summer 2015 - West Suburban Special Recreation Association

Transcription

summer 2015
hablamos
español
Board of Directors
Board Meetings
berwyn park district
clyde park district
village of elmwood park
park district of forest park
park district of franklin park
village of harwood heights
hawthorne park district
norridge park district
north berwyn park district
park district of oak park
river forest park district
The Board of Directors of the Association meets on the second
Tuesday of the month, 8 times per year at 5:00pm. Call the
office for a meeting schedule and locations. The public is
invited to attend.
jeff janda
larry banks
al schmidt
steve thomas
joseph d. modrich
michael gadzinski
dennis raleigh
mark desalvo
joseph c. vallez
sandy lentz
mike sletten
West Suburban Special Recreation Association
2915 maple street, franklin park, il 60131
847.455.2100 ··· voice or tty
office hours
8:30 am – 5:00 pm ··· monday through friday
WSSRA Staff
Marianne Birko
Gretchen Dennis
Robert A. Foster
Maryellen Bilek
Annie Hart
Matt Barber
April Ryan
Nathan Sheade
Elizabeth Pliego
Carlos Marroquin
Brittany Prysock
Aaron Glickson
Lisa Gershak
Noelia Hernandez
Laurie Kibler
Christopher Swasko
Luz Rocha-Serrano
Larry Feldt
Mike Zych
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executive director
superintendent of recreation
superintendent of safety & operations
outreach specialist
inclusion manager
staff manager
program manager
recreation specialist
finance manager
registrar
lekotek leader
graphic designer
wssra driver/lekotek leader
wssra driver
wssra driver
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[email protected]
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Key to Abbreviations
Table of Contents
ADD
ADHD
ALZ
AUT
DD
EC
ED
HI
LD
MI
MH
MLH
PI
SL
SO
SP
VI
SUMMER CALENDAR
3
Alzheimer’s
CHILDREN & YOUTH
6–7
Autism
SWIM LESSONS
9
Early Childhood
TEENS & ADULTS
10 – 12
Emotional Disturbance
SPORTS, FITNESS, & SO
13 – 16
Learning Disability
OLDER ADULTS
17 –18
Mental Impairment
HOT SUMMER DAYS
19
OVERNIGHT TRIPS
20 – 21
Attention Deficit Disorder
Attention Deficit Hyperactivity Disorder
Developmental Disability
Hearing Impairment
Multiple Handicaps
Mental Health
Physical Impairment
Speech and Language Delay
Special Olympics
Severe and Profound Mental Impairment
Visual Impairment
Registration Update
All Summer 2015 registration is taken on a first come, first
served basis
summer deadline
may 29th, 2015
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.
follow us on
/wssra
@wssra
On the Cover
Mateo at Strider Bike Camp
wssra.net1
Program locations
EMERGENCY PHONE
The purpose of this phone number
is to allow access to WSSRA for
emergencies only during
non-office hours.
1. The phone may be called Monday
through Friday, from 5:00pm 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 the WSSRA on the web
for directions to program locations
and up to date program information.
Email your comments to us:
[email protected]
BERWYN
FRANKLIN PARK
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
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
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
10125 W Grand Ave .............. 847.349.5425
WSSRA Office
2915 Maple St......................... 847.455.2100
BENSENVILLE
Harwood Heights Village Hall
7300 Wilson Ave .................... 708.867.7200
White Pines Golf Course
500 W Jefferson St.................. 630.766.0304
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
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
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HARWOOD HEIGHTS
MELROSE PARK
Mannheim Middle School
2600 Hyde Park Ave .............. 847.455.5020
NORRIDGE
Norridge Park District
4631 N Overhill Ave .............. 708.457.1244
OAK PARK
Andersen Center
820 Hayes Ave . ...................... 708.524.2050
Ascension Church
808 S East Ave......................... 708.848.2703
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
610 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
Summer 2015
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
MONDAY
AQUA EXERCISE &
STINGRAY SWIM TEAM
8:00 – 8:45am
SPECIAL EVENTS
WALK-N-DINE
TOWERS SOCIAL
12:30pm – 2:30pm
Franklin Towers
Franklin Park
FALLIN’ FOR
OUR STARS
TEAM UP
9:30 – 11:00am
Franklin Park
Community Center
9:30am – 12:15pm
WILDCARD
WEDNESDAYS
9:30 – 12:00pm
Franklin Park
Community Center
SWIM LESSONS
8:15 – 8:45am
BOOT CAMP
9:00 – 10:00am
Rehm Park
Oak Park
SATURDAY FUN CLUB
9:00 – 11:30am
