
New Members 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 $40,000 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.
SAVE THE DATE!
West Suburban Special Recreation Association & Foundation present
10.12.18 7:00 - 11:00pm Cheney Mansion Oak Park
A special night of fun & fundraising to benefit the Stars of WSSRA
Food & Hors-d’oeuvres
Featuring:
Event Chairpersons: Lisa Masucci Karern Mullarkey Kerrins Beth Kaplan Lisa Shanahan Margaret O’Rourke
WSSRA provides year round recreation opportunities for individuals with disabilities living in Oak Park, River Forest, Forest Park, Berwyn, Cicero, Elmwood Park, Franklin Park, Harwood Heights, North Riverside and Norridge.
3SUMMER 2018 wssra.net
Table of Contents SUMMER CALENDAR ............................................ 7 SPECIAL EVENTS .............................................9-12 OVERNIGHT TRIPS ............................................. 13 CHILDREN & YOUTH ......................................14-15 SWIM LESSONS ................................................. 16 TEENS & YOUNG ADULTS .................................... 17 SOCIAL CLUBS ................................................. 18 OLDER ADULTS .............................................19-20 SPORTS & FITNESS ..............................................21 SPECIAL OLYMPICS .......................................22-24 ONLINE REGISTRATION ....................................... 26 REGISTRATION FORMS ...................................27-32 REGISTRATION INFORMATION & POLICIES .........33-34
Registration Update All Summer 2018 registration is taken on a first come, first served basis. Summer deadline ..... June 1, 2018
Key to Abbreviations ADD Attention Deficit Disorder ADHD Attention Deficit Hyperactivity Disorder ALZ Alzheimer’s AUT Autism DD Developmental Disability EC Early Childhood ED Emotional Disturbance HI Hearing Impairment LD Learning Disability MI Mental Impairment MH Multiple Handicaps MLH Mental Health PI Physical Impairment SL Speech and Language Delay SO Special Olympics SP Severe and Profound Mental Impairment VI Visual Impairment
For more program information please contact....
Carla Pakenas Children & Youth, (pages 14-15)
Wendy Springgate Teens & Young Adults, Inclusion Support (pages 17)
For questions about Special Olympics, please call the WSSRA office.
follow uS on /wSSra @wSSra @w.S.S.r.a
West Suburban Special Recreation Association 2915 maple street
franklin park, il 60131 847.455.2100 - voice or tty
office hours monday through friday 8:30 am – 5:00 pm
Our Program Guide A great effort has been made to assure the accuracy of the information provided in our Program Guide. Due to the large amount of information, however, errors and changes may occur related to program schedules, locations, transportation and fees. WSSRA reserves the right to make adjustments as necessary. WSSRA will make every effort to notify participants of changes and corrections as quickly and efficiently as possible. We apologize for any inconvenience our errors may cause.
PLEASE REVIEW OUR REGISTRATION POLICIES, THEY HAVE BEEN UPDATED!
Kelly Baran Swim programs, Social Clubs, Older Adults (pages 16,18, 19, 20)
wssra.net SUMMER 20184
Mike Zych ..................................................... wSSra driver
Frank Quaranta .............................................. wSSra driver
WHO WE ARE...... The West Suburban Special Recreation Association is part of your local park district or village recreation department. We provide recreation programs for individuals who have any type of disability. Your park district or village governs the operation of the Association.
berwyn park district .................. jeff janda
clyde park district .................. larry banks
village of elmwood park .............. al schmidt
park district of forest park ........ larry piekarz
park district of franklin park ... joseph modrich
village of harwood heights .......anna wegrecki
hawthorne park district .......... dennis raleigh
norridge park district ............. mark desalvo
north berwyn park district .........joseph vallez
park district of oak park ......... kassie porreca
river forest park district ........... mike sletten
village of north riverside ..........teresa mrozik
Board of Directors Board Meetings The Board of Directors of the Association meets on the second Tuesday of the month, 8 times per year at 4:00pm. Call the office for a meeting schedule and locations. The public is invited to attend.
5SUMMER 2018 wssra.net
Take a minute to get to know our Front Office Staff!
PERSONAL INTERESTS: Tony: I play PC games
Karina: Binge-watching Netflix shows, spending time with my son Sammie and my family.
Noly: Doing fun things with my husband and my children, just spending time with them!Hanging out with our jeep club friends and family going off-roading enjoying the weather. Going to church and watching movies!
FAVORITE MOVIES: Tony: Ready Player One, Black Panther
Karina:I like all types of movies! Too hard to choose but I can always go for a good scary movie!
Noly: Matilda, the Notebook and any Hallmark or Lifetime movies - girly movies.
FAVORITE SPORTS TEAMS: Tony: Chicago Cubs!!!!!
Karina:The Chicago Cubs
FAVORITE FOOD: Tony: Pozole, cow tongue tacos
Karina: I love shrimp and fries! I also love my sweets and am always eating candy at work!
Noly: I like anything but if I had to pick it would be Mexican Food.
FAVORITE THING ABOUT WSSRA: Tony: The staff - how positive they stay even in stressful situations.
Karina:The people I work with and getting to know participants and their families on the phone and in person. I have learned so much at WSSRA!
Noly: Being able to help families with questions and letting them know we are here to serve them with anything they need. Also knowing their children are learning and enjoying our programs.
Sta ff
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BERWYN 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 Ave ........... 708.222.5700 North Berwyn Park District Community Center 1619 Wesley Ave ......... 708.749.4900 PAV Berwyn YMCA 2947 S Oak Park Ave ..... 708.749.0606 Proksa Park 3001 Wisconsin Ave ..... 708.795.2892
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 Ave ...... 708.652.3545 Columbus West School 5425 W 31St .............. 708.780.4482 Duck Pond Pool 5105 31st St Hawthorne Park District 5200 W 29th Pl ........... 708.863.6511 Morton East High School 2423 S Austin Blvd ....... 708.222.5264 Unity East Junior High School 2115 S 54th Ave .......... 708.863.8229 Woodbine School 3003 S 50th Ct ............ 708.652.8884
ELMWOOD PARK Elmwood Park Recreation Center 2 Conti Pkwy .............. 708.452.3935 Elmwood Park Family Aquatic Center 2 Conti Pkwy .............. 708.452.3935 Elmwood Park High School 8201 W Fullerton Ave .. 708.452.7272
FOREST PARK Circle Lanes 7244 Circle Ave .......... 708.366.2810 Field Stevenson School 925 Beloit Ave ............ 708.366.5703 Park District of Forest Park 7501 Harrison St ......... 708.366.7500 Forest Park Middle School 925 Beloit Ave ............ 708.366.5703
FRANKLIN PARK Centre at North Park 10040 Addison St ........ 847.928.8478 Enger School 10401 W Grand Ave ..... 847.455.5299 Franklin Park Community Center 9560 Franklin Ave ....... 847.455.2852 Franklin Park Ice Arena 9711 Waveland Ave ..... 847.671.4268
Karate for Kids 9670 Franklin Ave. #5 ... 847.349.5425 O'Hare CrossFit 9100 Belden Ave ......... 708.417.8502 WSSRA Office 2915 Maple St ............ 847.455.2100
HARWOOD HEIGHTS Harwood Heights Village Hall 7300 Wilson Ave ......... 708.867.7200
MELROSE PARK Mannheim Middle School 2600 Hyde Park Ave ..... 847.455.5020
NORRIDGE Norridge Park District 4631 N Overhill Ave ..... 708.457.1244
NORTH RIVERSIDE North Riverside Community Room 2359 S. DesPlaines Ave . 708.442.5515
OAK PARK Andersen Center 820 Hayes Ave ............ 708.524.2050 Barrie Recreation Center 1101 S Lombard Ave .... 708.383.6905 Carroll Recreation Center 1125 S Kenilworth Ave .. 708.383.6906 Dole Center 255 Augusta St ........... 708.848.7050 Field Recreation Center 935 Woodbine Ave ...... 708.383.6907 Fox Recreation Center 624 S Oak Park Ave ....... 708.383.6908 Gymnastics & Recreation Center (GRC) 21 Lake St ................. 708.725.2200 Irving School 1125 S Cuyler Ave ....... 708.524.3090 Longfellow Recreation Center 610 S Ridgeland Ave .... 708.383.6909 Longfellow School 715 S Highland Ave ...... 708.524.3060 Oak Park Conservatory 615 Garfield St ............ 708.725.2400 Oak Park Country Club 2001 Thatcher Ave ....... 708.453.5554 Oak Park River Forest High School 201 N Scoville Ave ....... 708.383.0700 Rehm Park 515 Garfield St ............ 708.848.9661 Ridgeland Commons Rec Complex 415 Lake St ................ 708.725.2300 Whittier School 715 N Harvey Ave ........ 708.524.3080
RIVER FOREST Keystone Center 7920 Central Avenue .... 708.366.6660
EMERGENC Y 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 5:00pm to 11:00pm, Saturday, 7:00am to 11:00pm when programs are in session only.
