Winter 2016 - Warren Township

WARREN SPECIAL RECREATION ASSOCIATION
Winter 2016
Inspiring People With Disabilities Through Meaningful Recreation
GRANDWOOD PARK PARK DISTRICT• GURNEE PARK DISTRICT
WARREN TOWNSHIP • WILDWOOD PARK DISTRICT
Registration deadline for most programs is Friday, December 18, 2015
2
Contents
HERE’S WHERE YOU’LL FIND…
General Information...............................3 - 4
Preschool, Youth & Teen Programs
Young Swimmers I & II ................................5
Wiggles & Giggles
Sensory Experiences
Autism Movement Therapy
Swim Lessons
Friends & Company.....................................6
Kids Days Off
Teen Lock-In...............................................7
Spring Fling Camp
The FrogLady Family Special Event
Prime Time Club......................................12
SRACLC’s Winter Wonderland Dance
Mambo Italiano
SRSNLC’s Valentine’s Dance
Karaoke & Bingo Night
Portillo’s & Games
St. Patty’s Day Party
Adult Programs.......................................13
Leisure Enrichment for Adult Pursuits (LEAP)
Critics Corner
Hooray for Hollywood
Adult Special Events...............................14
Around the World in ONE Night!
Teen Club...................................................8
Game Night
Mambo Italiano
Open Swim
Valentine’s Day Party
Karaoke & Bingo Night ................................9
Mall Mayhem
Action Territory
The Giant Egg Drop & Pizza Party
Special Olympics
Track & Field
Bocce Ball
SO Parent Information
Teen & Adult Programs ...........................10
Fun Fitness
Walk & Dine
Creation Station
Strikes & Spares
Staff & Board Members ..........................19
Winter Registration Information
Registration Form .....................................15
Program List & Fees..................................16
Annual Information Form...........................17
FACILITIES
Brunswick Zone
Fountain Square
631 Lakehurst Rd.
Waukegan, IL 60085
(847) 473-2600
FitNation
1655 Nations Dr.
Gurnee, IL 60030
(847) 623-4506
Warren Special Recreation Offices
Greenleaf
100 S. Greenleaf St.
Gurnee, IL 60031
(847) 244-6619
Warren Special Recreation &
Warren Township Center (WTC)
17801 W. Washington St.
Gurnee, IL 60031
(847) 244-6619
Hunt Club Community Center
920 N. Hunt Club Rd.
Gurnee, IL 60031
(847) 623-7788
WSRA HOTLINE
We record a message on our
phone system on days when the
weather or other factors force a
change in the program schedule.
Teen & Adult Special Events ...................11
Chicago Wolves
Mardi Gras
Winterfest
Milwaukee Bucks
SRSNLC Bowling Tournament
Call the
Township main number
847-244-1101
and select
voicemail box *730.
Register
Early!
Registration deadline
for most programs
is Friday,
December 18, 2015
If you’re looking for more info on
our Preschool, Youth & Teen
Programs, contact Nicole Estrada
at 847-244-6619 or
[email protected]
If you’re looking for more info on
our Adult & S.O. Programs
contact Amber Bodame at
847-244-6619 or
[email protected]
If you’re looking for more info on
our Adult Day Program/LEAP,
contact Emily Thomas at
847-244-6619 or
[email protected]
2
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
3
General Information
WSRA
Warren Special Recreation Association provides leisure and recreation
activities for adults and children with disabilities. Enhancing abilities
in enjoyable social settings is a goal of WSRA programs. Participants
learn new skills, practice sports, dance and sing with friends and
take advantage of WSRA’s large variety of programs.
OFFICE HOURS
RESIDENCY REQUIREMENTS
Residents of Grandwood Park, Gurnee, Warren Township and
Wildwood are considered in-district. Individuals residing outside
these boundaries may attend programs at an increased cost.
BEHAVIOR CODE OF CONDUCT
Although WSRA encourages fun for all of its participants, certain rules
are necessary to ensure everyone’s safety and enjoyment. The
Association’s behavior code states that participants shall show respect
to all participants and staff, refrain from using foul language, refrain
from causing bodily harm and show respect to equipment, supplies
and facilities at all times. Additional policies may be created for
specific programs, camps and integrated programs.
AMERICANS WITH DISABILITIES ACT
WSRA complies with the ADA and will make reasonable
accommodations to enable people with disabilities to participate in
and enjoy recreational programs. If you have a question about WSRA’s
compliance, or feel that WSRA has discriminated against you, please
contact Executive Director Brenda Zeck at (847) 244-6619.
RISK MANAGEMENT
GENERAL INFORMATION
WSRA is open 9 a.m. to 5 p.m. Monday through Friday. Our staff would
be glad to answer your questions. Call them at (847) 244-6619; voice
mail will take your call if they are unavailable. The WSRA fax number is
(847) 855-8687.
participation. Thank you for your cooperation. The form is also
available for download on the website and in our brochure.
WSRA is committed to provide recreation programs and services in
the safest possible manner and to keep the safety of all individuals at
the forefront. Participants and parents must realize there is some
degree of risk which is inherent in all recreation activities. In an
effort to minimize exposure to unsafe conditions, WSRA conducts an
ongoing risk management program and strictly enforces that safety
procedures be adhered to by all participants and staff. WSRA does
not carry medical or accident insurance for injuries sustained during
programs or services. Each person registering himself/herself or a
dependent in a WSRA program should review and maintain his/her
own insurance coverage. The absence of any medical insurance
coverage does not make WSRA automatically responsible for the
payment of medical expenses.
HEALTH POLICY
INTEGRATED SERVICES
In the best interest of all participants, it is imperative to keep your child
home if he/she is ill. Should he/she come to a program in such a state,
WSRA will call you to come pick him/her up. Please call the office to
inform them of your child’s absence. Your child needs to be free from
fever, vomiting and/or diarrhea for 24-hours prior to returning to
WSRA programs. This is important to staff our programs and avoid
unnecessary stops on vehicle routes.
WSRA and its member districts believe that all participants should be
provided with leisure opportunities that allow for performance at their
highest level of ability. WSRA therefore offers an integration service
to provide a smooth transition from WSRA to a member Park District/Township program. If you are interested in a Park District/Township program and desire integration assistance, contact the WSRA
office at (847) 244-6619. There is no extra charge for this service,
only the program fee.
MEDICATION
Medication that a participant requires during a program must be
given to a staff member for secure storage prior to the start of the
program. Medication must be properly and clearly labeled with the
participant’s name, name of medication, dosage and time of
administration. The “Permission to Dispense Medication” waiver and
“Medication Dispensing Information” form must be completed by
parents or guardians in advance of the program. Call the WSRA office
if you need these forms.