Barrie Center
Oak Park
OUTDOOR ADVENTURES
9:15am – 12:15pm
Building #4
SUPER SATURDAYS
12:15 – 2:45pm
Barrie Center
Oak Park
STINGRAY SWIM TEAM
6:00 – 7:45pm
PAV YMCA
Berwyn
FRIDAY SHOW TIME
Time Varies
Barrie Center
Oak Park
FOOD CRITICS
6:30 – 9:15pm
Barrie Center
Oak Park
MOONLIGHTERS &
SOCIALITES
6:00pm – 9:00pm
Carroll Center
Oak Park
HOT SHOTS &
CITY SLICKERS
6:00pm – 9:00pm
Building #4
SWIM LESSONS
3:45 – 6:00pm
PAV YMCA
Berwyn
SWIM LESSONS
7:10 – 7:40pm
RCRC
Oak Park
JUNIOR GOLFERS
6:00 – 7:00
Bensenville
YOGA FOR WELLNESS
10:00 – 11:15am
Village of
Harwood Heights
A F T E R N O O N S
SWIM LESSONS
5:00 – 6:00pm
Elmwood Park
Aquatics Center
WEEKLY WORKOUT
7:00 – 8:15pm
Park District of
Franklin Park
FLAG FOOTBALL
6:00 – 7:15pm
Elmwood Park
High School
INTRO TO GOLF
7:00 – 8:00pm
Bensenville
SATURDAY BOWLING
LEAGUE
1:00pm-3:00pm
Circle Bowling Lanes
Forest Park
SWIM LESSONS
7:10 – 7:40pm
RCRC
Oak Park
BOBCATS SOFTBALL
6:30 – 8:00pm
Field Park, Oak Park
Birch Park, Franklin Park
ZUMBA
6:15 – 7:15pm
Liberty Center
Berwyn
E V E N I N G S
TAE KWON DO
7:15 – 8:00pm
Karate for Kids
Franklin Park
BOBCATS VOLLEYBALL
GAME SEASON
6:00 – 8:15pm
Franklin Park
Community Center
SWIM LESSONS
4:15 –4:45pm
Duck Pond Pool
Cicero
HEALTHY START
10:00 – 11:30am
Franklin Park
Community Center
OCTOBER 16
WHITE SOX PARTY
JUNE 7
SPLISH SPLASH
SUMMER BASH
JULY 30
IN-TENTS
WILDERNESS
AUGUST 11 – 13
ISO BOWLING
TOURNAMENT
JULY 25
BRADFORD
WOODS 3-DAY
AUGUST 3 – 5
BRADFORD
WOODS 5-DAY
AUGUST 3 – 7
SHEBOYGAN TRIP
AUGUST 18 – 20
ON MILWAUKEE!
SEPTEMBER 2 – 3
BOBCATS VOLLEYBALL
PRACTICE SEASON
6:30 – 7:30pm
Ascension Gym
Oak Park
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 $20,000 each
year to support WSSRA programs. At each meeting, Foundation
members have the opportunity to give input and ideas about
program offerings. So come join the fun and help WSSRF
improve and expand programs for persons of all ages with
disabilities.
4wssra.net
Get involved!
WSSRA is looking for energetic & caring staff to assist in recreation programs for individuals
with disabilities. You will:
· Meet new people while participating in fun recreation activities
· Enjoy personal growth
· Have a flexible schedule
(Morning, afternoon, evening & weekend hours available)
· Gain leadership skills
· Enhance self-esteem by being part of a team that brings out the
best in everyone
For more information, call 847.455.2100 or visit wssra.net
Staff Spotlight
WSSRA would like to welcome Aaron Glickson to the staff
as our new Recreation Specialist.
Greetings! My name is Aaron Glickson. I am extremely
excited to be joining this team, the communities that WSSRA
serves, and getting to know your families. So far, everyone
has been very welcoming and helpful. I have been working in
the parks and recreation field since the age of 14. Wheeling
Park District is where I began part time lifeguarding, teaching
swim lessons, and managing the indoor and outdoor water
parks. Other part time experience of mine include working
for Northwest Special Recreation Association (NWSRA),
Buffalo Grove Park District (where I grew up), and University
Recreation at Western Michigan University (WMU). I attended
WMU from 2008-2011 and completed a double major in
Recreation Management and Communication Studies. During
my undergrad, I coached Special Olympics Swimming,
Bowling, and Golf. The last two years I ran the Gurnee Park
District Aquatic Programs; primarily the swim lesson program
during the school year and managing day-to-day operations
of the outdoor Aquatic Center in the summer.
personal interests
Swimming, cooking, and spending time with friends and family
favorite movies
Coach Carter and the Batman movies
favorite food
Chicago Style hot dogs
favorite sports teams
favorite thing about wssra
The Blackhawks, Michigan State University, Indiana University,
Getting to know all of the participants and seeing them grow, and
Western Michigan University, and those Cubbies
the fun and energetic office environment.
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children & youth
Lekotek
Tae Kwon Do
Jr. Golfers
ALL ABILITIES
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:
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:
MI, AUT, DD, MH
· 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!
For children birth – 6 years
North Berwyn Park District, Irving School in
Berwyn, or WSSRA office
Registration will resume for our Fall 2015
session of Lekotek.
Please call the office for more information.