2. Leave a message with your phone number at 708.491.3779 and a WSSRA staff will return your call if necessary.
3. The emergency phone should not be a substitute for calling the office for non-emergency questions, such as pick up times.
WWW.WSSRA.NET
Check out WSSRA on the web for directions to program locations and up to date program information.
Email your comments to us: [email protected]
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9:30-12:00
Cam p Red Leaf
In-tents Cam ping
W esthaven, M
I Page 13
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Sensory Saturdays Page 15
wssra.net SUMMER 20188
WSSRA is seeking volunteers for our ITRS Softball Tournament on Sunday, July 15, 2018.
Interested in volunteering?
ITRS Softball Tournament
• Field Umpires
• Registration & Snack Table Volunteers
The tournament will be located at Veteran’s Park located at 7550 W 26th St, North Riverside.
If you are interested volunteering please contact April Ryan at [email protected] or (847) 455-2100.
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SUMMER 2018 wssra.net
Parent and Child Cooking Class – Pie Night (Children ages 7 - 16 and their parent/guardian)
THIS RACE IS PRESENTED BY the Community Bank of Oak Park River Forest,
the River Forest Park District, Concordia University Chicago,
and Fenwick High School.
The race is a 3.1 mile USATF-certified and CARA Certified Green Race course through the flat,
tree-lined streets of River Forest
Race proceeds benefit WSSRA
We’re kicking off the summer with a special event for families with the chefs at Sugar Beet Schoolhouse in River Forest. They will guide the group through making homemade pizza and individual pies that you will then get to enjoy together.
Location: Sugar Beet Schoolhouse, River Forest
Day Dates Time Fee Fri 6/1 6:00 – 7:30p $20/person
Saturday, September 15
8:00am Concordia University
(Bolingbrook Park District)
Fee: $15.00/person Departure Location: TBA
Summer is a time for soakin’ up the hot rays and coolin’ off in the water. Join your friends from
various SRAs for a day at the pool.
Please wear swim attire, bring a towel and a lunch or money for concessions. This is a joint event with other SRA’s in the Chicagoland area. Come out and
meet new friends! Rain or shine.
North Riverside
July4th OF
Oak Park
Parade W e d n e s d ay, J u ly 4 t h
9:30-11:30AM
M o n d ay, M ay 2 8 t h 9:30-11:30AM
River Forest
Join WSSRA & Opportunity Knocks Everyone is welcome to walk! Friends, family, anyone who
wants walk, wheel, carry banners & pass out candy! Call the WSSRA office at 847-455-2100 for more information or to register.
Parents must accompany family members who need supervision.
Memorial Day Parade
JULY 19, 2018 6:30 - 9:30PM
LOCATION: PARK DISTRICT OF FOREST PARK AQUATICS CENTER 7501 HARRISON STREET • FOREST PARK, IL
$5 PER PERSON / $2 PER DUCK
Featuring the Wacky Quacky Duck Splash
Spl i s h Splash Spl i s h Splash Summer BashSummer Bash
Bring your friends and family for a night of swimming, water slides,
a kids play area, fun games and activities, concessions, and more!
JULY 19, 2018 6:30 - 9:30PM
Visit wssra.net to register, adopt your ducks and for Sponsorship Information!
GRAND PRIZE $250 2ND PRIZE $100 Rubber ducks will race down the water slides for
chances to win prizes throughout the night! After the
final heat a champion duck will be crowned. All funds
raised will support the WSSRA scholarship program.
For over 40 years, WSSRA has provided opportunities
to residents with disabilities of the park districts of
Berwyn, Clyde, Forest Park, Franklin Park, Hawthorne,
Norridge, North Berwyn, Oak Park, River Forest, and
the villages of Elmwood Park, North Riverside and
Harwood Heights.
WACKY quacky
d u c k s p l a s h
WSSRA 2915 Maple Street Franklin Park, IL 60131
Mailed adoption forms MUST be received
in the WSSRA office by July 14
Checks payable to WSSRA
Duck adoption will be available at the Splish-Splash Summer Bash.
DUCK ADOPT ION FORM Name _________________________________________
Address _______________________________________
City/State/Zip __________________________________
Phone _________________________________________
_______________________________________________
individual ducks $2.00 each
GRAND PRIZE $250
2ND PRIZE $100
WAC K Y quacky d u c k s ONLY $2
WAC K Y quacky d u c k s ONLY $2
GRAND PRIZE $250
2ND PRIZE $100
847.455.2100
13
Overnight Adventures: Camp Red Leaf
Camp Red Leaf fulfills a vital need for safe, reliable, and enriching programming for individuals with special needs. The highly adaptable programs strive to increase self-esteem, promote interaction, improve social skills and encourage independence in a natural environment.
Activities include: • Swimming • Campfires • Zip-lining • Ropes Courses • Arts & Crafts • Adaptable Sports • Archery • Heated Pool & Lake activities
Location: JCYS Camp Henry Horner/Camp Red Leaf (26710 W. Nippersink Rd., Ingleside IL, 60041)
3-Day Adventure (Age: 13 & older) SP, MH, AUT
This Camp is designed for our WSSRA participants who: • Require assistance with personal care and daily living skills • May require hand-over-hand assistance for participation in recreation activities • Require smaller staff to participant ratio for behavioral and emotional support Days Dates Fee Mon-Wed 8/6-8/8 $325.00
5-Day Adventure (Age: 13 & older) DD, MI, AUT
This Camp is designed for our WSSRA participants who: • Are responsible for independent personal care including feeding, dressing and toileting; • Devoid of emotional outburst that require 1:1 staffing; • Successful socially within 1 staff person per 4 participant ratio. Days Dates Fee Mon-Fri 8/6-8/10 $545.00
WILDERNESS TRIP WILDERNESS TRIP
Beach Bummin’ (Age: 18 and older) DD, MI, AUT
Pack your swimsuit, we’re heading to Michigan City, IN to wind down the dog days of summer with a little bit of grillin’ and chillin’, and lounging on the beach.
Participants attending the trip must be: • Have successfully attended a previous overnight trip with WSSRA; • Responsible for independent personal care including feeding, dressing and toileting; • Independent in mobility, either walking or wheeling; • Devoid of emotional outburst that require 1:1 staffing; • Successful socially within 1 staff person per 4 participant ratio.
Location: Michigan City, IN Days Dates Fee Mon-Wed 8/27 – 8/29 $325.00
(Age:10-15 ) LD, ED
WSSRA will be camping at Van Buren State Park in South Haven, MI for our annual tent camping trip. We will climb sand dunes, build sand castles, swim in Lake Michigan and cook over an open fire.