ANNUAL INFORMATION FORM
WSRA requires all participants to complete an Annual Information
Form (AIF). The form provides WSRA with valuable information to
conduct its activities in the safest possible manner and to meet the
basic needs of participants. If you are new to WSRA, do not have a
current form on file, or need to update information (change in
medication, behavior, etc.), please call the office. All information will
be kept strictly confidential and will enhance successful
PACE
Pace, in cooperation with Warren Township, offers Dial-A-Ride
service in Warren Township to senior citizens and persons with
disabilities. Call 800-201-6446 for more information.
TDD USERS
If you use a Telecommunications Device for the Deaf (TDD) and
would like to communicate over the telephone line to a non-user, call
7-1-1 or (800) 526-0844. The Illinois Relay Center will provide
operator assistance to relay telephone conversations between
persons who use a TDD and persons who use a standard telephone.
A person using a standard phone, wishing to call a person with TDD,
can call 7-1-1 or (800) 526-0857 for assistance. Users of the relay
service pay for the call as though they dial directly. This relay service
is made possible through the Illinois Telecommunications Access
Corporation.
3
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
4
General Information
TRANSPORTATION
SCHOLARSHIP PROGRAM
WSRA will provide door-to-door transportation to in-district
residents, when indicated, on a first-come-first-served basis. The
office will call with specific transportation times prior to the
beginning of a program. Transportation may not be available after
the registration deadline. WSRA requires a minimum of three
participants requesting transportation to provide the service.
An accessible bus is available to transport individuals who use
wheelchairs.
A limited amount of financial assistance through program
scholarship is available for in-district participants who might
otherwise be denied the privilege of being involved with WSRA
activities. Requests are reviewed by the Executive Director, and
participants are notified. If you are in need of financial assistance,
please call the WSRA office at (847) 244-6619.
TRANSPORTATION POLICIES
The following procedures will be followed to maintain safe
transportation of WSRA staff and participants.
1. All passengers must comply with WSRA’s Behavior
Code of Conduct.
2. All passengers must be sitting in seats with belts securely
fastened. Those in wheelchairs must wear shoulder and lap belts.
No trays will be attached to wheelchairs during transport. The driver
will not proceed until all seat belts are fastened.
3. WSRA staff will determine whether or not an individual may be
transported safely due to behavior, health or equipment concerns.
If WSRA determines a participant can’t be transported safely, a
parent pick up will be required.
4. WSRA staff will not leave any person unattended after a
program unless there is written permission from the
individual’s parent/guardian.
5. All wheelchairs must be in proper working condition.
Persons riding in Amigo type wheelchairs must transfer to a
seat and must use a seat belt.
6. No object or part of the body is to protrude from the vehicle, nor
should any object be thrown from the vehicle at anytime.
Windows will be opened only upon permission from the staff.
7. Upon request, WSRA drivers will assist participants to and from
their homes, but will not enter homes. Driveways and walkways
must be clear of debris and snow/ice.
8. Participants must be ready when the bus arrives. The driver will
wait only a maximum of 10 minutes due to scheduling.
WSRA reserves the right to refuse or discontinue transportation
services to any individual. These policies have been developed to
ensure the safety of everyone riding in Warren Township vehicles.
Thank you for your cooperation.
CAR SEATS
In compliance with the Illinois Vehicle Code, Child Passenger
Protection Act, WSRA requests that parents provide the agency with
a child restraint system any time we transport a child under 8 years
of age in a WSRA vehicle. This means that parents of children under
8 will need to provide a car or booster seat for their child for
transportation purposes. Children weighing more than 40 pounds
may be transported while wearing a seatbelt.
REGISTRATION INFORMATION POLICIES
1. Registration will be conducted on a first-come, first-served basis.
If a program is at maximum capacity, a waiting list will be
necessary. Please note WSRA residents who register prior to the
registration deadline will have priority over out-of-district
participants.
2. Registration is considered complete when full payment is
received, unless other arrangements have been made. Please
contact Brenda Zeck at (847) 244-6619 for scholarships and
payment plan information.
3. Program fees from previous sessions must be paid in full in order
to register. Registrations will not be processed if a balance
remains from a previous session.
4. Nonresidents are welcome to register for all programs at an
increased fee. Their registration will not be processed until after the
registration deadline.
5. Instructors may not receive payment or register participants for
programs. Registrations and payments must be made through
the WSRA office only.
6. Registration for all programs must be finalized by the noted
registration deadline. WSRA will notify you only if you have not
been accepted into a program.
DEADLINE
Registration ends December 18 for most winter programs. Late
registration must be approved by staff.
LATE REGISTRATIONS MAY...
• Be placed on waiting list if enrollment has reached its maximum.
• Miss at least one class.
• Be omitted from transportation schedule.
The agency providing liability coverage for WSRA requires the
mandatory execution of a Waiver and Release form for all programs.
Thank you for your cooperation.
REFUND POLICY
Requests for refunds from any program or event must be made five
(5) working days prior to the first day of the program/event. A $5.00
processing fee will be charged on all refunds. In the event of
prolonged illness or moving, a prorated refund will be issued. A
doctor’s notice is required for illness. If the program/event is canceled
by WSRA, those registered will be notified and will receive a full
refund or credit. Refunds cannot be given for programs/events that
require advance purchase of admission or entrance fees.
4
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
Preschool, Youth, Teen
YOUNG SWIMMERS
WIGGLES & GIGGLES
Allow your child the opportunity to learn the fundamentals of
swimming in a safe and supportive environment. Supported floats,
beginning arm and leg movements are just a few of the skills we
will be introducing. We will explore the water and practice skills
using songs and games. Swimmers will work on individual goals
based on ability and the pool may be shared with other swim
programs. Children in diapers must wear swim diapers and
plastic pants.
Listen to music and play with friends in this fun filled sensory
environment involving music, games and social interaction. We will
improve flexibility and strength while spending social time with our
peers.
Wednesdays, January 13 - March 16
(10 weeks)
Young Swimmers I
6:15 - 6:50 pm
Code 120101
Young Swimmers II
6:55 - 7:30 pm
Code 120102
Ages 3 - 10
Min/Max 4/6
FitNation, Gurnee
Fee (R/NR) $140/$280
Thursdays, January 14 – February 18
(6 weeks)
4:00 – 5:00 pm
Ages 3 - 12
Min/Max 4/8
WSRA, Greenleaf
Fee (R/NR) $40/$80
Code 110102
SENSORY EXPERIENCES
WSRA provides a therapeutic experience that will be sure to
excite your senses. We have designed a room at our Greenleaf
facility that caters to your auditory, tactile and visual sensory
needs. Each week we will have a different featured experience.
Come and join us in this comfortable setting and find out how
sensory stimulation helps you!
