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REGISTRATION NOW OPEN! WINNETKACOMMUNITYHOUSE.ORG FALL 2012 PROGRAMS Winnetka Community House martial arts karate taekwando all ages

Martial Arts at WCH Fall 2012

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Check out Karate and Taekwondo classes for all ages and skill levels.

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Page 1: Martial Arts at WCH Fall 2012

R E G I S T R A T I O N N O W O P E N !W I N N E T K A C O M M U N I T Y H O U S E . O R G

F A L L 2 0 1 2 P R O G R A M SWinnetka Community House

mart i a l a r t skarate taekwando all ages

Page 2: Martial Arts at WCH Fall 2012

Martial Arts Fall 2012

K A R A T EA b o u t O u r K a r a t e P r o g r a mTraditional Karate is a martial art which emphasizes the principles and applications of weaponless self-defense. Our Karate Program follows a systemized belt ranking for all participants. There are 11 belt levels (kyu) before first-degree black belt (shodan). A new student is assigned the white belt rank (eleventh kyu). One must fulfill certain requirements under normal practice conditions and in a test environment to secure progressive promotions up to and including the black belt (dan) levels. When one has acquired a strong foundation in the fundamentals of Karate, he or she can be promoted to the rank of first degree black belt.Uniforms, belt tests and tournaments. are optional and will incur additional costs.

Level: Class: Dates Day: Time: Ages: Member: Non-Member:Pee Wee Karate 3009-3 September 11–December 6 Tuesday, Thursday 3:10–3:40 p.m. 4–5 $365 $438Beginner Karate I 3009-4 September 11–December 6 Tuesday, Thursday 3:45–4:30 p.m. 5–8 $485 $582 Saturday 8:45–9:30 a.m.Beginner Karate II 3009-5 September 11–December 6 Tuesday, Thursday 4:30–5:15 p.m. 5–8 $485 $582 Saturday 9:30–10:15 a.m.Intermediate Karate 3009-6 September 11–December 6 Tuesday, Thursday 5:15–6:00 p.m. 6–10 $485 $582 Saturday 9:30–10:15 a.m.Karate 3009-7 September 11–December 6 Tuesday, Thursday 6:00–6:45 p.m. 8–13 $485 $582 Saturday 10:20–11:20 a.m. 3009-8 September 6–December 6 Tuesday, Thursday 6:45–7:45 p.m. 8–13 $485 $582 Saturday 10:20–11:20 a.m.Adult Karate 3009-9 September 11–December 6 Tuesday, Thursday 7:45–9:10 p.m. 14 and up $505 $606 Saturday 10:20–11:20 a.m.No class: 10/16, 10/18, 10/20, 11/22

M E E T O U R K A R A T E I N S T R U C T O R S

Frank Chrzanowski, chief instructor, developed the Traditional Karate Program for Winnetka Community House in 1989. He has trained in Karate since 1975 and has attained the rank of fourth degree black belt in the Japan Karate Association. He has been featured in articles in the Chicago Tribune, the Sun Times and the Pioneer Press, and has appeared on local and national television programs.

Ron Stein has trained in karate since 1981 and is a third degree black belt in the Japan Karate Association. His karate experience extends to Europe and Japan, where he lived for four years, training under many instructors and studying various Japanese martial arts. His karate teaching experience includes The University of Chicago, The University of Illinois at Urbana-Champaign, and the United States Marine Corps in Tokyo. He has been with Winnetka Community House Karate Program since 1994.

P e e W e e K a r a t e Students learn how to control their energy levels and concentration through study of fundamental Karate principles. Participants will learn how to follow instructions and exercise self control in a fun and exciting environment.

B e g i n n e r K a r a t e I This is an introduction to Karate. No experience is necessary. (Beginner to Orange Belt/White Stripe)

B e g i n n e r K a r a t e I I Students must have the belt rank of orange or yellow belt to participate.