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· Self-control
· Courtesy
· Friendship
· Confidence
· Self-awareness
· Self-esteem
· Perseverance
· Self-improvement
· Respect
· Dedication
Ages 9-14 ··· Mondays, 7:15-8:00pm
Karate for Kids, Franklin Park
uniform fee: $40.00/one-time fee for new
participants in addition to program fee
dates: June 8 – July 20
no program july 6
registration #: 313
fee: $61.20
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
· Positive parent/child interactions
· Proper golf rules & etiquette
Ages 6 – 12 ··· Thursdays, 6:00 – 7:00pm
White Pines Golf Course, Berwyn
no program july 2
registration #: 335
fee: $15.30
saturdays
Saturday Fun Club
Super Saturdays
ALL ABILITIES
ALL ABILITIES
Ages 3 – 6 ··· Saturdays, 9:00am – 11:30am
Barrie Recreation Center fee: $10.60/week
reg #: 304
Ages 7 – 11 ··· Saturdays, 12:15 – 2:45pm
Barrie Recreation Center fee: $10.60/week
activity
reg #: 306
date
reg #
Summer Challenge Game Day!
Are you ready for a morning full of outside Olympic style challenges?
June 13
304-01
Father’s Day is Tomorrow?
Let’s make something special for Dads and other special people in our lives. Show them how much we care!
June 20
304-02
Happy Birthday America!
We’re celebrating the 4th a little early! Come dressed in your best red, white, and blue. Happy Birthday America!
June 27
304-03
No program today ··· Happy 4th!
July 4
Hoops there it is!
Nothing like a fun morning of basketball themed games. Make sure to wear closed toe shoes.
July 11
304-04
Splish, Splash Fun
Wear your bathing suit & bring a towel! We’ll finish our summer season off with a day of water play!
July 18
304-05
306-01
306-02
306-03
306-04
306-05
Outdoor Adventures
MI, DD, LD, VI
We fill our Saturday mornings with fun and thrills as we explore our communities. The vans will depart 5 minutes after scheduled start
time for our out trips! We do a lot of indoor AND outdoor activities each week. Please make sure that you are dressed for both!
Ages 12 – 22 ··· Saturdays, 9:15am –12:15pm
Park District of Forest Park, Building #4
fee: $14.00/week
Please see weekly program descriptions for any changes in fee or program time
activity
date
reg #
Splash Parkapalooza
June 20
331–01
Drink the Wild Air
June 27
331–02
Print Making in the Park
July 11
331–03
Fun in the Sun
July 18
331–04
Soak your friends with cannons, spray spouts, and more at the Ty Warner Splash Park.
Wear your swimsuit. Don’t forget to bring sunscreen and a towel.
Nothing says summer like a walk through Sagawau Environmental Learning Center to learn about Cook
County’s only canyon and the unique plants and rock formations in the area. We’ll enjoy a nice picnic outside
followed by a hike through Waterfall Glen.
$28.00 this week, extended hours ··· 9:15am – 3:15pm. Don’t forget sunscreen and good walking shoes!
It’s time to relax in the sun and carve out your own printing block. We’ll be transferring your images with
printing ink onto fabrics and more!
We’ll hang out in the park today for a morning filled with games and playground fun.
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join WSSRA & OPPORTUNITY KNOCKS
Everyone is welcome to walk! Friends, family, anyone who wants to
walk, wheel, carry banners & pass out candy!
Parents must accompany family members who need supervision.
Saturday
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9:30–11:30AM
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4th of July program # 394-00 · Memorial Day program # 395-00
swim l essons
ALL ABILITIES
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 Stingray Swim Team page! WSSRA swim
lessons use the progressive American Red Cross Learn-To-Swim program. 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.
DUCK POND POOL, CICERO
Monday
3 years & up
4:15 – 4:45pm
June 8 – July 13
351-01
$26.55
RIDGELAND POOL, OAK PARK
Mondays & Wednesdays
3 years & up
7:10 – 7:40pm
June 8 – June 24
351-02
$26.55
Mondays & Wednesdays
3 years & up
7:10 – 7:40pm
June 29 – July 15
351-03
$26.55
ELMWOOD PARK AQUATICS CENTER
Wednesday
3 years & up
5:00 – 5:30pm
June 10 – July 15
351-04
$26.55
Wednesday
3 years & up
5:30 – 6:00pm
June 10 – July 15
351-05
$26.55
Friday
3 years & up
3:45 – 4:15pm
June 12 – July 17
351-06
$24.65
Friday
3 years & up
4:20 – 4:50pm
June 12 – July 17
351-07
$24.65
Friday
3 years & up
4:55 – 5:25pm
June 12 – July 17
351-08
$24.65
Friday
3 years & up
5:30 – 6:00pm
June 12 – July 17
351-09
$24.65
8:15 – 8:45am
June 13 – July 18
351-10
$24.65
PAV YMCA, BERWYN
no program july 3
no program july 3
no program july 3
no program july 3
PARK DISTRICT OF FOREST PARK
Saturday
3 years & up
no program july 4
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teens & young adults
Food Critics
Show Time
MI, DD, AUT, MLH
MI, DD, AUT, MLH
You got beef, dog!? Let’s get our taste buds rolling! Join us as
we go around town tasting the best Italian beefs and hot dogs we
can find! Lively discussion about what we liked best each week
is all part of the fun. Bring $25 to cover your food and share of
the tip. Participants must be able to sit for a meal with minimal
interruptions to others.