Days Dates Fee Sun-Wed 8/12 – 8/15 $260.00
Due to the popularity of these trips, it will be offered as a lottery. All participants interested in attending must register by June 25th. WSSRA will notify you by July 2nd. Participants eligible for the In-Tents camping trip are not eligible for the 5-day Overnight Adventure. Please Contact Carlos Marroquin with questions about the overnight trips.
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wssra.net SUMMER 201814
Lekotek (Age: birth – 6 years) All Abilities Borrow toys from WSSRA’s toy lending library. We have over 2,000 toys!! Our certified Lekotek leaders will guide you through a monthly play session and introduce you to a variety of adaptive toys, making play possible for ALL children.
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; • Self-esteem building; • Sibling play and fun!
Day/Time: Call WSSRA to schedule your individual sessions
Registration: Registration will resume for our FALL 2018 session of Lekotek. Call the office for more info.
Jr. Golfers (Age: 6-12 years) MI, AUT, DD, MLH
Join this Parent & Child program to learn the basics of golf under the instruction of a professional.
Participants will be introduced to the following: • Proper stance • Swing and stroke technique • Basic principles of clubs • Proper golf rules & etiquette
This program is made possible through the sponsorship of the Chicago District Golfing Foundation.
Location: White Pines Golf Course Day Dates Time Fee Thurs 6/14 – 7/19 7:00-8:00pm $12.75
Tae Kwon Do (Age: 9-14) All Abilities
This 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.
The building blocks for this system include: • Self-control • Courtesy • Integrity • Friendship • Confidence • Self-awareness • Self-esteem • Perseverance • Self-improvement • Respect • dedication
Location: Karate for Kids (10125 W. Grand Ave., Franklin Park) Day Dates Time Fee Sat 6/16-7/28* 9:00-9:45am $61.50 *No program on 7/14
Uniform Fee: $40.00/one-time fee for new participants in addition to program fee
Bike Bonanza (Age: 3 – 7 years) All Abilities
The wheels on the bikes go round and round! We’ll help your little one learn to ride a bike using the Strider ®curriculum. This program is built on the foundations of balancing, leaning, and steering while self-propelling. WSSRA will provide the Strider ® No-Pedal Balance Bikes, helmets, instruction, and tons of fun!
Location: Stevenson Center, Oak Park Day Dates Time Fee Sat 6/16 – 7/ 21 10:15 – 11:30am $34.00
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Sensory Explorers (Age: 3 – 7) All Abilities
This is a perfect program for the little ones to experience exploration and sensory stimulation! We will keep our hand busy with sensory bins, toys, and multiple crafts and movement activities
Location: Stevenson Center, Oak Park Day Dates Time Fee Sat 6/16 – 7/21 9:00 – 10:15am $34.00
Music Makers (Age: 7-14 years) All Abilities
This music therapy class incorporates instrument playing, sing – a – longs, dancing and sensory explorations to promote communication, socialization and sensory regulation. Class will be led by a certified music therapist from Dynamic Lynks.
Location: Dynamic Lynks (1100 Lake St. 100C, Oak Park) Day Dates Time Fee Thurs 6/14 –7/ 19 4:30p – 5:45p $33.75
Round Trip Transportation Fee: $37.20 15
Saturday Fun Club (Age: 8 - 11 years) All Abilities
Fill your afternoon with active fun and games! We will play sports-themed games as well as team building games and other movement activities.
Program benefits: • Socializing and fun with friends. • Expanding our teamwork skills. • Refining sport and movement
Location: Barrie Center, Oak Park Day Dates Time Fee Sat 6/16 – 7/21 12:15 – 1:30pm $34.00
Sensory Saturdays (Age: 8 - 11 years) All Abilities
This is the perfect program for children to get down and dirty! Join us for hands on fun as we get in touch with our senses. We will explore touch, sight and smell in a variety of ways.
Location: Barrie Center, Oak Park Day Dates Time Fee Sat 6/16 – 7/21 1:30 – 2:45pm $34.00
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wssra.net SUMMER 201816
Duck Pond Pool, Cicero Day Time Dates Age Fee Mon 4:15-4:45p 6/11 – 7/16 3 & up $27.45
Ridgeland Pool, Oak Park Day Time Dates Age Fee T/TH 6:45 – 7:15p 6/12 – 7/19 3 – 8 $39.90 T/TH 7:15 – 7:45p 6/12 – 7/19 6 & up $39.90
Elmwood Park Aquatics Center Day Time Dates Age Fee Wed 5:00-5:30p 6/13 – 7/18* 3 – 8 $25.40 Wed 5:30-6:00p 6/13 – 7/18* 6 & up $25.40 *No lessons 7/4*
PAV YMCA, Berwyn Day Time Dates Age Fee Fri 3:45-4:15p 6/15 – 7/20 3 – 8 $27.45 Fri 4:20-4:50p 6/15 – 7/20 3 – 8 $27.45 Fri 4:55-5:25p 6/15 – 7/20 6 & up $27.45 Fri 5:30-6:00p 6/15 – 7/20 6 & up $27.45 Fri 6:05-6:35p 6/15 – 7/20 ADVANCED* $27.45 *Advanced swimmers must be able to swim 1 length of the pool independently
SwimSwim Lessons
Please note
registration
form
WSSRA conducts swim lessons to allow all individuals to progress from beginner to advanced swimming abilities. Our swim lessons cover fundamental body positions, breath control, stroke drills, and age appropriate safety skills. If you are looking to learn more advanced, competitive, and technical strokes to improve your swimming check out or Bobcat Swim Team page! Parents are responsible for locker room supervision and assistance. Public health code requires that anyone with possible incontinence must wear protective, rubber pants in addition to a swim diaper.
(Age: 3 years & up) All Abilities
17
Outdoor Adventures (Age: 12-22 years) MI, DD, LD, VI
We fill our Saturday mornings with fun and thrills as we explore our communities. The vans will depart promptly at 9:20am! We’re doing a lot of fun and adventurous activities this summer; please make sure you’re prepared with good walking shoes, sun block, hats and a labeled water bottle.
Location: Forest Park, Building 4
Mooooo-ving into Summer Take a trip to Historic Wagner Farms. We will learn about how dairy farms operate, meet some farm animals and enjoy the summer sun! Day Dates Time Fee Sat 6/16 9:00a-12:00p $14.95
Splish Splash Take a dip at Forest Park Pool with WSSRA. Bring money if you would like to purchase a snack. Day Dates Time Fee Sat 6/23 9:00a-12:00p $14.95
Chicago Botanic Gardens Art Festival Frolic in the flowers and enjoy art from around the world at Chicago Botanic Gardens. Bring money if you would like to purchase a snack at the cafe. Day Dates Time Fee Sat 6/30 9:00a-12:00p $14.95
Shop Local Join WSSRA as we visit the Oak Park Farmers Market. Bring money if you would like to purchase anything at the market. WSSRA will provide a light snack at the market. Day Dates Time Fee Sat 7/7 9:00a-12:00p $14.95
CANNONBALL! Take a dip at Forest Park Pool with WSSRA. Bring money if you would like to purchase a snack Day Dates Time Fee Sat 7/14 9:00a-12:00p $14.95
The Big 5-0!! We’re headed to Soldier Field to the Global Day of Inclusion where we’ll celebrate the 50th anniversary of Special Olympics. We’ll also check out the new Eternal Flame of Hope monument. For more information on how to get involved with the 50th anniversary visit www.specialolympics.org/50th Day Dates Time Fee Sat 7/21 11:30a – 5:00p* $25.00
Special Time*
Food Critics (Age: 15 and older) MI, DD, AUT, MLH
Food Critics- Around the World! Come and enjoy the taste of what different countries have to offer! Come and socialize and participate in a lively discussion about what we liked best each week. Bring at least $30 to cover your food and share of the tip. Participants must be able to sit for a meal with minimal interruptions to others.