I n t e r m e d i a t e K a r a t e Students may join with the permission of the instructor.

K a r a t e Curriculum enables the beginner through advanced student to develop an effective form of self-defense. Keen perception skills and a mind that is increasingly alert and sensitive are acquired. Students learn how to relax in stressful conditions and keep an emotional balance.

A d u l t K a r a t e Students seek the human body’s most complete mental and physical development through self-defense techniques. An extraordinary fluidity of perception and self-defense skill can be achieved.

Page 3: Martial Arts at WCH Fall 2012

Fall 2012 Martial Arts

T A E K W O N D OTaekwondo, one of the newest Olympic sports, is a 2000-year-old martial art, offering a variety of benefits for people of all ages and physical abilities. Students have the opportunity to improve concentration and self-esteem, achieve lifelong physical fitness and learn self-defense skills. Classes are taught under the direction of G.Master Ki Hong Kim* (Eighth Dan World Taekwondo Federation.) A $45 uniform fee is required at the first class. Belt testing is offered through The KH Kim Taekwondo at an additional fee and is held twice a year. All colored belt students are required to have complete sparring gears.

L i t t l e D r a g o n s T a e k w o n d oThis introductory class is designed to captivate our youngest students. Skills are developed through gentle instruction and appropriate games for their ability. This class focuses on developing balance, coordination and respect for the discipline of martial arts training.

Class: Level: Day: Date: Time: Ages: Member: Non-Member: No class:3010-3 Beginner–Yellow Wednesday September 5–December 19 4:00–4:40 p.m. 4–5 $208 $250 10/173010-4 Orange and up Wednesday September 5–December 19 4:45–5:25 p.m. 4–5 $208 $250 10/17

E a r l y T a e k w o n d oDesigned especially for the younger children of six–seven years, this program helps kids develop conditioning, coordination, listening skills and self-confidence through creative activities.

Class: Level: Day: Date: Time: Ages: Member: Non-Member: No class:3010-5 White–Green Wednesday September 5–December 19 5:30–6:15 p.m. 6–7 $208 $250 10/173010-6 Purple and up Wednesday September 5–December 19 7:10–8:00 p.m. 6–7 $208 $250 10/17

Y o u t h T a e k w o n d oThis program includes a balanced cardiovascular workout, including punching, kicking and blocking skills, using the Taekwondo tradition, and self-control. Participants will improve coordination, power of concentration, balance and both physical and mental discipline.

Class: Level: Day: Date: Time: Ages: Member: Non-Member: No class:3010-7 White–Green Wednesday September 5–December 19 6:20–7:05 p.m. 8–13 $208 $250 10/173010-8 Purple and up Wednesday September 5–December 19 7:10–8:00 p.m. 8–13 $208 $250 10/17

P a r e n t / C h i l d T a e k w o n d oThis class provides families with a fun opportunity to spend time together while improving physical and mental conditioning through cardiovascular drills, calisthenics and traditional Taekwondo techniques including punching, kicking and blocking. Fee includes instruc-tion for one parent and one child.

Class: Level: Day: Date: Time: Ages: Member: Non-Member: No class:3010-9 All belts Wednesday September 5–December 19 8:05–8:55 p.m. 7 and up $416 $500 10/17

A d u l t T a e k w o n d oRestricted to high school students and older, this program concentrates on Taekwondo techniques through the study of forms, stances and the skills of punching, kicking and blocking. Class: Level: Day: Date: Time: Ages: Member: Non-Member: No class:3011-0 All belts Wednesday September 5–December 19 8:05–8:55 p.m. Adult $208 $250 10/17

Page 4: Martial Arts at WCH Fall 2012

A tradition in Winnetka since 1915! Mount your broomsticks and fly on over for Halloween thrills at this popular Community House tradition