Enjoy a night with popcorn and the big screen. WSSRA will notify
participants of the show and program time on Wednesday, the
week of the movie. In order 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.
Ages 15 and older ··· Fridays, 6:30 – 9:15pm
Ages 15 and older ··· Fridays
pick up point trans trans fee: $2.75/week
· WSSRA Office
· Cicero McDonald’s
pick up point trans trans fee: $2.75/week
· WSSRA Office
program fee: $12.25/week
date
June 12
June 26
July 17
reg #
361-01
361-02
361-03
destination
Romano’s
Portillo’s
Johnnie’s Beef Franklin Park
Forest Park
Elmwood Park
DATE
REG #
June 19 360-01
July 10 360-02
WSSRA will notify participants of the
movie & times on the Wednesday
before the show.
Team Up!
AUT, DD
WSSRA is pleased to partner with Community Support Services (CSS) in its offering of the Team Up program. WSSRA provides a 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. Oak Park residents only.
22 and older ··· Wednesdays and Thursdays, 8:30 – 1:30pm
dates: Ongoing now – December 2015
criteria: Participants must meet residency criteria, must be successful socially with a 1:4 staffing ratio, and must be independent in
personal care.
to register or for more information: Contact Francisca Favela at Community Support Services, 708.354.4547
10wssra.net
moonlighters & socialites
interested in joining the saturday night fun?
Check out pages 11 and 12, we have tons of exciting programs for ages 15 and up!
Join a club for some Saturday evening fun! We'll visit some of our favorite local attractions
with friends while focusing on enhancement of social skills. Activities planned are
intended for adults who want to venture out in the name of fun!
Call the office and we'll help you get into the right group ··· 847.455.2100
MI, AUT, DD
Ages 15 and older ··· Saturdays, 6:00-9:00pm ··· Carroll Center, Oak Park
pick-up point: WSSRA Office or Cicero McDonald’s trans fee: $2.75 per week
moonlighters reg #: 375 socialites reg #: 376
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.
activity
date
reg #
fee
Summer Madness!
June 6
375-01
$14.30
Links & Tees Golfing in Addison!
June 20
375-02
$16.35
Plant it for the Planet!
June 27
375-03
$12.25
Take a Hike!
July 11
375-04
$14.30
Karaoke Pool Party!
July 18
375-05
$12.25
Aug 7
375-06
$18.40
Kick off our summer season with a night of dancing, music, fun and friends with the Answer Inc.
Show us your golfing skills at this the out-door miniature golfing facility that Links & Tees has to
offer!
Join the fun as we do a good deed and plant a seed at this informational Gardening 101 activity
Meet at the Oak Park Conservatory
Hike, walk, or jog the beautiful scenery that Naperville Park District has to offer, then hop on a
paddle boat for a relaxing cruise on the river
Join us for a Karaoke practice before the SRA Karaoke Off! Then freshen up with a splash at the
Forest Park pool
Bring a swim suit ··· Meet at Forest Park Main Building
SRA Karaoke-Off
Time to show off your best vocals and sing to your favorite song that you’ve practiced for all
summer at an evening of music and talent performed by other SRA participants! Space is limited!
Friday Night ··· 5:15 – 9:30pm. Meet at Barrie Center. Please note new registration number
376-01
376-02
376-03
376-04
376-05
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hot shots & city slickers
MI, AUT, DD
Ages 15 and older ··· Saturdays, 6:00-9:00pm ··· Park District of Forest Park, Building #4
pick-up point: WSSRA Office or Cicero McDonald’s trans fee: $2.75 per week hot shots reg #: 373 socialites reg #: 374
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.
activity
date
reg #
fee
Summer Madness!
June 6
373-01
$14.30
Colors in Motion!
June 20
373-02
$14.30
Plant it for the Planet!
June 27
373-03
$12.25
Painting in the Park!
July 11
373-04
$16.35
Karaoke Pool Party!
July 18
373-05
$12.25
Aug 7
375-06
$18.40
Kick off our summer season with a night of dancing, music, fun and friends with the Answer Inc.
Leave your brushes at home, we’re shooting colors not just water! So don’t forget to wear your
white Tees--today we are the canvas and the games are endless!
Join the fun as we do a good deed and plant a seed at this informational Gardening 101 activity
Meet at the Oak Park Conservatory
Easels out for this artistically creative evening. Whether you are an undiscovered Picasso or a
beginner, this program will be fun for you, follow the strokes of the instructor as we paint on canvas
Join us for a Karaoke practice before the SRA Karaoke Off! Then freshen up with a splash at the
374-01
374-02
374-03
374-04
374-05
Forest Park pool
Bring a swim suit ··· Meet at Forest Park Main Building
SRA Karaoke-Off
Time to show off your best vocals and sing to your favorite song that you’ve practiced for all
summer at an evening of music and talent performed by other SRA participants! Space is limited!