Thursdays, February 25 - March 17
(4 weeks)
4:00 – 5:00 pm
Ages 3 - 12
Min/Max 4/8
WSRA, Greenleaf
Fee (R/NR) $35/$70
Code 120103
SWIM LESSONS
AUTISM MOVEMENT THERAPY
Allow your child the opportunity to learn the fundamentals of
swimming in a safe and supportive environment. Supported floats,
beginning arm and leg movements are just a few of the skills we
will be introducing. We will explore the water and practice skills
using songs and games. Swimmers will work on individual goals
based on ability and the pool will be shared with other swim
programs. Participants in diapers must wear swim diapers and
plastic pants.
Autism Movement Therapy is the first therapy designed for
individuals with Autism combining music and movement. It
stimulates communication between the right and left hemispheres
of the brain to increase overall cognitive processing. The goal is to
increase concentration, focus and social interaction.
Wednesdays, January 13 – March 16
(10 weeks)
7:35 - 8:10 pm
Ages 10 - 20
Min/Max 4/6
FitNation, Gurnee
Fee (R/NR) $140/$280
Code 130206
Tuesdays, February 9 – March 15
(6 weeks)
4:30 - 5:30 pm
Ages 3 - 12
Min/Max 4/8
WSRA, Greenleaf
Fee (R/NR) $40/$80
Code 120104
5
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
6
Youth Programs
FRIENDS & COMPANY
Need some fun and relaxation after a hard day at school? Well then Friends &
Company is for you. WSRA is offering after school recreation for individuals with
disabilities. Our qualified and caring staff is dedicated to meeting the needs of our
participants and their families. Come enjoy activities, games, and outdoor play, as
well as a variety of arts and crafts. An afternoon snack may be sent. It is strongly
suggested that participants attending this program have independent self-help
skills which include the ability to perform personal hygiene practices and display
the ability to conduct their self in a socially-appropriate manner. WSRA reserves
the right to determine if the program is appropriate for an individual.
Payment & Registration Information
• Fees are due at the beginning of each month. A late fee of
$10.00 will be assessed for payments not received by the
10th of the month, this will be strictly enforced.
• Participants who sign up for Monday – Friday will receive
priority registration up until the registration deadline.
Program
F&CI
F &C II
F & C III
F & C IV
F&CV
(1 day/wk)
(2 days/wk)
(3 days/wk)
(4 days/wk)
(5 days/wk)
Fee
$80.00/month
$160.00/month
$240.00/month
$320.00/month
$400.00/month
To inquire about openings, call the WSRA office at
(847) 244-6619. Please allow at least 3 working days from
enrollment before your child attends.
Dates are subject to changes based on the school schedules. Parents are
responsible for contacting the school about school bus drop-off information. Fees
are based on the number of days of Friends & Company and then divided into 9
monthly installments. The minimum commitment is one month. Flexible options
are available upon request (i.e. M/W/F or T/TH). Friends & Company will be held
on early release days if there is a minimum of 6 participants attending. Friends &
Company will not be held on school days off or during school breaks. Check the
brochure for Kids Days Off programs or Camps during winter [12/21-1/4] and
spring [3/21-3/25] breaks. Due to the Thanksgiving holiday there will be no
program Nov. 26-27th.
Friends & Company will begin after winter
break on January 5th.
2:00 - 6:00 pm
Ages 7 - 21
Min/Max 6/14
WSRA at Warren Township Center
Fee $400/month (Residents Only)
KIDS DAYS OFF
Join your friends at WSRA for a day filled with
fun and games! Arts and crafts and socializing
with peers will take care of your school day
off in a safe and familiar environment. Please
bring a sack lunch.
Monday, January 18th
Registration deadline is
December 18
Code 130201
Monday, February 15th
Registration deadline is January 25
Code 130202
Monday, March 7th
Registration deadline is February 15
Code 130203
8:30 am - 5:30 pm
Ages 7 - 21
Min/Max 5/10
WSRA, WTC
Fee (R/NR) $45/$90 per day
6
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
Teen Programs
TEEN LOCK-IN
SPRING FLING CAMP
Looking for a special night out with friends? We’ve got it covered!
Join your peers at WSRA for a whole night of fun & friendship! We
will provide dinner, play games and watch a movie before the lights
go out. In the morning we will share a few more laughs while we
cook breakfast.
March 11 - 12
Drop Off at WSRA, Greenleaf 6:30 pm
Pick Up at WSRA, Greenleaf 9:30 am
Ages 13 - 20
Min/Max 5/10
WSRA, Greenleaf
(R/NR) $40/$80
Code 140201
F A M I L Y
Spring has finally sprung! Knock those winter blues away by
joining your friends at WSRA for some camp fun. We will forget
about school for the week and have fun playing games, making
crafts, enjoying sports, attending mini field trips and much, much
more. You do NOT want to miss out on this camp. Please send a
sack lunch each day. Registration deadline is February 26th.
Monday – Friday
March 21 – 25
8:30 am – 5:30 pm
Camp Time 9:30 am – 3:30 pm
Ages 6 – 21
Min/Max 6/13
WSRA, WTC
Fee (R/NR) $225/$550
Code 130205
S P E C I A L
E V E N T
FAMILY EVENT FEATURING THE FROGLADY!
Join us for an evening dedicated to reptiles & amphibians. Deb Krohn, The FrogLady will guide us through the differences and
similarities between reptiles and amphibians. We will be introduced to over 20 live animals that participants will get to touch and meet
up close. Following the presentation families will have the opportunity to mingle and enjoy refreshments.
Please note this is a family event. All participants
need to be accompanied by an adult.
Friday, January 8
6:00 – 8:30 pm
The presentation will begin at 6:30 pm
Family Event
Min/Max 40/60
WSRA/Greenleaf
Fee (R/NR) $10 per person
Code 170201
7
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
8
Teen Programs
TEEN CLUB
AGES 12 – 20 ● MIN/MAX 5/13
OPEN SWIM
Cannonball! Teen Club is heading to the pool to wash away the
winter blues. We are going to open swim at the new FitNation pool
so please don’t forget your swimsuit and towel!
GAME NIGHT
January 29
Drop Off at WSRA, WTC 6:15 pm
Pick Up at WSRA, WTC 8:30 pm
FitNation, Gurnee
(R/NR) $20/$40
Code 140103
Play some of WSRA’s favorite games with friends or bring your own
and teach us something new! Root beer floats will be provided as
a tasty treat.
January 15
Drop Off at WTC 7:00 pm
Pick Up at WTC 9:00 pm
WSRA, WTC
(R/NR) $10/$20
Code 140101
MAMBO ITALIANO
Bon appetite! Join with Prime Time Club as we team up to make a
delicious spaghetti dinner. After the preparation is complete, dine
by candlelight while the staff serve your entrée. Please dress up for
the occasion.
January 22
Drop Off at WSRA, Greenleaf 6:00 pm
Pick Up at WSRA, Greenleaf 8:00 pm
WSRA, Greenleaf
(R/NR) $15/$30
Code 140103
VALENTINE’S DAY PARTY
Love is in the air! Come play Valentines games, make tasty snacks,
and hang out with great friends.