“Not So Scary” Haunted HouseAges 10 and underDo your kids wonder what the haunted house is all about but aren’t sure they want to visit because it might be too scary? Join us on Friday, October 26 for an event like no other. Enjoy the twists, turns and excitement with the lights on, music down and no ghouls jumping out. Purchase your tickets at the WCH front desk the day of the event and enjoy some Halloween fun!Friday, October 26 10:00 a.m.–2:00 p.m.$2/person single visit (accompanying adult – free)

Haunted HouseVisit our traditional haunted house with your family and friends and be prepared to get scared. Follow the twists and turns of our classic maze... if you dare! All ages are welcome... to get frightened.Friday, October 26 7:00–9:00 p.m.$5/person single visit

Page 5: Martial Arts at WCH Fall 2012

CIRCUS BOY'S ACTION PACKED COMEDY SHOW

MONDAY, OCTOBER 8 11:00 –12:00

TICKETS: $5

pm

reserve your tickets today atwinnetkacommunityhouse.org

WINNETKA COMMUNITY HOUSE •�620 LINCOLN AVE., WINNETKA, IL 60093 •�847-446-0537

S C H O O L H O U S E R O C K L I V E !

TUESDAY, NOVEMBER 6 11:00 –12:00

TICKETS: $5

pm

reserve your tickets today atwinnetkacommunityhouse.org

WINNETKA COMMUNITY HOUSE •�620 LINCOLN AVE., WINNETKA, IL 60093 •�847-446-0537

Page 6: Martial Arts at WCH Fall 2012

Join us for our

C e n t e n n i a lc l o s i n g c e r e m o n y

Friday, November 2F i n d o u t m o r e a t w i n n e t k a c o m m u n i t y h o u s e . o r g / c e n t e n n i a l

Page 7: Martial Arts at WCH Fall 2012

Winnetka Community House makes birthday parties easy! We offer full service birthday parties with complete set up and clean up. Our party coordinator can help you plan your party and select from a variety of entertainers and activi-ties. We also partner with popular vendors to help you save on food for your WCH party. Our parties will make your child's birthday an event they'll never forget!

PARTIES SO EASY THEYMIGHT AS WELL BE MAGIC

To see all our parties visit winnetkacommunityhouse.org/birthdays or call 847-446-3207

B r e a k f a s tw i t h S a n t a

D e c e m b e r 8w i n n e t k a c o m m u n i t y h o u s e . o r g

Mark your calendars for our Wine Tasting, coming March 8, 2013

P r o d u c e d b y t h e W o m a n ’ s B o a r do f W i n n e t k a C o m m u n i t y H o u s e

Page 8: Martial Arts at WCH Fall 2012

Registration Fall 2012

Becom

e a

Member!C O M M U N I T Y H O U S E

Become a

Don’t forget!Members also receive special offers and rewards throughout the year! Watch your email for Member’s Only specials on programs, events and more!

Step 1 Register your whole family!A one year Community House Membership is $150. All family members in your household are eligible for membership benefits. When registering for, just list your family members, and they will automatically be eligible for benefits when registering.

Step 2Use your Membership to regis-ter early for WCH programs!Registration begins a week early for Community House Members. Check out our website or program guide to find out when member registra-tion begins.Note: Membership does not guarantee placement in all classes. Some classes fill quickly.

Step 3Save money on classes!Community House members save up to 20% on registration! Find the Member price listed for each program and save on your whole family’s programs all year!

R E G I S T R A T I O N I N F O R M A T I O NMember registration opens July 16, 2012, and will be processed on a first come, first served basis.Membership does not guarantee placement in a class.All non-members will be able to register July 23, 2012. Registration received through the mail, fax, or in person will be processed by 5:00 p.m. the next business day. The best way to ensure that your registration is processed immediately is by using our online registration at winnetkacommunityhouse.org

M e m b e r s h i p I n f o r m a t i o nEarly registration: Members are eligible to register for all classes one week prior to the start of seasonal registration. Early registration can be done via the web at winnetkacommunityhouse.org, fax or in person at Winnetka Community House. Please note: early registration does not guarantee a spot in a class.Who is eligible for benefits? All family members in your household are eligible for membership benefits. When registering for membership, just list your family members, and they will be included for the program registra-tion benefits automatically when registering for classes.Membership renewal: Members receive a notice about one month prior to the expiration, so the membership can be renewed for the next year.Refunds for memberships will not be available.