Location: Carroll Center, Oak Park
New Star Restaurant! Tonight, we will be celebrating Chinese culture at New Star Restaurant in Elmwood Park. Day Dates Time Fee Fri 6/15 6:30-9:15pm $13.00
Maria’s Tonight, we will be celebrating Mexican culture at Maria’s in Elmwood Park. Day Dates Time Fee Fri 6/29 6:30-9:15pm $13.00
Olive Garden! Tonight, we will be going to Olive Garden for some Italian Food. Day Dates Time Fee Fri 7/13 6:30-9:15pm $13.00
Anyway’s Pub! Tonight, you will be able to choose from American, Italian & Mexican food when we go to Anyway’s Pub in Oak Brook Terrace. Day Dates Time Fee Fri 7/20 6:30-9:15pm $13.00
Trans Fee: $2.80/week Transportation Pick-Up Points: WSSRA Office Cicero McDonalds
NEW!! - Hip Hop Dance (Age: 13 and older) All abilities
Dance, dance, dance your way to a healthier you! Pop, jerk, drop! Do you got what it takes!? Come bust out your best moves to today’s hottest hip hop Jams and Beats! You’ll break a sweat and learn some new steps!
Location: Village of North Riverside, Community Room
Day Dates Time Fee Wed 6/13 – 7/18* 5:30 – 6:30p $35.75
*No Program July 4* Round Trip Transportation Fee: $31.0
Showtime (Age: 15 and older) MI, DD, AUT, MLH
Enjoy a night with popcorn your friends and the big screen. WSSRA will notify participants of the show and program time on Wednesday, the week of the movie. To minimize disturbance to other movie patrons, participants must be able to focus on a movie for two hours with minimal breaks. Participants need to bring $20 for ticket and snacks.
Location: Carroll Center, Oak Park
Day Dates Time Fee Fri 6/22 6:30-9:15pm $13.60 Fri 7/6 6:30-9:15pm $13.60
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Moonlighters (Age: 15 and older) MI, DD, AUT
Jackpot! Meeting Location: Village of North Riverside “Luck be a Moonlighter Tonight” Join us as we head over to Rivers Casino and try to win big! Bring money for burgers at Flipt and money for gambling. Recommended amount at least $50. Day Dates Time Fee Sat 6/16 6:00-9:00pm $15.30
Scavenger Hunt Meeting Location: Village of North Riverside Can you find the hidden prizes using your detective skills? Find out tonight if you can be the next Sherlock Holmes. Day Dates Time Fee Sat 6/23 6:00-9:00pm $13.05
Chicago Dogs! Meeting Location: Forest Park Building #4 Come and cheer on Rosemont’s newest baseball team the Chicago Dogs. Game time is 7:00 and we will be staying for the entire game. Calls will be made when we are leaving the game for pick up times. Bring extra money for concession stands and souvenirs. Day Dates Time Fee Sat 6/30 6:00-9:00pm $21.30
Strikes and Spares oh My! Meeting Location: Village of North Riverside Join us for a fun night of bowling over at Circle Lanes in Forest Park. Bring extra money for vending machines. Day Dates Time Fee Sat 7/7 6:00-9:00pm $15.30
Cannon Ball! Meeting Location: Forest Park Main Building Tonight, we will be going to the Forest Park Pool for an end of the season pool party! Don’t forget your swimsuit and towel. Day Dates Time Fee Sat 7/14 6:00-9:00pm $13.05
The Big 5-0!! Meeting Location: Forest Park Building #4 We’re headed to Soldier Field to the Global Day of Inclusion where we’ll celebrate the 50th anniversary of Special Olympics. We’ll also check out the new Eternal Flame of Hope monument. For more information on how to get involved with the 50th anniversary visit www.specialolympics.org/50th Day Dates Time Fee Sat 7/21 11:30a – 5:00p* $25.00 Special Day/Time and Location*
Trans Fee: $2.80/week Transportation Pick-Up Points: WSSRA Office & Cicero McDonalds
Hot Shots & City Slickers (Age: 15 and older) MI, DD, AUT Meeting Location: Forest Park Building #4
Karaoke Night! Come and sing your heart out and have a rocking good time with your friends tonight. Day Dates Time Fee Sat 6/16 6:00-9:00pm $13.05
Strikes and Spares oh My! Join us for a fun night of bowling over at Circle Lanes in Forest Park. Bring extra money for vending machines. Day Dates Time Fee Sat 6/23 6:00-9:00pm $15.30
Chicago Dogs! Come and cheer on Rosemont’s newest baseball team the Chicago Dogs. Game time is 7:00 and we will be staying for the entire game. Calls will be made when we are leaving the game for pick up times. Bring extra money for concession stands and souvenirs. Day Dates Time Fee Sat 6/30 6:00-9:00pm $21.30
Happy 4th of July! Come and enjoy a night full of games and Independence Day crafts at this patriotic program. Day Dates Time Fee Sat 7/7 6:00-9:00pm $13.05
Cannon Ball! Meeting Location: Forest Park Main Building Tonight, we will be going to the Forest Park Pool for an end of the season pool party! Don’t forget your swimsuit and towel . Don’t forget your swimsuit & towel! Bring extra money for snacks from the concession stand. Day Dates Time Fee Sat 7/14 6:00-9:00pm $13.05
The Big 5-0!! We’re headed to Soldier Field to the Global Day of Inclusion where we’ll celebrate the 50th anniversary of Special Olympics. We’ll also check out the new Eternal Flame of Hope monument. For more information on how to get involved with the 50th anniversary visit www.specialolympics.org/50th Day Dates Time Fee Sat 7/21 11:30a – 5:00p* $25.00 Special Day/Time and Location*
Trans Fee: $2.80/week Transportation Pick-Up Points: WSSRA Office Cicero McDonalds
Join a club for some Saturday evening fun! We’ll visit some of your favorite attractions with friends while focusing on enhancement of social skills. Activities planned are
intended for adults who want to venture out while having fun! If you’re new to Saturday nights, call Nick at the office and he’ll help you find the right group!
When Social Clubs are scheduled to attend sporting events, plays, concerts, etc, our return to the meeting locations is approximate. WSSRA will remain at these events until they end. If the group is going to be more than 15 minutes late,
staff will attempt to contact families with updated information. For all out trips, the vans will depart the meeting location 5 minutes after the scheduled start time.
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Walk & Dine (Adults) HI, VI, PI, MLH
Walk or wheel your way to a healthier heart with your friends at WSSRA! We’ll end each week with lunch at a local restaurant. Participants must be independent in mobility. Participants are responsible for purchasing their own lunch ($15/week).
Location: varies
Destination: Lilacia Park Lunch: Main Street Cafe Day Dates Time Fee Tues 6/12 9:30am-12:15pm $12.05 Destination: Commons Park Lunch: Buona Beef Day Dates Time Fee Tues 6/19 9:30am-12:15pm $12.05 Destination: Brookfield Zoo Lunch: At the Zoo Day Dates Time Fee Tues 6/26 9:30am-1:00pm* $12.05 *Pease note extended time
Destination: Proska Park Lunch: Lalo’s Restaurant Day Dates Time Fee Tues 7/3 9:30am-12:15pm $12.05 Destination: Lindberg Park Lunch: Panera Bread Day Dates Time Fee Tues 7/10 9:30am-12:15pm $12.05
Round Trip Transportation Fee: $6.20/week
Yoga for Wellness (Adults) PI, VI, HI, Chronic Illness
Did you know that yoga can help improve flexibility, balance, breathing and concentration? Plus, it can help decrease stress and improve your mood! Join WSSRA as we start the day with breathing exercises and gentle stretching and yoga. Yoga poses will be taught in a seated position in chairs.
Location: Village of Harwood Heights
Day Dates Time Fee Tues 6/12 – 7/17 10:00-11:15am $19.20
Wildcard Wednesdays (Adults) HI, VI, PI, MLH
Start your day with some card shuffling fun! Light & healthy refreshments will be served. Sign up for the weeks that fit your schedule!