February 12
Drop Off at WSRA, WTC 7:00 pm
Pick Up at WSRA, WTC 9:00 pm
WSRA, WTC
(R/NR): $15/$30
Code 140104
8
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
9
Teen Programs
TEEN CLUB
AGES 12 – 20 ● MIN/MAX 5/13
ACTION TERRITORY
At Action Territory we will challenge each other to a game of laser
tag, followed by arcade games and a stop at the snack shop.
Please send extra money for snacks at the Action Eatery.
KARAOKE & BINGO NIGHT
Come play a little bingo and see who the big winners are! Prime
Time & Teen Clubbers will enjoy some pop and popcorn. Then we
will sing our hearts out on the brand new karaoke system!
March 4
Drop Off at WTC 6:00 pm
Pick Up at WTC 9:00 pm
Action Territory, Kenosha
(R/NR) $20/$40
Code 140107
February 19
Drop Off at WSRA, Greenleaf 7:00 pm
Pick Up at WSRA, Greenleaf 9:00 pm
WSRA, Greenleaf
(R/NR) $10/$20
Code 140105
THE GIANT EGG DROP & PIZZA PARTY
Do you have what it takes to save your egg? Participants will each
have supplies and a precious egg to try and keep from cracking
while being dropped from the top of a 10ft ladder. If your egg
makes it you get pizza! Otherwise, it looks like scrambled eggs
for you!
MALL MAYHEM
March 18
Drop Off at WTC 6:00 pm
Pick Up at WTC 8:00 pm
WSRA, WTC
(R/NR) $15/$30
Code 140108
Join your fellow teens for a night of shopping and food court fun!
Please bring extra money if you wish to purchase while shopping
and at least $10 for dinner.
February 26
Drop Off at WSRA, WTC 6:00 pm
Pick Up at WSRA, WTC 8:00 pm
Gurnee Mills, Gurnee
(R/NR) $10/$20
Code 140106
9
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
10
Teen & Adult Programs
WALK & DINE
FUN FITNESS
Let’s get moving! Each week we will explore different ways to get
fit. We will try workout videos, yoga, exercise challenges, dancing
and so much more. There’s no better time than now to learn new
ways to be active.
Mondays, January 4 – February 15
(7 weeks)
3:00 – 4:00 pm
Ages 16 & Older
Min/Max 5/10
WSRA, Greenleaf
Fee (R/NR) $40/$80
Code 150101
Winter weather can’t stop us from getting in some exercise! This
season we will head indoors at Hawthorne or Gurnee Mills mall
for our walk, then off to a local restaurant for dinner. Please be
sure to wear comfortable shoes, bring a water bottle and $15 for
dinner/tax/tip.
Mondays, January 4 – February 15
(7 weeks)
4:30 - 7:00 pm
Ages 16 & older
Min/Max 5/10
Fee (R/NR) $100/$200
Code 150105
Pick Up
3:45
4:00
4:20
Transportation
Location
Drop Off
WSRA-WTC
7:40
Greenleaf
7:30
St. Mark’s
7:10
(A minimum of three participants need to use the
pickup point for it to be offered)
STRIKES & SPARES
Come on down to the Brunswick Zone –
Fountain Square to let the good times roll!
This program is sure to bring lots of laughs,
strikes and even some spares. You can bring
your own equipment if you wish or borrow
some from the alley. Hurry and sign up now
as spots fill up fast! For an additional fee,
door to door transportation is available
for residents only.
CREATION STATION
It’s time to get creative and discover the artist in you! Each week
we will be creating a new masterpiece. We will explore many
different areas of art, from watercolors to woodworking. Don’t
miss out on this wonderful opportunity to express yourself
artistically!
Wednesdays, January 6 - February 24
(8 weeks)
5:30 - 6:30 pm
Ages 13 & older
Min/Max 5/10
WSRA Greenleaf
Fee (R/NR) $60/$120
Code 150110
Wednesdays, January 6 – March 16
Code 150111
OR
Thursdays, January 7 – March 17
Code 150112
11 weeks
5:00 – 6:15 pm
Ages 13 & older
Min/Max 10/25
Brunswick Zone – Fountain Square
Fee (R/NR) $130/$260
Door to door transportation for residents only
Wednesdays - $77 (Code 150113)
Thursdays - $77 (Code 150114)
10
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
Teen & Adult Special Events
CHICAGO WOLVES
“Let’s Go WOLVES”! The Wolves will be taking on the mighty
Rockford Icehogs. This game is sure to be a sellout and a fun one
to watch as the Icehogs are the Chicago Blackhawks affiliate
team! Wear your maroon, gold and white proudly as we cheer on
the Wolves. Bring spending money for dinner, a snack and
souvenirs if you wish.
Saturday, January 30
Puck Drops at 7:00 pm
Ages 16 & older
Max 20
Allstate Arena, Rosemont
Fee (R/NR) $45/$90
Code 150203
Pick Up
5:30
5:10
4:50
Transportation
Location
Drop Off
WSRA-WTC
11:45
Greenleaf
11:30
St. Mark’s
11:15
MARDI GRAS
Twenty four years of beads and masks.
All of these filled with fun and laughs.
Crafts, music, magic and food.
Photos capturing the festive mood.
Dress in colors purple, green, & gold.
What fun the night will hold.
See you at the Warren Town Hall.
It’s obvious we’ll have a ball.
Friday, February 5
7:00 – 9:00 pm
Ages 12 & older
Warren Town Hall
Fee $20
Code 150202
Light refreshments, music
and entertainment will be provided.
If WSRA,WTC is your usual pick up and drop off point, please
go straight to the Warren Town Hall at 7:00 pm. Festivities
will be over at 9:00 pm.
Transportation
Pick Up
Location
Drop Off
6:20
St. Mark’s
9:40
6:40 WSRA, Greenleaf
9:20
WINTERFEST
Join your friends as we head to Riviera Park in beautiful Lake
Geneva for a morning full of magic, music and sculptures. We
will spend the morning walking through the creations and then
head to a local restaurant for lunch. Please send $20.00 for
lunch and participants must dress appropriate for outdoor
weather!
Sunday, February 7
Drop Off at WSRA, WTC at 8:45am
Pick Up at WSRA. WTC at 2:45pm
Ages 13 & older
Min/Max 6/12
Riviera Park, Lake Geneva
Fee (R/NR) $25/$50
Code 150206
MILWAUKEE BUCKS
We will head to the Bradley Center to see the Bucks take on the
Detroit Pistons. Please send spending money for food, beverages
or souvenirs. Sign up now because our cheering section is
guaranteed to sell out.