H o w T o R e g i s t e r• To register for membership, simply list all eligible members on the registra-

tion form. Then check the box and add the membership fee in with your registration.• Register for programs online at winnetkacommunityhouse.org or on the

enclosed registration form.• Please print clearly.• Read and fill out form completely.• By listing your email address, you agree to receive email communications

from Winnetka Community House. We will never sell your address, but love to keep in touch with our users to give news about programs, events, and special offers from Winnetka Community House. If you do not wish to receive these emails, simply unsubscribe.

• Sign the registration form.• Unsigned forms will not be processed, but will be returned to you. This

will delay processing your registration.• Registration forms may be mailed or faxed. Registration by telephone

are not accepted.

C r e d i t C a r d sYou may use your credit card for all programs which appear with a class number or for a Fitness Centre membership. Fitness Centre memberships are obtained at the Fitness Centre only. Be sure to fill out the credit card information completely and sign the form. We do not take telephone registration. However, if you are paying by credit card, you may fax your registration to (847) 446-0609.

C a n c e l l a t i o n o f C l a s s e sPrior to any class, registration is reviewed to determine if the enrollment is sufficient to hold the class. Register early! Do not wait until the day of the first class to register. You may find the class has been cancelled due to low enrollment.

R e f u n d P o l i c yFull refunds will be issued for courses that are cancelled by Winnetka Community House due to insufficient registration. A refund, less a 10% service charge (not to exceed $25), may be granted if the refund request is received five full working days prior to the start of the program. No refunds will be allowed after this time unless a medical condition develops and a written explanation from a physician on his/her letterhead is presented. Due to advanced reservation requirements, no refunds for trips, outings, or special events will be given.

P r o r a t e d P o l i c yClasses may be prorated if you would like to enroll in a class after it has started, provided the instructor has space, and allows for late registration. The supervisor must approve the prorated amount.

I n c l e m e n t W e a t h e rWinnetka Community House will not hold classes on days when the Winnetka Public Schools have cancelled classes due to inclement weather.

R e l i g i o u s H o l i d a y sWinnetka Community House makes every effort to avoid scheduling programs or events on religious holidays. Anyone affected will be offered the option of attending a session of the same program on a different date as a make-up, or receiving a prorated refund of the series fee for the date missed.• Winnetka Community House is not responsible for the supervision

of children on site prior to or remaining on site after the established program times.

• Winnetka Community House is handicapped accessible.• If you or any member of your family has special needs, please see our

Executive Director.• Winnetka Community House receives no tax dollars. We are supported by

our programs, fund raising events, our annual campaign, and donations.• Winnetka Community House assumes no responsibility and carries no

accident or medical insurance for injuries or accidents at programs or activities on Community House property. It is advisable to review your own personal health insurance plan to be certain that you and your family have proper and sufficient insurance coverage.

B r o c h u r e E r r o r sComplete details of program policies, procedures, and guidelines are sometimes inadvertently omitted. Errors in days, times, registration requirements, and fees may occur in the brochure. When such errors occur, the staff will advise you of the change as quickly as possible. We thank you for your understanding.

C o p y A n d F a x S e r v i c e A v a i l a b l eCopy service is available at $.10/copy. Fax service is available at $2/first page and $1/each additional page. Cost to receive a fax: $1/page (Faxes are limited to 847, 312, 773, 708, and 630 area codes)Winnetka Community House asks that all participants be courte-ous to our neighbors when driving and parking in the area.