Friday Night ··· 5:15 – 9:30pm. Meet at Barrie Center. Please note new registration number
12wssra.net
sports, fitness & special olympics
Intro to Golf
Advanced Golf
Flag Football
MLH, MI, AUT, DD
MLH, MI, AUT, DD
MLH, MI, AUT, DD
Woods, Irons, Drivers, 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:
Swing that dust off your clubs with a 200
yard drive during Advanced Golf! This
1-hour lesson provided by a golf pro will
not only allow you be outside, but enjoy
the company of your friends. Do you have
the farthest drive or the closest putt?
Participants must be able to demonstrate
basic golf skills and an understanding of
golf rules & etiquette with minimal staff
support.
Have you always wanted to run a deep post
and catch a touchdown? Take the handoff
and bust off a huge run through the
offensive line? Or sack the quarterback?
Well, now is your chance! WSSRA is starting
a flag football team. We’ll even scrimmage
some of the other SRAs. We'll focus on
the fundamentals of flag football, get some
physical activity, and most importantly,
have fun!
15 and older ··· Thursdays, 6:00 – 7:00pm
15 and older ··· Wednesday, 6:00 – 7:15pm
Oak Park Country Club
Elmwood Park High School
dates: May 7 –June 4
· 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.
12 and older ··· Thursdays, 7:00 –8:00pm
White Pines Golf Course, Bensenville
round trip trans
trans fee: $30.25
registration #: 236
fee: $17.35
no program july 2
round trip trans
trans fee: $30.25
registration #: 333
fee: $15.30
pick up point trans
trans fee: $19.75
· Liberty Center, Berwyn
· Longfellow Center, Oak Park
registration #: 344
fee: $58.60
Healthy Start
Boot Camp
Aqua Exercise
ALL ABILITIES
ALL ABILITIES
Start your week with a healthy dose of
exercise! We’ll emphasize:
Time to get our sweat on! Join our fitness
boot camp for low to high intensity work
outs that focus on developing coordination,
strength, cardio, and flexibility. All levels
are welcome! Workouts will be adapted to
each individual’s ability level.
MLH, MI, AUT, DD
· Stretching
· Flexibility
· Moderate aerobics
· Use of exercise equipment
Exercise routines will be monitored by staff
to meet your individual needs.
21 and older ··· Mondays, 10:00 –11:30am
round trip trans
trans fee: $36.30
registration #: 345
fee: $33.30
15 and older ··· Saturdays, 9:00 –10:00am
Rehm Park, Oak Park
no program july 4
registration #: 343
fee: $11.50
new day and time!
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, and range of motion
15 and older ··· Saturdays, 8:00 – 8:45am
no program july 4
round trip trans
trans fee: $30.25
registration #: 348
fee: $29.45
wssra.net13
Special Olympics
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, Softball, Track & Field, Volleyball, and Gymnastics.
Criteria for Participation
Good Sportsmanship
All Special Olympic athletes must have a current, completed
We all share a responsibility in making the Special Olympics
Application for Participation in Illinois Special Olympics on
training and competition program a positive experience that
file with the Special Olympic coordinator at WSSRA. This form
promotes the growth & development of our athletes. With this
contains 4 sections:
belief, we have identified expectations for our WSSRA Athletes,
· Athlete information
Parents, & Spectators:
· Parent or Guardian Authorization & Medical Authorization
WSSRA’s Expectations of Athletes
· Health Insurance and Emergency Information
· Demonstrate respect for the rules of the sport
· Medical Clearance (MUST be completed by a physician)
· Demonstrate respect for coaches, teammates,
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 22 for the application.
opponents, opposing coaches and officials. Failure to do
so may result in loss of playing time
· Come to practices and games ready to play with
a positive attitude.
Anyone interested in participating, starting a new sport, or
WSSRA’s Expectations of Spectators
volunteering please contact the WSSRA Special
WSSRA spectators are asked to provide positive support during
Olympic Coordinator.
practice and competition. Negative comments are incredibly
detrimental to team morale. Spectators are expected to:
· Show respect & positive support for ALL WSSRA athletes
and our opponents.
· Show respect & positive support for ALL WSSRA coaches,
opposing coaches, officials, and other spectators
· 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.
14wssra.net
Bobcat Volleyball
Zumba®
MI, AUT, DD
ALL ABILITIES
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.
Dance, dance, dance your way to a healthier you! We
promise to keep moving in this Latin and international dance
fitness program.
13 and older ··· Wednesdays, 6:15 – 7:15pm
Liberty Center, Berwyn
round trip trans
trans fee: $36.30
registration #: 326
fee: $38.10
For participants15 and older
Practice Season Info
Weekly Workout
Mondays, 6:30 – 7:30pm, June 15 – July 27
MLH, MI, AUT, DD
Ascension School, Oak Park
Finish your day with a great workout! Improve your physical
condition with exercise stations, weight lifting, and low
impact aerobics.