Saturday, February 27
Tip Off at 7:30 pm
Ages 16 & older
Max 20
BMO Harris Bradley Center, Milwaukee
Fee (R/NR) $50/$100
Code 150205
Transportation
Pick Up
Location
Drop Off
4:30
WSRA, WTC
11:45
4:50 WSRA, Greenleaf 11:30
5:10
St. Marks
11:15
SRSNLC BOWLING TOURNAMENT
Join your friends as we head to the Brunswick Zone – Fountain
Square for a morning of bowling, prizes and snacks. If you are
not registered for Strikes & Spares but wish to participate you
must submit a three game average to Amber by February 8th.
Bowling balls and shoes are available at the alley if you do not
own equipment.
Saturday, March 5
9:30 am – 12:30 pm
Drop off at WSRA, WTC 8:45 am
Pick up at WSRA, WTC 1:15 pm
Ages 12 & older
Min/Max 5/15
Brunswick Zone – Fountain Square, Waukegan
Fee (R/NR) $25/$50
Code 150204
11
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
Adult Programs
Prime Time Club
Ages 21 & older Min/Max 6/20
JANUARY 15
SRACLC’S WINTER WONDERLAND DANCE
Music plays, are you listening? On the floor, dance moves are
glistening. Groove to the beat as our friends from other agencies
join the party as well. Warm refreshments and delicious treats will
be provided. Please eat dinner before the program.
Sullivan Center, Vernon Hills
Dance Time 7:00 - 9:00 pm
Fee (R/NR) $22/$44
Code 160102
Transportation
Pick Up
Location
Drop Off
5:55
WSRA, WTC
10:05
6:15
St. Marks
9:45
6:30 WSRA, Greenleaf
9:30
FEBRUARY 19 • KARAOKE & BINGO NIGHT
Let’s play a little bingo and see who the big winners are! Prime
Time & Teen Clubbers will enjoy some pop and popcorn. Then we
will sing our hearts out on the brand new karaoke system!
WSRA, Greenleaf
Program Time 7:00 – 9:00 pm
(R/NR) $10/$20
Code 160105
Transportation
Pick Up
Location
Drop Off
6:25
WSRA, WTC
9:35
6:45
St. Marks
9:15
7:00 WSRA, Greenleaf
9:00
MARCH 4 • PORTILLO’S & GAMES
JANUARY 22 • MAMBO ITALIANO
Bon appetite! Join in with Teen Club as we make a delicious
spaghetti dinner. Then dine by the candlelight and be served by
your staff. Please dress up for the occasion.
WSRA, Greenleaf
Program Time 6:00 – 8:00 pm
(R/NR) $15/$30
Code 160103
Transportation
Pick Up
Location
Drop Off
5:25
WSRA, WTC
8:35
5:45
St. Marks
8:15
6:00 WSRA, Greenleaf
8:00
FEBRUARY 12
SRSNLC’S VALENTINE’S DANCE
Love will be in the air at this year’s Valentine’s Dance. Dance the
night away while the DJ spins the hits. Refreshments will be served
and everyone receives a Valentine’s keepsake. Please eat dinner
before you come to program.
SRSNLC, Waukegan
Program Time 6:30 – 8:30 pm
(R/NR) $25/$50
Code 160104
Transportation
Pick Up
Location
Drop Off
5:45
WSRA, WTC
9:20
6:00 WSRA, Greenleaf
9:05
6:15
St. Marks
8:50
Great food…check! Great fun…check! Great friends…check!
Looks like we have all we need for a night out on the town. Come
and enjoy dinner at the new Portillo’s in Gurnee Mills and then we
will swing over to Tilt Studios for some arcade and laser tag fun.
Please bring $15.00 for dinner and money for the arcade games if
you wish.
Portillo’s & Tilt Studios, Gurnee Mills
Program Time 6:00 – 8:30 pm
(R/NR) $20/$40
Pick Up
5:00
5:20
5:40
Transportation
Location
Drop Off
WSRA, WTC
9:20
Greenleaf
9:05
St. Marks
8:50
MARCH 11 • ST. PATTY’S DAY PARTY
Who will have the Luck O’ the Irish at this party? Join your friends
for an evening of games, crafts, dancing and fun! Let’s see if we
can catch the friendly Leprechaun as well! Light refreshments will
be provided. Please eat dinner before attending program.
WSRA, Greenleaf
Program Time 7:00 – 9:00 pm
(R/NR) $18/$36
Code 160107
Transportation
Pick Up
Location
Drop Off
6:25
WSRA, WTC
9:35
6:45
St. Marks
9:15
7:00 WSRA, Greenleaf
9:00
12
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
13
Adult Programs
CRITICS CORNER
HOORAY FOR HOLLYWOOD
Move over Ebert and Roeper there are new critics in town. Each
week we will enjoy some cinema snacks while watching a new
release on DVD. After the movie we will discuss it as a group and
give our final review.
Calling all movie buffs! Come catch the latest flicks with all
your friends at WSRA. The cost of the movie is included in the
program fee but please send extra money for concessions if you
wish. You will be notified of the exact movie time, title and pick
up point times the Friday prior to the date.
FRIDAYS
January 29 (Code 160109)
February 26 (Code 160110)
March 18 (Code 16011)
6:30 - 9:00 pm
Ages 18 & older
Min/Max 6/15
WSRA, Greenleaf
Fee (R/NR) $10/$20 per date
SATURDAYS
January 16 (Code 160112)
February 6 (Code 160113)
March 12 (Code 160114)
Approximately 7:00 - 9:00 pm
Ages 18 & older
Min/Max 6/12
Various Theaters
Fee (R/NR) $25/$50 per date
LEISURE ENRICHMENT FOR ADULT PURSUITS
LEAP is a community based recreation program that emphasizes leisure independence, health and fitness, independent living skills and
community integration. Structured recreational activities will help adults with disabilities continue to grow and learn by focusing on 4 key
elements, Independent Living Skills, Health and Fitness, Community Integration and Recreation/Leisure Awareness.
Participants attending this program must be able to successfully participate in a 1 staff to 4 participants ratio and have independent
self-help skills which include the ability to perform all basic personal hygiene practices as well as the ability to conduct themselves in a
socially-appropriate manner. WSRA reserves the right to determine if the program is appropriate for an individual.
A monthly calendar of activities will be handed out at the beginning of each month. Participants should bring a bagged lunch each day
unless otherwise stated on the monthly calendar. On occasion additional money is required for activities.
*If you are new to LEAP please contact to the office to inquire about availability and to schedule an intake appointment.
Monday - Thursday
January 4 - March 17
Fee R/NR
Mondays $385/$770
Tuesdays $385/$770
Wednesdays $385/$770
Thursdays $385/$770
No Program Dates for 2016
(you are not billed for these days)
March 21 - 24
May 30 - June 2
July 4
September 5 - 8
November 24
December 19 - 29
9:00 am - 2:00 pm
Ages: 21 & older
Min/Max 5/15
WSRA Greenleaf
13
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
14
Adult Special Events
AROUND THE WORLD IN ONE NIGHT!