STEPHEN DUSTMAN MEMORIAL SCHOLARSHIP FUNDWinnetka Community House has established the Stephen Dustman Memorial Scholarship Fund to any resident who would like to take part in a Winnetka Community House activity, but is unable to render full payment. Persons in-terested may submit their need in writing to the attention of the Executive Director for confidential review. If further information is desired, please call our main office.Donations to this scholarship fund are gratefully accepted.

Page 9: Martial Arts at WCH Fall 2012

Fall 2012 Registration Page 49

Becom

e a

Member!C O M M U N I T Y H O U S E

Become a

Don’t forget!Members also receive special offers and rewards throughout the year! Watch your email for Member’s Only specials on programs, events and more!

Step 1 Register your whole family!A one year Community House Membership is $150. All family members in your household are eligible for membership benefits. When registering for, just list your family members, and they will automatically be eligible for benefits when registering.

Step 2Use your Membership to regis-ter early for WCH programs!Registration begins a week early for Community House Members. Check out our website or program guide to find out when member registra-tion begins.Note: Membership does not guarantee placement in all classes. Some classes fill quickly.

Step 3Save money on classes!Community House members save up to 20% on registration! Find the Member price listed for each program and save on your whole family’s programs all year!

Page 10: Martial Arts at WCH Fall 2012

Winnetka Community House is committed to conducting its recreation programs and activities in the safest manner possible, and holds the safety of the participants in the highest possible regard. Participants and parents registering their child in recreation programs must recognize, however, that there is an inherent risk of injury when choosing to participate in recreation activities. Winnetka Community House continually strives to reduce such risks, and insists that all participants follow safety rules and instructions which have been designed to protect the participants’ safety. Please recognize that Winnetka Community House does not carry medical accident insurance for injuries sustained in its programs. The cost of such would make program fees prohibitive. Therefore, each person registering himself\herself or a family member for a recreation program/activity should review his/her own health insurance policy for coverage. It must be noted that the absence of health insurance coverage does not make Winnetka Community House automatically responsible for payment of medical expenses. Due to the difficulty and high cost of obtaining liability insurance, the agency providing liability coverage for Winnetka Community House requires the execution of the following Waiver and Release. Your cooperation is greatly appreciated. Please read this form carefully, and be aware in participating in the program(s) listed on this page, you will be waiving and releasing all claims for injuries you might sustain arising out of the activities of this program.

WAIVER AND RELEASE OF ALL CLAIMSAs a participant in the program, I recognize and acknowledge that there are certain risks of physical injury, and I agree to assume the full risk of any injuries, including death, damages or loss, regardless of severity, which I may sustain as a result of participating in any and all activities connected with or associated with such program. I agree to waive and relinquish all claims I may have as a result of participating in the program against Winnetka Community House and its officers, agents, servants and employees. I do hereby fully release and discharge Winnetka Community House and its officers, agents, servants and employees from any and all claims from injuries, including death, damages or loss which I may have or which may accrue to me on account of my participation. I further agree to indemnify and hold harmless and defend Winnetka Commu-nity House and its officers, agents, servants and employees from any and all claims from injuries, including death, damages or losses sustained by me or arising out of, connected with, or in any way associated with the activities of the program. In the event of emergency, I authorize Winnetka Community House officials to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my immediate care, and agree that I will be responsible for payment of any and all medical services required. All participants agree that any photography taken while participating in a class, special event or use of a facility may be used for promotional purposes Winnetka Community House. Participants agree to receive emails from Winnetka Community House.

REFUND AND PRORATE INFORMATIONFull refunds will be issued for courses that are cancelled by Winnetka Community House due to insufficient registration. A refund, less a 10% service charge (not to exceed $25), may be granted if the refund request is received five full working days prior to the start of the program. No refunds will be allowed after this time unless a medical condition develops and a written explanation from a physician on his/her letterhead is presented. Due to advanced reservation requirements, no refunds for trips, outings, or special events will be given. Classes may be prorated if you would like to enroll in a class after it has started, provided the instructor has space, and allows for late registration. The supervisor must approve the prorated amount.