Game Season Info
Tuesdays, 6:30 – 8:00pm, August 11 – September 29
registration #: 359
season
fee: $117.20includes practice & game
REGISTRATION DEADLINE: FRIDAY, JULY 10
13 and older ··· Tuesdays, 7:00 – 8:15pm
round trip trans
trans fee: $36.30
registration #: 347
fee: $27.75
Stingray Swim Team
Stingray Swim Team is a training and team building program for those who have excelled in WSSRA swim lessons and can now swim
at least one length (25m) of the pool independently. Athletes are pushed and challenged to continually develop their competitive
swimming skills further with our dedicated coaches and staff. Training consists of consecutive lap-swimming throughout the program
along with technique refinement. Stingray members are encouraged to participate in Special Olympic Competition, but not obligated
to do so. Swim team members are not eligible to register for WSSRA swim lessons.
WSSRA round trip trans is available for Forest Park sessions only ··· trans fee: $30.25
Stingray Swimmers may select ONE of the following summer practice sessions:
PAV YMCA, BERWYN
Thursday
6:00 – 6:45pm
June 11 – July 16
341-01
$32.55
Thursday
7:00 – 7:45pm
June 11 – July 16
341-02
$32.55
June 13 –July 18
341-03
$29.45
PARK DISTRICT OF FOREST PARK
Saturday
8:00 – 8:45am
no program july 4
wssra.net15
Bobcat Softball
MI, AUT, DD
Hey Bobcats! Make sure you have your calendars marked with 2 upcoming softball tournaments. Coaches will have more information
as we get closer to tourney time!
ITRS Tournament, Sunday, July 12
···
ISO District Softball Tournament, Sunday, July 26
Saturday Bowling
ISO Bowling Tournament
MI, AUT, DD, MH
If you’re registered for Saturday Bowling League, compete in
ISO annual tournament! See Special Olympics information
on page 14.
Sharpen your bowling skills while spending time with friends. An
adaptive ball and bowling ramp will be available.
see below for iso bowling tournament information!
Ages 13 and older ··· Saturdays, 1:00 – 3:00pm
Circle Lanes, Forest Park
no program july 4
pick up point trans
trans fee: $13.75
· WSSRA Office
registration #: 310
16wssra.net
· Harwood Heights Village Hall
· Elmwood Park Recreation Center
fee: $48.50
Saturday, July 25, 9:00am – 2:00pm
Stardust Bowl, Addison
pick up point trans
trans fee: $2.75
· WSSRA Office
registration #: 342
fee: $20.40
older adults
Towers Social
Wildcard Wednesdays
ADULTS PI, VI, MLH
ADULTS PI, VI, HI, MLH
Join us one Friday a month for socializing, games and trivia.
We’ll enjoy coffee and a light snack while we play cards
“Garbage” style.
Start your day with some card shuffling fun! Light & healthy
refreshments will be served. Sign up for the weeks that fit
your schedule!
Older adults ··· Fridays, 12:30 – 2:30pm
Older Adults ··· Wednesdays, 9:30 – 12:00pm
Franklin Towers, Franklin Park
round trip trans
round trip trans
trans fee: $6.05/week
program fee: FREE
DATE
June 19 July 17
August 21
DATE
June 10
June 17
June 24
REG #
379-01
379-02
379-03
REG #
365-01
365-02
365-03
DATE
July 1
July 8
July 15
REG #
365-04
365-05
365-06
Walk & Dine
Shop & Dine
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 will
be responsible for purchasing their own lunch.
We’ll hit the stores today and stock up on your necessities.
We’ll end each week with lunch at a local restaurant.
Participants must be independent in mobility. Participants
will be responsible for their own purchases and lunch.
Older adults ··· Tuesdays, 9:30am – 12:15pm
Older adults ··· Tuesday, 9:30am-12:15pm
round trip trans
round trip trans
activity
date
reg #
activity
date
reg #
Yorktown Mall
Lunch at The Patio Restaurant
June 9
367-01
Super Target, Hillside
Lunch at Panda Express
June 30
368-01
Harlem Irving Plaza
Lunch at Noodles & Company
June 16 367-02
Lindberg Park
Lunch at Lou Malnati’s
June 23 367-03
Sign up for Shop & Dine today!
June 30
Garfield Park Conservatory
Lunch at Pete’s Red Hots
July 7
367-04
Proksa Park
Lunch at Famous Dave’s
July 14
367-05
wssra.net17
older adults
Yoga for Wellness
Summer in the City
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.
We’ll get out and about, and take in some of the enjoyable sights,
sounds and tastes of our area!
Yoga poses will be taught in a seated position in chairs.
Older adults ··· Tuesdays, 10:00 – 11:15am
reg #
369-01
Session One
June 9 – July 14
fee: $15.75
369-02
Session Two
activity
Village of Harwood Heights
session
round trip trans
August 11 – September 15
fee: $15.75
reg #
Music in the Park
Sunday, June 28 ··· 5:15 – 7:45pm
366-01
Come join us for a concert in the park presented
by Park District of Oak Park, and if we have time get
some ice cream.
Café Con Leche
Wednesday, July 22 ··· 6:30 – 8:30pm
366-02
Come try some amazing Central Latin cuisine that
will make your taste bud explode!
Bring money for your dinner
Just This Once
Older adults ··· Wednesdays, 9:00am – 3:00pm Please see event descriptions for destinations and program fees
round trip trans
activity
fee
date
reg #
Place Your Bets
Come try your luck at Horseshoe Casino, Hammond, IN. We’ll enjoy brunch at the
Village Square Buffet
Must be 21 at attend. Bring a photo ID and $20 for the lunch buffet
$10.20
July 29, 9:00 – 3:00
372-01
Mangia!