Location: Village of Elmwood Park Rec Center
Day Dates Time Fee Wed 6/13 –7/18* 9:30am-12:00pm $56.50 *No program on 7/4 Round Trip Transportation: $31.00
Towers Socials (Adults) HI, VI, PI, MLH
Join us one Friday a month for games and trivia. We’ll enjoy coffee and a light snack while meeting new people and learning new games.
Day Dates Time Fee Fri 6/15 12:30-2:30pm FREE Fri 7/20 12:30-2:30pm FREE Fri 8/17 12:30-2:30pm FREE
Round Trip Transportation: $6.20 /week
Shop and Dine (Adults) HI, VI, PI, MLH
We will hit the stores to stock up on your necessities and then head to lunch at a local restaurant. Participants must be independent in mobility. Participants will be responsible for purchasing their own lunch ($15/week).
Destination: Forest Park Walmart Lunch: Portillo’s
Day Dates Time Fee Tues 7/17 9:30am-12:15pm $12.05
O ld
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regarding the programs for which you have
registered. Please take 3-4 minutes to help us
improve the services we offer. All answers are
anonymous, confidential, and will be used only by
WSSRA.
Just visit wssra.net and click on “tell us what you think!”
Thanks for your
assistance!
Join us as we get out and about to enjoy the wonderful sights, sounds, and tastes of the Chicago suburbs. Participants are responsible for purchasing their own lunch ($15/week).
Pick up/drop off point: Longfellow Park, Oak Park
Destination: Hollywood Casino in Aurora Join us as we try our luck at the Hollywood Casino in Aurora. Bring some spending money for games of your choice and lunch at the buffet! Buffet is $13.99 Day Dates Time Fee Thurs 6/28 10:00am- 3:00pm $15.60
Destination: Chicago Botanical Gardens We will stroll around the beautiful grounds and enjoy a tram tour to learn about the history and science of the Gardens. Lunch will be at the Garden View Café. Day Dates Time Fee Thurs 7/12 10:00am- 3:00pm $15.60 Destination: The Financial Park of Rosemont We will keep busy as we visit the Big Ten Museum, stop for lunch at the Adobe Grille, and head over to the AMC Theatre to watch Mama Mia, Here We Go Again! Please bring money if you want movie snacks. Audio equipment available upon request. Day Dates Time Fee Thurs 7/26 10:00am- 3:00pm $15.60
Destination: Long Grove We will take a tour of the Long Grove Confectionary Co. and enjoy a sweet treat before heading to historic Long Grove to stroll among the shops and enjoy lunch at the famous Village Tavern. Day Dates Time Fee Thurs 8/9 10:00am- 3:00pm $15.60
Round Trip Transportation Fee: $6.20/week
WindyWindy CityCity
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Healthy Start (Age: 21 and older) All Abilities
Start your week with a healthy dose of exercise! We offer Healthy Start TWO days each week—Mondays and Thursdays too, pick one day or both days! Set a fitness goal and let’s accomplish it!
We’ll emphasize: • Stretching & flexibility; • Moderate aerobics; • Use of exercise equipment (Cardio and Weights) Exercise routines will be monitored by staff to meet your individual needs.
Day Dates Time Fee Location: Franklin Park Community Center Mon 6/11 - 7/16 10:00-11:30am $36.50 Round Trip Transportation: $37.20
Day Dates Time Fee
HNEW Location: ROOS Building, Park District of Forest Park Thurs 6/14 – 7/19 10:00-11:30am $36.50 Round Trip Transportation: $37.20
Weekly Workout (Age: 13 and older) MI, AUT, DD, MLH
Finish your day with a great workout! Improve your physical condition through: • Exercise stations; • Weight lifting; • Low impact aerobics
Location: Franklin Park Community Center Day Dates Time Fee Tues 6/12 – 7/17 7:00-8:15pm $30.40
Round Trip Transportation Fee: $37.20
Aqua Exercise (Age: 15 and older) MLH, MI, AUT, DD
Aqua exercise is one of the best exercises for the body with minimal gravitational pull, all muscle groups are worked out. Workouts cover cardio and strength. While having fun in the pool with your friends to various-upbeat music, you will also improve your:
• Strength; • Flexibility; • Mobility; • Resting Heart Rate; • Range of motion
Location: Ridgeland Commons, Oak Park Day Dates Time Fee Tues 6/12 – 7/17 6:45 – 7:45pm $39.90
Round Trip Transportation: $37.20
Intro to Golf (Age: 12 and older) MI, AUT, DD, MLH
Woods, Irons, Driving, and more, OH MY! Come learn the basics of golf under the direction of a professional so you don’t have to yell “fore” on every swing! Focus on the following while enjoying the nice evening summer breeze: • Proper stance; • Swing and stroke technique; • Basic principles of clubs; • Proper golf rules & etiquette. This program is made possible through the sponsorship of the Chicago District Golfing Foundation.
Location: White Pines Golf Course, Bensenville
Day Dates Time Fee Thurs 6/14 – 7/19 7:00-8:00pm $19.75
Round Trip Transportation: $31.00
Saturday Bowling League (Age: 13 and older) MI, AUT, DD, SP, MH
Sharpen your bowling skills while spending time with friends. Bumpers and ramps are available.
Location: Circle Lanes, Forest Park Day Dates Time Fee Sat 6/16 – 7/21 1:00-3:00pm $59.80
Transportation Fee: $16.80 Transportation Pick Up Points: WSSRA Office Harwood Heights Village Hall Elmwood Park Recreation Center Cicero McDonalds
See page 23 for Special Olympics Bowling Tournament Information
Team Up (Age: 22 and older)
WSSRA is pleased to partner with Community Support Services (CSS) in its offering of the Team Up fitness program. WSSRA provides a structured fitness component once a week to individuals who are enrolled in the program.
This program is grant- funded through the Community Mental Health Board of Oak Park residents only.
Criteria: Participants must meet residency criteria, must be successful socially with a 1:4 staffing ratio, and must be independent in personal care.
Day Dates Time W & Th Ongoing 8:30am-1:30pm To Register or for more information: Contact Bailey Pedersen
at Community Support Services 708-354-4547
2022
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ly m
p ic
s Illinois Special Olympics provides year round sports training in a variety
of Olympic-type sports for individuals who are 8 years and older and who have mental impairments or closely related developmental disabilities.
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:
Aquatics, Basketball, Bowling, Golf, Gymnastics, Softball, Track & Field, and Volleyball.
Good Sportsmanship We all share a responsibility in making the Special Olympics training and competition program a positive experience that promotes the growth & development of our athletes. We’re counting on you and your athlete to do the following:
WSSRA’s Expectations of Athletes 1. Demonstrate respect for the rules of the sport
2. Demonstrate respect for coaches, teammates, opponents, opposing coaches and officials. Failure to do so may result in loss of playing time.
3. Come to practices and games ready to play with a positive attitude.
WSSRA’s Expectations of Spectators WSSRA spectators are asked to provide positive support during practice and competition. Negative comments are incredibly detrimental to team morale. Spectators are expected to: 1. Show respect & positive support for ALL WSSRA athletes and our opponents. 2. Show respect & positive support for ALL WSSRA coaches, opposing coaches, officials, and other spectators 3. Be a role model for proper behavior and demonstrate good sportsmanship, and self-discipline. Failure to do so will result in removal from the practice or competition and may jeopardize your attendance at future events.
Criteria for Participation All Special Olympic athletes must have a current, completed Application for Participation in Illinois Special Olympics on file with the Special Olympic coordinator at WSSRA. This form contains 4 sections:
1. Athlete information
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. See page 24 for the Application.
23
Bobcat Volleyball (Age: 15 and older)
We are getting ready for another season!! WSSRA will emphasize teamwork and good sportsmanship throughout the practice season while developing individual and team volleyball skills. Competition begins in August. Players must participate in the practice season to be eligible to compete with the Bobcats. Special Olympics competition requires that all teams are uniformed. New and replacement uniforms will have an additional fee. Team coaches will be able to provide more details once practice season is underway.