Please list any specific medical allergies, medications, chronic illness or other conditions which staff should be aware of:

Winnetka Community House operates in compliance with the Americans with Disabilities Act. If you believe you or your child need accommodations to facilitate participation

in Winnetka Community House program(s) for which you are registering, please check box.

CONTACT INFORMATIONPARENT/GUARDIAN’S LAST NAME: PARENT/GUARDIAN’S FIRST NAME:

ADDRESS: CITY: STATE: ZIPCODE:

PHONE: WORK PHONE:

EMAIL: I WOULD LIKE TO RECEIVE NEWS FROM THE WCHEMERGENCY CONTACT NAME: EMERGENCY CONTACT PHONE:

REGISTRATION FORMRegister online at winnetkacommunityhouse.org, via fax at 847-446-0609 or mail this form with payment in full to: Registraiton - Winnetka Community House, 620 Lincoln Ave., Winnetka, IL 60093. Contact us by phone at 847-446-0537 with any questions. Please print.

PARTICIPANT INFO CLASS INFOFULL NAME BIRTH DATE M/F SCHOOL CLASS CODE CLASS NAME FEE

I would like to register for a Community House Membership! Please list all family members on the reverse side of this form $150

$100 I would like to donate a Centennial gift of $100 to the Community House along with my registration.

TOTAL

SIGNATURE: DATE:

Reg i s t r a t i on f o rm w i l l no t be p ro ce s s ed w i t hou t wa i ve r s i gna tu r e .

CASH VISA CHECK MASTERCARD

CARD NUMBER EXP. DATE

TOTAL PAYMENT SIGNATURE

I have read and fully understand the aforementioned Program Details, Waiver and Release of All Claims and Permission to Secure Treatment.

5 7 S C U L P T U R E S D E S I G N E D B Y L O C A L A R T I S T SD I S P L AY E D T H R O U G H O U T T H E S U M M E R A N D

A U C T I O N E D O N N O V E M B E R 2 .

F I N D O U T M O R E ATW I N N E K TA C O M M U N I T Y H O U S E . O R G / S TA R S

Page 11: Martial Arts at WCH Fall 2012

Winnetka Community House is committed to conducting its recreation programs and activities in the safest manner possible, and holds the safety of the participants in the highest possible regard. Participants and parents registering their child in recreation programs must recognize, however, that there is an inherent risk of injury when choosing to participate in recreation activities. Winnetka Community House continually strives to reduce such risks, and insists that all participants follow safety rules and instructions which have been designed to protect the participants’ safety. Please recognize that Winnetka Community House does not carry medical accident insurance for injuries sustained in its programs. The cost of such would make program fees prohibitive. Therefore, each person registering himself\herself or a family member for a recreation program/activity should review his/her own health insurance policy for coverage. It must be noted that the absence of health insurance coverage does not make Winnetka Community House automatically responsible for payment of medical expenses. Due to the difficulty and high cost of obtaining liability insurance, the agency providing liability coverage for Winnetka Community House requires the execution of the following Waiver and Release. Your cooperation is greatly appreciated. Please read this form carefully, and be aware in participating in the program(s) listed on this page, you will be waiving and releasing all claims for injuries you might sustain arising out of the activities of this program.