Shop and dine at Eataly, one of Chicago’s largest Italian fresh food markets
Bring money for shopping and lunch
$10.20
August 12, 9:30 – 2:00
372-02
Hours Among the Flowers
Enjoy a tram tour of the beautiful Chicago Botanic Garden, Glenoce
Bring $20 for lunch
$15.25
August 26, 9:00 – 3:00
372-03
18wssra.net
hot summer days
ALL ABILITIES
Ages 6 – 22 ··· 9:00am – 3:00pm ··· Please event descriptions for locations and program fees
Round trip trans
fee: $6.05 per event
ACTIVITY
DATE
REG #
FEE
Par-Tee Time!
Tuesday, June 2
315-01
$28.60
Surf’s Up!
Thursday, June 4
315-02
$21.45
A Day at the Farm
Tuesday, July 28
315-03
$21.45
Cruisin’ the Coasters
Thursday, July 30
315-04
$28.60
Surf’s Up!
Tuesday, August 18
315-05
$21.45
Par-Tee Time!
Thursday, August 20
315-06
$28.60
Put your golf skills to the test! We’re heading to Top Golf, Wooddale
Meet at Carroll Center, Oak Park ··· Lunch will be provided
Grab your suit and get ready for some fun, we’re heading the Loyola Beach
for a day in the sun
Meet at Carroll Center, Oak Park ··· Bring a swimsuit, towel, sunscreen and lunch
Enjoy a day of archery, fishing and kayaking at St. James Farm, Warrenville
Meet at Park District of Forest Park, Main Building ··· Bring a lunch
Enjoy rides, animals and entertainment at Santa’s Village Azoosment Park, East Dundee
Meet at Park District of Forest Park, Main Building ··· Bring a lunch
Grab your suit and get ready for some fun, we’re heading the Loyola Beach
for a day in the sun
Meet at Carroll Center, Oak Park ··· Bring a swimsuit, towel, sunscreen and lunch
Put your golf skills to the test! We’re heading to Top Golf, Wooddale
Meet at Carroll Center, Oak Park ··· Lunch will be provided
wssra.net19
overnight trips
Overnight Adventures: Bradford Woods
Bradford Woods is a beautiful learning and outdoor education center located in Martinsville, Indiana. The center is situated on more
than 2,500 acres of pristine forest, which includes a 140-acre lake and over 10 miles of hiking trails. All facilities at Bradford Woods are
fully accessible and air-conditioned. Our activities will include:
· Swimming in the pool and lake
· Hiking the trails
· Archery
· Camp fires
· Canoeing
· Pontoon boat rides
· Fishing
· Use of the Sports Pavilion
Due to the popularity of the Bradford 3 and 5 Day trips, they will be offered as a lottery. All participants interested must register by
June 19. WSSRA will notify you by June 26. Scholarships are not available for this trip.
3 Day Adventure
5 Day Adventure
This camp is designed for our WSSRA participants who:
This camp is designed for our WSSRA participants who are:
SP, MH, AUT
DD, MI, AUT
· Require assistance with personal care and daily living skills
· May require hand-over-hand assistance for participation in
recreation activities
· Require a smaller staff to participant ratio for behavioral and
emotional support
· Toilet trained
· Responsible for independent personal care including feeding,
dressing, and toileting
· Devoid of emotional outbursts that require 1:1 staffing
· Successful socially within 1 staff person per 4 participant ratio
Ages 11 – 22 ··· Monday – Wednesday, August 3 – 5, 2015
Ages 12 and older ··· Monday – Friday, August 3 –7, 2015
Registration #: 340
Registration #: 337
20wssra.net
Fee: $306
Fee: $510
tell us how
we’re doing!
In-Tents Wilderness
LD, ED
WSSRA wants
your feedback!
Let’s get explorin’! Grab your hiking gear and join us as we visit the
beautiful and historic Turkey Run State Park in Marshall Indiana!
We will be experiencing:
· Hiking · Horseback riding
· Fishing
· Tenting
· Swimming
· Canoeing
· Cooking by the campfire
Ages 10 – 15 ··· Tuesday – Thursday, August 11 – 13
Turkey Run State Park, Marshall, Indiana
registration deadline: july 24
registration #: 339
fee: $183.60
Ahoy Blue Harbor
DD, MI, AUT
We want your feedback and
suggestions 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.
Whether you are into extreme adventure or want to chill out by the
pool, the Blue Harbor Resort in Sheboygan, Wisconsin has it all for
you! We’ll experience water park attractions, beach fun, kayaking,
and paddle boating just to name a few of the fun outdoors
experiences.
18 years and older ··· Tuesday – Thursday, August 18 – 20
Trip location: Blue Harbor Resort, Sheboygan, Wisconsin
Registration #: 338
Fee: $382.50
registration deadline: july 24
On Milwaukee!