Practice Season Info: Location: Village of Elmwood Park Rec Center Day Dates Time Mon 6/11 –7/ 23 6:30 – 7:30pm
Game Season Info: Location: Village of Elmwood Park Rec Center Day Dates Time Fee Tues 7/31 – 9/18* 6:30 – 8:00pm $105.00**
*No program 8/7* **includes practice & game season Regional Tournament: 9/23 at LaGrange Park District
Bobcats Swim Team (Age: 8 and older)
Summer Swim Team is an exercise and training program for those who have excelled in WSSRA swim lessons and can now swim at least one length of the pool independently. Training consists of consecutive lap-swimming throughout the program along with technique refinement. Swim team members are not eligible to register for WSSRA swim lessons.
Location: Park District of Forest Park Pool Day Dates Time Fee Sat 6/16 – 7/21 9:00 – 9:45a $33.75
Transportation Fee: Round Trip $37.20
SO Bowling Tournament If you’re registered for Saturday Bowling League, compete in ISO annual tournament! Winners will advance to the Sectional competition on 10/14.
Registration Deadline: 5/21
Location: Stardust Bowl, Addison Day Dates Time Fee Saturday 7/14 9:00am-3:00pm $24.60 (approximate)
Transportation Pick Up Points: WSSRA Office & Fox Park Trans Fee: $2.80
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SUMMER 2018 wssra.net
Derby Gala - May 5, 2018 Table Sponsorships o GOLD CUP $1,000 - VIP SEATING FOR 8 + FULL PAGE AD IN GALA BOOK o SILVER CUP $900 - SEATING FOR 8 + HALF PAGE AD IN GALA BOOK o BRONZE CUP $800 - SEATING FOR 8 + QUARTER PAGE AD IN GALA BOOK
AD BOOK SPONSORSHIPS o FULL PAGE $600 FULL PAGE: 4 3/4” X 7 3/4” o HALF PAGE $300 HALF PAGE: 4 3/4” X 3 3/4” o QUARTER PAGE $150 QUARTER PAGE: 3 3/4” X 2 1/4” OR 2 1/4” X 3 3/4” o HONOR ROLL $100 HAVE YOUR COMPANY LISTED AS SUPPORTER
o AUCTION DONATION
July 19, 2018 o Gold Sponsor - $500 • Sponsor’s name prominently displayed at the race. • Sponsor has the opportunity to display promotional materials at the event. • A framed sign promoting your sponsorship for display at your location. • Sponsor thanked with full color agency logo in 5,500 WSSRA Fall brochures disseminated throughout the 12 WSSRA communities. • Sponsors listed on the WSSRA’s website through the month of August
o Silver Sponsor - $250 • Sponsor’s name displayed at the race. • Sponsor thanked in 5,500 WSSRA Fall Brochures disseminated throughout the 12 WSSRA communities. • Sponsors listed on the WSSRA’s website through the month of August
o Friend - $50 • Sponsor’s name displayed at the race. • Sponsors listed on the WSSRA’s website through the month of August
o Prize Donor • Your company name posted at the event
o Media Sponsor Sponsor provides one promotion photo 1-2 weeks before event in your publication/website. Sponsor includes provided duck ad or “copy” in publication/website on 3 different dates within 2-3 weeks of event. • Sponsor’s name displayed at the race. • Sponsor thanked in 5,500 WSSRA Fall Brochures disseminated throughout the 12 WSSRA communities. • Sponsors listed on the WSSRA’s website through the month of August. Opportunities for Community Exposure may vary based uponvalue of publication.
October 12, 2018
o $800 GOLD STAR: Full page Ad in 6000 WSSRA brochures + 4 complimentary tickets + 1 month Ad post on website
o $500 SILVER STAR: Half page Ad in 6000 WSSRA brochures + 2 complimentary tickets + 1 month Ad post on website
o $300 BRONZE STAR: 1/4 page Ad in 6000 WSSRA brochures + complimentary ticket
o $100 FRIEND: Listed as a Friend in 6000 WSSRA brochures
WSSRA
Summer Bash
Spl i s h Splash Spl i s h Splash Summer Bash
For more information about becoming an event sponsor, please contact Nicole Walsh at [email protected] or 847-455-2100.
Visit our website at wssra.net for more information about these and other sponsorship opportunities.
O n lin
wssra.net SUMMER 201826
Step 1. Go to WSSRA.net and click on the Register tab
Step 2. Create an account
Step 3. Add participants to your Account that you would like to enroll in programs or activities. Don’t forget to include yourself as the Primary Account Holder.
Step 4. On the registration tab, select an activity that you would like to enroll in - it will be added to your shopping cart.
Step 5. Once you select the activity be sure to select the correct name of the registrant.
Step 6. Check out items in your Shopping Cart.
REGISTER ON LINE: H
O W
T O
For help with creating an account or registering for programs, please call the WSSRA office at 847-455-2100.
mail to: wssra, 2915 maple street, franklin park, il 60131 ··· fax to: 847.455.2157 ··· signed registration must be received by June 1, 2018
participant’s name: ________________________________________________________ birth date: ________________________ gender:________________
address: ________________________________________________________________ city/state: _______________ zip: ___________________________
who should be contacted if parent/guardian is unavailable? name: ______________________________________________ phone: _________________________
present school/workshop/other: ______________________________________________ teacher/supervisor name: ___________________________________
does participant use wheelchair/walker? specify: ____________________________________ ______________________ can participant transfer? *yes
is participant subJect to seizures? *yes *no if yes, please complete and return seizure information form
is medication taken at program? *yes *no list any medication: ______________________________________________________________________________
list any allergies: _______________________________________________________________________________________________________________
does participant have a communicable disease? *yes *no if yes, please explain: ____________
*no
SUMMER 2018 REGISTRATION FORM
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$
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to credit card
PAYMENT OPTION ··· PLEASE CHECK ONE ··· PAYMENT IS EXPECTED AT REGISTRATION, IF YOU ARE UNABLE TO PAY YOUR FULL BALANCE,
A $5.00 DEPOSIT IS REQUIRED FOR EACH PROGRAM, WITH A MAXIMUM DEPOSIT OF $20.00
* total payment enclosed * total payment to follow (if faxed) * deposit made ($5 per prog)
* payment plan arranged with bob foster * request scholarship ($5 per prog deposit still required)
* credit card * visa * master card
card number: expiration date: _____ / _____ amount to be charged: $___________
i have read the waiver release of all claims and hold harmless agreement on the reverse side and unless i have checked no under the three authorizations, i approve them.
parent/participant/guardian signature date
West Suburban Special Recreation Association
WAIVER RELEASE OF ALL CLAIMS AND HOLD HARMLESS AGREEMENT 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.
0 yes 0no
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.
0 yes 0no
*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.