Whoever said traveling was hard work should think again! Join your
friends as we travel around the world all in ONE night. First we will
visit Mexico to learn about their culture and enjoy a homemade
Mexican style appetizer. Next, we will cruise on over to Germany to
cook authentic cuisine and try out some German dancing. Our final
stop will be in Japan as we craft beautiful cranes and top off our meal
with a Japanese dessert. Come hungry and leave full, you won’t want
to miss this!
Saturday, February 20
5:00 – 8:00 pm
Ages 18 & older
Min/Max 5/10
WSRA, Greenleaf
Fee (R/NR) $25/$50
Code 160101
Special Olympics
TRACK & FIELD
BOCCE BALL
Eyes up, knees bent and in a good starting stance. Track season is
back and we are ready to run, jump and throw! The track coaches
will assess each athlete and place them in appropriate events. Fees
include nine weeks of practice and two track meets. A valid
Special Olympics medical application is required prior to the
start of the program and is mailed after registration is
received.
Are you looking for a laid back game to play? Look no further than
the WSRA bocce ball team. During our practices we will work on
the fundamentals of the game, different strategies for play and
teamwork. Program fee includes nine weeks of practice and the
Special Olympics competition. A valid Special Olympics medical
application is required prior to the start of the program and is
mailed after registration is received.
Mondays, February 22 – April 25
No program on March 21
(9 weeks)
4:00 – 5:15 pm
Ages 12 & older
Min/Max 5/15
Hunt Club Park Community Center
Fee (R/NR) $100/$120
Code 150601
Tuesdays, February 9 – April 12
No program March 22
(9 weeks)
4:00 – 5:15 pm
Ages 12 & older
Min/Max 6/16
Cyd Lash Academy, Gages Lake
Fee (R/NR) $80/$100
Code 150602
All athletes must be picked up at the Community Center at 5:15
pm. There will be NO transportation back to the Township Center.
SPECIAL OLYMPICS PARENT INFORMATION
All Special Olympics information for 2016 will be emailed to
families by the end of January. If you do not have a current email
address on file with WSRA please update your information.
Packets can be mailed if you prefer, please call Amber Bodame to
request a mailed copy. The SO handbook, new family forms,
medical applications and much more will be included in the
mailing. If your athlete’s medical application will expire in 2016
you will receive a new form as well. If at any time you have any
questions or concerns regarding Special Olympics please do not
hesitate to call our office.
14
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
2016 Winter Registration Form
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N W I N T E R R E G I S T R AT I O N
100 S. Greenleaf St.• Gurnee, IL 60031
PARTICIPANT'S NAME ________________________________________________
NICKNAME ______________________
PARENTS NAME _________________________________PHONE_____________________ CELL PHONE ___________________
ADDRESS _______________________________________________________________CITY/ZIP _________________________
BIRTHDATE___________________ AGE _____________________DISABILITY _________________________________________
EMAIL ADDRESS __________________________________________________________________________________________
EMERGENCY CONTACT ______________________________PHONE_____________________ CELL PHONE __________________
TEACHER / SCHOOL / PHONE NUMBER _________________________________________________________________________
Please complete this entire form in full.
( ) I DO ( ) I DO NOT give WSRA permission to contact school personnel, case workers and other professionals, to assist in the placement of my
son/daughter in WSRA programs. WSRA also has my permission to schedule observations. Any and all reports, assessments, and/or IEPs deemed
appropriate by the school district and/or reviewing agent are permitted by me to be shared with WSRA staff.
CURRENT ANNUAL INFORMATION FORM ON FILE? Note: If there are changes with medications, emergency contacts, medical conditions, etc., please
contact the WSRA office. ( ) YES
( ) NO, PLEASE SEND A NEW FORM (forms are kept on file for one year)
PHOTOGRAPHS: Unless we are notified, WSRA may take pictures of participants in our programs, classes or events. Please be aware that these
pictures are only for WSRA use. Most likely in future brochures, pamphlets or flyers.
WAIVER AND RELEASE WARREN SPECIAL RECREATION ASSOCIATION
Important Information - Please Read
Warren Special Recreation Association is committed to conducting its recreation programs and activities in a safe manner and holds the safety of participants in high regard.
Warren Special Recreation Association and Warren Township continually strive to reduce such risks, and insist that all participants follow safety rules and instructions that are
designed to protect the participants safety. However, participants and parents/guardians of minors registering for this program/activity must recognize that there is an inherent
risk of injury when choosing to participate in recreational activities.
As participants, parents or guardians, you are solely responsible for determining if you or your minor child/ward are physically fit and/or skilled for the activities contemplated by
this agreement. It is always advisable, especially if the participant is pregnant, disabled in any way or has recently suffered an illness, injury or impairment, to consult a physician
before undertaking any physical activity.
Warning of Risk
Despite careful and proper preparation, instruction, medical device, conditioning and equipment, there is still a risk of serious injury when participating in any recreational
activity/program. Understandably, not all hazards and dangers can be foreseen. Participants must understand that certain risks, dangers and injuries due to acts of God, inclement
weather, slipping, falling, equipment failure, failure in supervision, premise defects and all other circumstances inherent to recreational activities/programs exist. In this regard, it
must be recognized that it is impossible for Warren Special Recreation Association and Warren Township to guarantee absolute safety.
Waiver and Release of All Claims and Assumption of Risk
Please read this form carefully and be aware that, in signing up and participating in this program/activity, you will be assuming the risk and legal liability and waiving and
releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and
associated with this program/activity (including transportation services, when provided).
I recognize and acknowledge that there are certain risks of physical injury to the participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or
loss, regardless of severity, that my minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish any and all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against Warren Special Recreation Association and Warren Township, including its officials, agents, volunteers and employees (hereinafter collectively referred to as Warren Special Recreation Association and Warren Township). I do hereby fully release and forever discharge Warren Special Recreation Association and Warren
Township from any and all claims for injuries, damages, or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward arising out of, connected with, or in any way
associated with this program/activity. In the event of an emergency, I understand and authorize WSRA Staff and officials to secure from any licensed hospital, physician and or medical personnel any
treatment deemed necessary for immediate care for myself or minor child and agree that I will be responsible for payment of any and all medical services. If registering via fax, my facsimile signature
shall substitute for and have the same legal effect as the original form signature. I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims. If registering a minor participant, I further attest that I have read the above to my minor child/ward.
__________________________________________________________________________________________
Signature of Parent or Guardian
Date
__________________________________________________________________________________________
Signature of Participant if he/she is his/her own legal guardian
Date
PARTICIPATION WILL BE DENIED if the signature of adult participant or parent/guardian and date are not on this waiver.