WAIVER AND RELEASE OF ALL CLAIMSAs a participant in the program, I recognize and acknowledge that there are certain risks of physical injury, and I agree to assume the full risk of any injuries, including death, damages or loss, regardless of severity, which I may sustain as a result of participating in any and all activities connected with or associated with such program. I agree to waive and relinquish all claims I may have as a result of participating in the program against Winnetka Community House and its officers, agents, servants and employees. I do hereby fully release and discharge Winnetka Community House and its officers, agents, servants and employees from any and all claims from injuries, including death, damages or loss which I may have or which may accrue to me on account of my participation. I further agree to indemnify and hold harmless and defend Winnetka Commu-nity House and its officers, agents, servants and employees from any and all claims from injuries, including death, damages or losses sustained by me or arising out of, connected with, or in any way associated with the activities of the program. In the event of emergency, I authorize Winnetka Community House officials to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my immediate care, and agree that I will be responsible for payment of any and all medical services required. All participants agree that any photography taken while participating in a class, special event or use of a facility may be used for promotional purposes Winnetka Community House. Participants agree to receive emails from Winnetka Community House.

REFUND AND PRORATE INFORMATIONFull refunds will be issued for courses that are cancelled by Winnetka Community House due to insufficient registration. A refund, less a 10% service charge (not to exceed $25), may be granted if the refund request is received five full working days prior to the start of the program. No refunds will be allowed after this time unless a medical condition develops and a written explanation from a physician on his/her letterhead is presented. Due to advanced reservation requirements, no refunds for trips, outings, or special events will be given. Classes may be prorated if you would like to enroll in a class after it has started, provided the instructor has space, and allows for late registration. The supervisor must approve the prorated amount.

Please list any specific medical allergies, medications, chronic illness or other conditions which staff should be aware of:

Winnetka Community House operates in compliance with the Americans with Disabilities Act. If you believe you or your child need accommodations to facilitate participation

in Winnetka Community House program(s) for which you are registering, please check box.

CONTACT INFORMATIONPARENT/GUARDIAN’S LAST NAME: PARENT/GUARDIAN’S FIRST NAME:

ADDRESS: CITY: STATE: ZIPCODE:

PHONE: WORK PHONE:

EMAIL: I WOULD LIKE TO RECEIVE NEWS FROM THE WCHEMERGENCY CONTACT NAME: EMERGENCY CONTACT PHONE:

REGISTRATION FORMRegister online at winnetkacommunityhouse.org, via fax at 847-446-0609 or mail this form with payment in full to: Registraiton - Winnetka Community House, 620 Lincoln Ave., Winnetka, IL 60093. Contact us by phone at 847-446-0537 with any questions. Please print.

PARTICIPANT INFO CLASS INFOFULL NAME BIRTH DATE M/F SCHOOL CLASS CODE CLASS NAME FEE

I would like to register for a Community House Membership! Please list all family members on the reverse side of this form $150

$100 I would like to donate a Centennial gift of $100 to the Community House along with my registration.

TOTAL

SIGNATURE: DATE:

Reg i s t r a t i on f o rm w i l l no t be p ro ce s s ed w i t hou t wa i ve r s i gna tu r e .

CASH VISA CHECK MASTERCARD

CARD NUMBER EXP. DATE

TOTAL PAYMENT SIGNATURE

I have read and fully understand the aforementioned Program Details, Waiver and Release of All Claims and Permission to Secure Treatment.

5 7 S C U L P T U R E S D E S I G N E D B Y L O C A L A R T I S T SD I S P L AY E D T H R O U G H O U T T H E S U M M E R A N D

A U C T I O N E D O N N O V E M B E R 2 .

F I N D O U T M O R E ATW I N N E K TA C O M M U N I T Y H O U S E . O R G / S TA R S

Page 12: Martial Arts at WCH Fall 2012

Non-Profit Org.U.S. Postage

PAIDPermit No. 50Winnetka, IL

WINNETKA COMMUNITY HOUSE620 LINCOLN AVE., WINNETKA IL 60093WINNETKACOMMUNITYHOUSE.ORG FACEBOOK.COM/WINNETKACOMMUNITYHOUSE TWITTER.COM/WCHNEWS847-446-0537

S AV E T H E D A T E : O C T O B E R 1 9 – 21T H E W I N N E T K A S H O W . C O M