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you can also email us your input at [email protected] | follow uS on /wSSra @wSSra @w.S.S.r.a
west suburban special recreation association
VERANO 2018 FORMA DE INSCRIPCIÓN ENVÍE A: 2915 Maple Street, Franklin Park, Il 60131 O POR FAX: (847)455-2157
nombre de participante: _________________________________________ fecha de nacimiento del participante:_________________ género_____________
dirección: ___________________________________________________ ciudad/estado: ____________________ código postal: ___________________
padre/guarda legal: _________________________________________________________________________________________________________
correo electrónico:
padre/guarda legal tel del trabaJo: _________________________________________ padre/guarda legal tel cel: ________________________________
¿a quien debemos llamar si el padre/tutor no esta disponible? nombre: _________________ telefono: _____________________________________________
escuela actual/trabaJo/otro: _____________________________________________ nombre del maestro/supervisor: _____________________________
discapacidad del participante: ___________________________________________________________________________________________________
¿usa el participante silla de ruedas/andador? especifique: ____________________ ________________ ¿puede el participante trasferirse? *sÍ *no
¿es el participante suJeto a ataques? *sÍ *no por favor adJunte su plan de tratamiento para ataques
¿se toma el medicamento durante el programa? *sÍ *no liste los medicamentos: _________
liste cualquier alergias: _______________________________________________________________________________________________________
¿tiene el participante una enfermedad comunicable? *sÍ *no sÍ la tiene, por favor explique: _____________________________________________________
OPCIÓN DE PAGO ··· MARQUE UNO ··· EL PAGO SE DEBE CUANDO SE REGISTRE, SI NO PUEDE PAGAR TODO EL BALANCE,
SE DEBE PAGAR UN DEPOSITO DE $5 POR CADA PROGRAMA, MAXIMO DE $20.00
* pago total adJunto * pago total a seguir (sÍ mando por fax) * deposito deJado ($5.00 cada programa)
* solicitar beca * plan de pago arreglado con bob foster
* tarJeta de crédito * visa * master card
numero de tarJeta: fecha de caducidad: _____ / _____
v code:________(3 números en la parte posterior de la tarJeta)
he leído la exencion de todas las reclamaciones y acuerdo de mantener indemne y a menos que yo no haya comprobado baJo las tres autorizaciones, los apruebo.
_________________________________________ ______________________ padre/participante/tutor firma fecha
$
$
$
$___________
West Suburban Special Recreation Association
EXENCION DE TODAS LAS RECLAMACIONES Y ACUERDO DE MANTENER INDEMNE Lea por favor esta forma con cuidado y esté enterado que en si firma y participa en el programa de la Asociación West Suburban de Recreación Especial, usted estará liberando y renunciando de todo reclamo de por heridas que surgieran de estos programas que usted o el participante denominado quizás sostenga. Los términos “yo”, “mí” y “mío” también se refieren a padres o tutores así como participantes en los programas. Al registrar para estos programas, usted concuerda de la siguiente manera:
Como participante en estos programas, yo reconozco que hay ciertos riesgos de heridas físicas, y yo concuerdo en asumir el riesgo total de cualquier herida, daños o pérdida que pueda sostener a consecuencia de tomar parte de cualquier manera, en cualquier y todas las actividades conectadas con o asociado de tales actividades que implique riesgos substanciales de alguna herida.
Concuerdo en renunciar y abandonar cualquier y todo reclamo que pueda tener a consecuencia de tomar parte en estos programas contra la Asociación West Suburban de Recreación Especial, cualquier y toda unidad gubernamental participante, cualquier y todos los contratistas independientes, oficiales, agentes, sirvientes, empleados de los cuerpos gubernamentales y contratistas independientes, y cualquier y todas las otras personas y entidades de cualquier naturaleza que quizás sea directamente o indirectamente responsable de cualquier herida que yo quizás sostenga al tomar parte en estos programas.
Yo por la presente renuncio y completamente y libero a la Asociación West Suburban de Recreación Especial y libero a otros partidarios de cualquier y todo reclamo por heridas, daños o pérdida, que puedan incurrirme por motivo de mi participación en estos programas.
Concuerdo aún más indemnizar, tener inocuo y defender, a la Asociación West Suburban de Recreación Especial y cualquier y todos los otros partidos de cualquier y todo reclamo que resulte en heridas, daños y pérdidas sostenidas por cualquiera, y surgiendo fuera de, conectado con, o en cualquier manera asociada con mi conducto y las actividades de estos programas.
Comprendo aún más y concuerdo que los términos como “participación”, y las “actividades”, se refirieron a en este Acuerdo, incluye todos ejercicios y los movimientos físicos de cualquier naturaleza mientras tomo parte en estos programas e incluye aún más la provisión, de o fracaso para proporcionar las instrucciones o la supervisión apropiadas, el uso y el ajuste de cualquier y toda maquinaria, equipo, y aparato, y algo relacionado con mi uso de los servicios, las facilidades, o Implicado en estos programas, y en el transporte a y de acontecimientos.
Comprendo la naturaleza de estos programas para el cual me inscrito, y he leído y comprendo completamente esta Renuncia, Liberación y Acuerdo Inocuo. Comprendo aún más que cualquier deliberación o advertencias de los riesgos particulares de estos programas que recibo subsiguientemente serán integradas por la referencia en y llegan a ser una parte de este Acuerdo.
En caso de emergencia, yo doy mi permiso para que el participante reciba primeros auxilios, transporte o atención médica que pueda ser requerida.
para comunicarse con los trabaJadores de escuela/doctor yo autorizo a los maestras, trabaJadores sociales, terapistas o doctores a comunicarse con wssra acerca de las necesidades del participante en relación a los programas de wssra. wssra guardara toda la información confidencial que recibimos.
o Si o No
para comunicarse con los acompanieros/miembros de wssra yo autorizo que wssra les puede dar información acerca del participante y su participación en programas y actividades a mi distrito de parque o municipalidad de mi ciudad, incluyendo nombre, dirección, numero de teléfono edad. discapacidad o registraciones, si no los revelar de nuevo sin mi firma de concento.
o Si o No
*yo entiendo que puedo cambiar a las declaraciones encima en cualquier momento entregando un aviso escrito a la oficina de wssra, para prohibir revelación adicional del información.
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follow uS on /wSSra @wSSra @w.S.S.r.ayou can also email us your input at [email protected] |
West Suburban Special Recreation Association
SEIZURE INFORMATION date: ___________________________
Please complete this form if the participant experiences seizures, or return a copy of your child’s seizure plan from his/her school. Please update this form whenever there is a change in the seizure plan and submit it with your registration. You will be asked to review this once a year and provide any necessary updates.
CONTACT INFORMATION
emergency contact relationship:_________________________________________________________________________________________________
email address:
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1. Seizure Type (please check):
* Generalized tonic-clonic seizures (grand mal seizures) are the most common and best known type of generalized seizure. They begin with stiffening of the limbs (the tonic phase), followed by jerking of the limbs and face (the clonic phase).
* Myoclonic seizures are rapid, brief contractions of bodily muscles, which usually occur at the same time on both sides of the body. Occasionally, they involve one arm or a foot. People usually think of them as sudden jerks or clumsiness.
* Atonic seizures produce an abrupt loss of muscle tone. They produce head drops, loss of posture, or sudden collapse. Because they are so abrupt, without any warning, and because the people who experience them fall with force, atonic seizures can result in injuries to the head and face. Protective headgear is sometimes used by children and adults.
* Absence seizures (petit mal seizures) are lapses of awareness, sometimes with staring, that begin and end abruptly, lasting only a few seconds. There is no warning and no after-effect.
* Simple partial show no loss of consciousness. Sudden jerking, sensory phenomena. Lasts about 90 seconds.
* Complex partial last about 1-2 minutes in which consciousness is impaired or lost. May have an aura. Symptoms include: Automatisms such as lip smacking, picking at clothes, fumbling. They may be unaware of the environment and may wander. Following the seizure they are often unaware of the seizure event and can be confused and sleepy. * Status epilepticus If seizures are prolonged, or occur in a series, there is an increased risk of status epilepticus. The term literally means a continuous state of seizure.
2. When was your/the participant’s last seizure? _____ /_____ /______ How long does the seizure last?
How long was the longest seizure? _________________________________________________________________________________________
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West Suburban Special Recreation Association
SEIZURE INFORMATION continued 4. Are you/the participant aware that they are about to have or have just had a seizure? yes no
5. Are there any symptoms or triggers prior to the onset of your/the participant’s seizure? (i.e. stomach pain, fear, smells, sounds, lights)
Explain: ___________________________________________________________________________________________________________________
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6. Has there been any recent change in your/the participant’s seizure pattern? yes no
Explain: ___________________________________________________________________________________________________________________
7. Have you/the participant ever been hospitalized for continuous seizures? (Status epilepticus) yes no
Explain: ___________________________________________________________________________________________________________________
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8. Please list below the necessary steps you would like WSSRA to take in the event of a seizure:
1. Call 911 for a seizure over ______ minute(s). WSSRA will call 911 if a seizure lasts 5 minutes
2. ______________________________________________________________________________________________________________________
3. ______________________________________________________________________________________________________________________
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10. Do you/the participant have a VNS (vagal nerve stimulator)? yes no If yes, contact WSSRA at 847.455.2100 to discuss further.