See other side for program registration.
15
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
16
Winter Program Fees
Program Name
R/Fee
Preschool & Youth & Teens
Young Swimmers I
Young Swimmers II
Swim Lessons
Wiggles & Giggles
Sensory Experiences
Autism Movement Therapy
____$140
____$140
____$140
_____$40
_____$35
_____$40
NR/Fee
____$280
____$280
____$280
_____$80
_____$70
_____$80
Kids Days Off
Monday, January 18th
Monday, February 15th
Monday, March 7th
_____$45
_____$45
_____$45
_____$90
_____$90
_____$90
Teen Lock-In (3/11 - 3/12)
_____$40
_____$80
Spring Fling Camp Mon-Fri (3/21 - 3/25)____$225
Program Name
____$550
Friends & Company (youth & teens)
F&CI
_____1 day/wk
_____$80/month
F & C II
____2 days/wk
____$160/month
F & C III
____3 days/wk
____$240/month
F & C IV
____4 days/wk
____$320/month
F&CV
____5 days/wk
____$400/month
Circle Day(s) Attending Friends & Company: M T W TH F
Family Special Event featuring The FrogLady
January 8 from 6:00 - 8:30 pm
Number of family members attending:
R/Fee
LEAP (Adults)
Mondays
Tuesdays
Wednesdays
Thursdays
Circle Day(s) Attending LEAP: M
____$10/person
T
____$385
____$385
____$385
____$385
W TH
NR/Fee
____$770
____$770
____$770
____$770
Prime Time Club (adults 21 & older)
SRACLC's Winter Wonderland Dance 1/15 _____$22
Mambo Italian 1/22
_____$15
SRSNLC's Valentine's Dance 2/12
_____$25
Karaoke & Bingo Night 2/19
_____$10
_____$20
Portillo's & Games 3/4
St. Patty's Day Party 3/11
_____$18
_____$44
_____$30
_____$50
_____$20
_____$40
_____$36
Critics Corner
January 29
February 26
March 18
_____$10
_____$10
_____$10
_____$20
_____$20
_____$20
Hooray for Hollywood
January 16
February 6
March 12
_____$25
_____$25
_____$25
_____$50
_____$50
_____$50
Teen & Adult Special Events
Chicago Wolves 1/30
Mardi Gras 2/5
Winterfest 2/7
Milwaukee Bucks 2/27
SRSNLC Bowling Tournament 3/5
Around the World in One Night 2/20
_____$45
_____$20
_____$25
_____$50
_____$25
_____$25
_____$90
_____$50
____$100
_____$50
_____$50
Special Olympics
Track & Field
Bocce Ball
____$100
_____$80
____$120
_____$100
Teen Club (ages 12 - 20)
Game Night 1/15
Mambo Italiano 1/22
Open Swim 1/29
Valentine's Day Party 2/12
Karaoke & Bingo Night 2/19
Mall Mayhem 2/26
Action Territory 3/4
The Giant Egg Drop & Pizza Party 3/18
_____$10
_____$15
_____$20
_____$15
_____$10
_____$10
_____$20
_____$15
_____$20
_____$30
_____$40
_____$30
_____$20
_____$20
_____$40
_____$30
Teen & Adults
Fun Fitness
Walk & Dine
Creation Station
Strikes & Spares Wednesdays
Transportation
Strikes & Spares Thursdays
Transportation
_____$40
____$100
_____$60
____$130
_____$77
____$130
_____$77
_____$80
____$200
____$120
____$260
A signed waiver with payment is required before
registration can be processed.
____$260
Please return with registration form on page 15.
Link-in
_____$5/hr
(2-hr limit )
Utilize link-in when transitioning from one program to another.
Minimums of three will be implemented for pick-up/drop-off points.
How do I register?
If paying by credit card, go to www.warrentownship.net/wsra and utilize E-Pay
Fax registration form to WSRA, 847-855-8687
Send or drop off registration form - WSRA, 100 S. Greenleaf St., Gurnee, IL 60031
Total Amount:
Register
Early!
$
Method of Payment:
( ) Cash
( ) Check#
If you would like to pay by credit card, please use E-Pay by going to www.warrentownship.net/wsra
or in person at the WSRA office.
( ) Total Payment Enclosed_____
( ) Request Scholarship TOTAL $_______
( ) Payment Plan____________
( ) Total Payment to Follow (if Faxed)__________
Registration
deadline
for most programs
is Friday,
December 18, 2015
FOR OFFICE USE ONLY
(
) Check#_______
(
) Cash $______
Date Recvd_________
Recvd By_______
16
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
17
Annual Information Form
TThis AIF must be completed and filed with the WSRA office, prior to registration for 2015 programs, in order for a
participant to join any WSRA program or event. The AIF contains extremely important information which is necessary for
WSRA staff to plan and execute safe and enjoyable programs. Please fill out and complete all information.
PARTICIPANT INFORMATION
Date Completed:_______________ Are you new to WSRA? □ Yes □ No
Participant is own guardian: □ Yes □ No
Participant Name: First___________________________Middle_______________Last_______________________________
Parent/Guardian Name (s):______________________________________________________________________________
Participant Address:____________________________________City:______________State:_____ Zip:_________________
Home Phone:_________________________Mom cell:____________________Dad cell:_____________________________
Email Address:_______________________________________________________________________________________
In case of emergency and parent/guardian cannot be reached, please contact (within 10 minutes distance):
Name:__________________________________Phone Number:____________________Relation:_____________________
Sex: □ M □ F
Date of Birth:_______________ Height:_________________Weight:_______________________
Primary Diagnosis:_______________________________Secondary Diagnosis:_____________________________________
Does participant have a seizure disorder? □ Yes □ No
*If yes, please complete Seizure Information Form
Date of last seizure: ______________________________________________________
School attending/other (work, day program):_________________________Phone:___________________________________
Teacher/Supervisor/Case Worker Name:_____________________________Phone:__________________________________
Accommodations needed for Inclusion: _____________________________________________________________________
ALLERGIES
□ Food Allergies:_____________________________________________________________________________________
*If yes, please provide a food allergy plan.
□ Medication Allergies:_________________________________________________________________________________
□ Other allergies:_____________________________________________________________________________________
Does participant carry/use an Epi-pen? □ Yes □ No
DIETARY INFORMATION
□ Restrictions:_______________________________________________________________________________________
□ Food Preferences:___________________________________________________________________________________
Does your child use a G-Tube for food consumption? □ Yes □ No If yes, explain:_____________________________________
__________________________________________________________________________________________________
If over 21 years, can consume alcohol: □ Yes □ No Quantity: ____________________________________________________
Additional Information:_________________________________________________________________________________
MEDICAL INFORMATION
Please list all medications participant takes:
Medication Name
Dosage
Time
Purpose
MOBILITY/TRANSPORTATION
□ Can walk independently: If yes, how long:__________________________________________________________________
□ Uses wheelchair: if yes, what type: □ Manual □ Electric
□ Transfers independently
□ Transfers with assistance:____________________________________________
□ Uses orthopedic equipment (walker, braces, canes, AFO’s):_____________________________________________________
□ Requires a vehicle with a lift
□ Requires staff assistance during transportation
Type of assistance:____________________________________________________________________________
17
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
18
Annual Information Form
COMMUNICATION NEEDS
□ Verbal □ Non-verbal
□ Independent communication □ Assisted/Facilitated communication □ Uses sign language □ Hearing Aid
□ Uses communication system (PECS, Picture schedule, talker)
BEHAVIOR INFORMATION
Best way to transition to new activity:_____________________________________________________________________
Best way to re-direct:_________________________________________________________________________________
Best way to calm:____________________________________________________________________________________
Behaviors exhibited when upset/frustrated:_________________________________________________________________
Fears/phobias:______________________________________________________________________________________
Preferred activities:__________________________________________________________________________________
Does participant have a behavior plan? □ Yes □ No
*If yes, please provide behavior plan.
SAFETY
Able to say name? □ Yes □ No
Able to consistently say phone number? □ Yes □ No
Does participant wander/run from group? □ Yes □ No □ Sometimes
Is participant responsible for own belongings? □ Yes □ No □ Sometimes
Can participant manage own money? □ Yes □ No □ Sometimes
Can participant recognize danger? □ Yes □ No □ Sometimes
Does participant swim? □ Yes □ No
Explain:____________________________________________________________________________________
DAILY LIFE SKILLS (If required, please explain the nature of assistance needed)
□ Requires assistance eating:___________________________________________________________________________
□ Requires assistance in bathroom:_______________________________________________________________________
□ Requires regular bathroom schedule:____________________________________________________________________
□ Requires assistance dressing:_________________________________________________________________________
SPORTS PROGRAMS
Shoe size:___________________
T-Shirt size: Child: S____ M ______ L______ XL_____ Adult: S______ M_____L_____XL_____ 2XL______
Shorts size: Child: S____ M ______ L______ XL_____ Adult: S______ M_____L_____XL_____ 2XL______
ADDITIONAL INFORMATION
Please share any additional information you feel is helpful:______________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
I grant photo permission for participant’s picture to be taken and used in WSRA publications and/or media.
□ Yes □ No
Participant is independent and does not require supervision at conclusion of program/drop off.
□ Yes □ No
_________________________________________________
Signature of Participant/Parent/Guardian
________________________________
Date
18
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
19
General Information
FALL STAFF
& VOLUNTEERS 2015
Thank you for making a difference! WSRA
recognizes the sincere efforts made to enrich and
inspire those who participate in our programs.
Aaron Abraham
Sara Adams
Marllys Banks
Emily Bear
Holly Beattie
Jenny Campos
Rejiemay Canda
Roni Cassel
Anna Davies
Samanatha Dunn
Jake Eldrup
Barret Hale
John Hannon
Katie Harr
Jimmy Ivers
Michaelia Jack
Taytum Kahl
Leah Kuzmicz
Rebecca Lopez
Natalie Lyjak
Amanda Massong
Jordan Miller
Toni Naber
Rachel Peterson
Mary Powalish
Stephanie Riquelme
Maddy Rose
Naseem Saleh
Haley Sharkey
Olivia Speer
Rachel Stoneberg
Joe Stubenvoll
Kim Thorn
Reba Varghese
Lisa Vitale
Emma Wade
Daphne Wang
Katy Wells
Chris Williams
Amber Yee
EMPLOYMENT OPPORTUNITIES
Join our dedicated team of staff for a lifetime of learning, growth and making
a difference in the community. These opportunities are perfect for those with
enthusiasm and interests in working with individuals of all abilities. If you
have or would like experience in working with individuals with special needs
call Susan Markey at WSRA 847-244-6619 to request an application.
19
WSRA STAFF
Executive Director
Brenda Zeck, CTRS
Superintendent
Susan Markey, CTRS
Inclusion
& S.O Coordinator
Amber Bodame, CTRS
Youth & Teen Coordinator
Nicole Estrada, CTRS, CPRP
Adult Day Coordinator
Emily Thomas, CTRS
Office Manager
Whitney Brooker
WSRA BOARD
MEETING DATES
January 11, 2016
March 14, 2016
Meetings are held at
100 S. Greenleaf St.,
Gurnee, IL. The meetings
begin at 4:00 pm and are
open to the public.
WSRA BOARD OF DIRECTORS
Join Our Team!
Employment
opportunities are
available. Call
Susan Markey
at WSRA
847-244-6619
WSRA is a cooperative of three park districts and one township.
Each partner district or township has a representative on the
WSRA Board of Directors. They are listed here.
Wildwood Park District
President
Maureen Jekot
Gurnee Park District
Treasurer
Susie Kuruvilla
Grandwood Park Park District
Vice President
Nancy Carlson
Warren Township
Board Member
Suzanne Simpson
19
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1
PRESORT STANDARD
U.S. POSTAGE
PAID
GURNEE, IL
PERMIT NO. 1538
Warren Township Reporter, Inc.
Warren Special Recreation Association
100 S. Greenleaf St.• Gurnee, IL 60031
WHY NOT TRY E-PAY?
WSRA accepts credit and debit card payments online using
The Illinois Funds E-Pay site. This program allows you to
safely pay for programs, make an installment payment,
purchase gift certificates or make a donation at your
convenience. We hope many will take advantage of this added
payment option that is simple and user friendly!
All you need to do is follow these simple steps:
1. Go to www.warrentownship.net/wsra
and click on the E-Pay link.
2. Some programs require a program number that
6-didgit number can be found with each program
description in the brochure. More complex programs
are supplied with drop down selections.
3. E-Pay accepts Visa, MasterCard, American Express,
or Discover.
FAMILY SPECIAL EVENT
FEATURING THE FROGLADY
Join us for an evening dedicated to reptiles & amphibians.
Deb Krohn, The FrogLady will guide us through the differences
and similarities between reptiles and amphibians.
Friday, January 8, 2016
6:00 – 8:30 pm
The presentation will begin at 6:30 pm
Details on Page 7
Please help us reduce waste
If you no longer wish to receive WSRA’s brochures or flyers,
please call (847) 244-6619 and give your name and participant’s
name, address, and school of your child,
if applicable. Thank you.
Please subscribe to WSRA’s Official Facebook page for up-to-date news,
photos and much more at www.facebook.com/WarrenSpecialRec
W A R R E N S P E C I A L R E C R E AT I O N A S S O C I AT I O N • 1 0 0 S . G r e e n l e a f S t . • G u r n e e , I L 6 0 0 3 1