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33SUMMER 2018 wssra.net
REGISTRATION OPTIONS In order to participate in Summer programs, your completed AND signed registration form must be received in the WSSRA office by June 1st. WSSRA registration is taken on a first-come, first-served basis.
REGISTRATION A completed AND signed registration form is required (along with a $5 deposit per program) in order to start participation. If your signed form is not received by June 1st, you will lose your spot in any of your selected programs and be put on a waitlist.
CLOSED PROGRAMS/WAIT LISTS If a program is at maximum enrollment, your participant will be placed on a wait list once your completed and signed registration form along with full payment or program deposit is recieved. Wait lists are reviewed on a weekly basis. You will be notified if additional space in the program becomes available.
NEW PARTICIPANTS If you are new to WSSRA, proof of residency is required at the time of enrollment. WSSRA will accept a current utility bill, mortgage or lease in your name.
PAYMENT Payment of program fees is due upon registration. If you are unable to pay your full balance, a $5.00 deposit is required for each program with a maximum deposit of $20 required. Billing statements are mailed out once a month. Call to arrange for a payment plan. A participant may not register for the next season until a balance from previous season is paid. WSSRA Program Supervisors MAY NOT accept payment or registration forms at program.
RETURNED CHECKS A $20.00 fee will be charged for any checks returned to WSSRA. The $20.00, as well as the balance, will need to be paid before registering for future programs.
PROGRAM CREDITS AND CANCELLED PROGRAMS 1. Program credits will not be issued for weather related cancellations. WSSRA will attempt to make up programs due to weather cancellations. 2. Program credits will not be issued for sports tournament cancellations.
3. If WSSRA is notified 5 business days prior to the start of a program season, the participant will be credited the cost of each program cancelled less a $5.00 processing fee. 4. A full, prorated program credit will be issued if for extended medical reasons and/or hospitalization with written verification from a physician. 5. A prorated program credit will be issued for programs that may have a postponed start due to low enrollment. If the program is subsequently cancelled, a full program credit will be issued. 6. A full program credit is issued if a program or special event is cancelled by WSSRA due to low enrollment. 7. If a participant chooses to cancel from a program after the season has begun, a prorated program credit will be issued for each program cancelled, less a $5.00 processing fee, the cost of a ticket (unless there is a person on a waiting list), contracted services, or specialized non- refundable supplies. 8. Program credits will not be issued retroactively. Prior notification of program cancellation to WSSRA office is necessary in order to be eligible for a program credit. 9. All credit requests will be reviewed on a monthly basis
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 submitted to the WSSRA office. Proof of income is required.
PARENT DROP-OFF & PICK-UP WSSRA programs are staffed according to the needs of the participants who are registered. If your participant does not show up to program, we will send staff home for the day. Please help WSSRA keep programs running safely with the necessary number of staff by making sure that your participant arrives for program at the start time of program. Please do not drop your participant off prior to the stated program start time. For the safety of your participant, at drop off & pick up, be sure to make contact with a WSSRA staff person.
When a program is scheduled to travel (i.e. Saturday nights, outdoor adventures, etc.), The WSSRA vehicles will leave the meeting location promptly at 5 minutes past the program’s listed start time.
LATE PICK-UP/DROP-OFF A $10.00 Fee will be charged for every 15 minutes, or portion thereof, that a participant is picked up late or WSSRA vehicle is delayed. A notice will be sent to you indicating the fee being charged to your account.
DROP OFF AT THE WSSRA OFFICE OR MAIL TO
WSSRA 2915 Maple St.
Franklin Park, IL 60131
SCAN & EMAIL TO [email protected]
FAX TO 847.455.2157
PHONE TO: 847.455.2100
WSSRA Registration & Policies
wssra.net SUMMER 201834
PARTICIPANT ILLNESS For the protection of all of the participants in program, your participant must be kept at home or will be sent home if he/she shows any of the following symptoms: · A temperature over 100.3. · Stomach ache accompanied by diarrhea or vomiting. · Any undiagnosed rash. · Sore or discharging eyes or ears. · Profuse nasal discharge (green or yellow). Please keep children with active colds at home. · Have a highly contagious condition such as chicken pox, measles, lice, etc.
PARTICIPANT ABSENCE If your participant is not going to attend a program for which you are registered, please notify the WSSRA office as soon as possible. Make sure you leave a voice mail if you call after our office has closed for the day.
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 specific questions, please call the WSSRA executive director or superintendent of safety & operations.
WSSRA TRANSPORTATION Transportation by WSSRA is available for some programs and with an additional fee. When offered, transportation information and fees are noted in a program’s registration information in this program guide. All riders must abide by the following WSSRA guidelines. Failure to do so will result in suspension from transportation. Repeat offenders will not be transported by WSSRA. · Riders must stay in their seat with a seatbelt on at all times. · Riders must not deface the vehicle. · Riders must keep their hands and feet to themselves. · Eating is not permitted on WSSRA vehicles. · Parents or participants must notify WSSRA in regard to any change in transportation. · Any registration received after September 11 may result in a late program start or no transportation. · Parents are requested to notify their child’s school on days the child will be picked up by WSSRA. · A participant under the age of 16 must be taken off of the WSSRA vehicle by a responsible person over the age of 12.
CAR SEATS Due to state legislation, car seats or boosters must be provided for all children ages seven and under. For more information contact the superintendent of safety & operations.
MEDICATION It is the parent/guardian and participant’s responsibility to inform WSSRA of any medication a participant is taking. This information is important in case of an emergency. Medication information should be noted ion the registration forms, as well as the annual information form. Any changes in medication should be communication to WSSRA.
SEIZURES Participants who have had a seizure must complete a seizure information form prior to beginning programs. Please see page 25 for this form. Forms can be found on the WSSRA website, scanned & emailed, or mailed to you. Forms need to be updated as changes with the seizures or medication occurs.
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 participant is injured, you are solely responsible for any costs incurred or caused by an injury that happens in an association program.
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 a participant can be in programs each season. 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 to 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 questions, call the WSSRA executive director. We appreciate your continued involvement and support.
NON-RESIDENT POLICY WSSRA programs are limited to people who live in the WSSRA partner districts and villages. If you live outside of the WSSRA communities and are interested in participating in a special recreation program, call your park district or village recreation department. Call the WSSRA executive director for more information.
SAY CHEESE Photos & videos are periodically taken of people participating in WSSRA & Inclusive Partner District programs & activities. All persons registering for WSSRA and Partner Inclusion programs/activities thereby agrees that any photograph or videotape taken by WSSRA may be used for promotional purposes including its electronic media, videotapes, brochures, flyers and other publications without additional, prior notice or permission and without compensation to the participant, rights to royalties or any other consideration now and in the future.
WSSRA Registration & Policies
Athlete of the Year:
West Suburban Special Recreation Association 2915 Maple Street, Franklin Park, IL 60131 P 847.455.2100 | F 847.455.2157 www.wssra.net
PRSRT STD U.S. POSTAGE
PAID PERMIT NO. 317
FOND DU LAC, WI
Spl i s h Splash Spl i s h Splash
Featuring the Wacky Quacky Duck Splash
LOCATION: PARK DISTRICT OF FOREST PARK’S AQUATICS CENTER 7501 HARRISON STREET • FOREST PARK, IL
6:30 - 9:30PM6:30 - 9:30PM