Adult 2 Day Trip
HI, VI, PI, MLH
Come take a ride with us just north of the Illinois boarder into
this town rich with history and a taste of modern in Milwaukee,
Wisconsin. During the 2 day, 1 night trip we will fill ourselves up
in local restaurants, enjoy the city during a day of shopping, test
our luck with a casino, and enjoy a musical and/or guided tour of
the city. Participants plan to bring spending money for meals and
souvenirs.
Just visit wssra.net
and click on “tell us
what you think!”
Thanks for your
Older Adults ··· Wednesday – Thursday, September 2 – 3
Registration #: 480
Fee: $170
assistance!
wssra.net21
west suburban special recreation association
SUMMER 2015 REGISTRATION FORM
mail to: wssra, 2915 maple street, franklin park, il 60131 ··· fax to: 847.455.2157 ··· signed registration must be received by may 29, 2015
participant’s name:_ ______________________________________________________________________________birth date:_______________________
address:_________________________________________________________________ city/state: _ _____________ zip:_____________________________
home phone:____________________________________ park district/village:_ ____________________________________________________________
parent or guardian name:_________________________________________________________________________________________________________
email address:
parent/guardian work phone:_____________________________________________ parent/guardian cell phone:______________________________
who should be contacted if parent/guardian is unavailable? name:___________________________________phone:__________________________
present school/workshop/other:_ ________________________________________ teacher/supervisor name:_________________________________
participant disability:_____________________________________________________________________________________________________________
does participant use wheelchair/walker? specify:____________________________ ______________________ can participant transfer? *yes *no
is participant subject to seizures? *yes *no
is medication taken at program? *yes *no
if yes, please complete and return seizure information form
list any medication:______________________________________________________________________
list any allergies:_ _______________________________________________________________________________________________________________
does participant have a communicable disease? *yes *no
program #
if yes, please explain:______________________________________________________
program name
day
fee
trans
program & trans
fee subtotal
total due:
FEE PAYMENT OPTION ··· PLEASE CHECK ONE ··· PAYMENT IS EXPECTED AT REGISTRATION UNLESS OTHER ARRANGEMENTS ARE MADE
* total payment enclosed
* credit card
* visa
* total payment to follow (if faxed)
* request scholarship * payment plan arranged with bob foster
* master card
card number:
expiration date: _____ / _____
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
HOLD HARMLESS
RELEASE ON
REVERSE SIDE
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.
 yes  no
to disclose information to wssra member partners*
WSSRA may disclose to my home park district or municipality information about the participant’s and my involvement in WSSRA programs or
activities, including our names, telephone number, address, program registrations, and the participant’s age and disability, provided that my
home park district or municipality shall not redisclose that information without my express written consent.
 yes  no
to release information for publicity purposes*
I authorize the use of photographs or descriptions of the participant or of me in publicity materials about WSSRA programs and services,
which may appear in newspapers, member partner brochures, video presentations, web sites and other similar mediums or displays.
 yes  no
*I understand that I can change my decisions regarding the statements above at any time for any reason by delivering a written notice to WSSRA, prohibiting
further disclosure information.
we welcome your input!
We invite you to share with us your program ideas and comments about our services:
_______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
you can also email us your input at [email protected] | support wssra by following us on
24wssra.net
/wssra
@wssra
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
participant name:_________________________________________________________________________________________________________________
person completing form:_ ________________________________________________________________________________________________________
parent/guardian:_________________________________________________________________________________________________________________
parent/guardian home phone:___________________________________ work:_ ___________________________cell:____________________________
emergency contact:______________________________________________________________________________________________________________
emergency contact home phone:________________________________ work:_ ___________________________cell:____________________________
emergency contact relationship:__________________________________________________________________________________________________
email address:
what is the best way to communicate with you about the participant's seizure?:_ _______________________________________________________
________________________________________________________________________________________________________________________________
current seizure related medication:
medication name
dosage
time of intake
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?_______________________________________________________________________________________________
3. Describe what a typical seizure looks like (be specific) :_____________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
wssra.net25
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: _________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
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: _________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
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. ____________________________________________________________________________________________________________________________
9. Please describe what constitutes an emergency for you/ the participant:_ ____________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
10. Do you/the participant have a VNS (vagal nerve stimulator)?  yes  no If yes, contact WSSRA at 847.455.2100 to discuss further.
11. Is there any other information that WSSRA should know?___________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
26wssra.net
wssra registration & policies
REGISTRATION
REFUNDS
In order to participate in Winter and Spring programs, your
completed AND signed registration form must be received in
the WSSRA office by Friday, May 29. WSSRA registration is taken
on a first-come, first-served basis.
Refunds will only be issued when the registrant cannot
participate for extended medical reasons and/or hospitalization
verified by a physician.
DROP OFF AT THE
WSSRA OFFICE OR MAIL TO
WSSRA
2915 Maple St.
Franklin Park, IL 60131
FAX TO
847.455.2157
SCAN & EMAIL TO
[email protected]
PHONE TO:
847.455.2100
REGISTRATION OPTIONS
A phone-in registration will only hold a spot in program. A
completed AND signed registration form is still required in order
to start participation. The form can be returned to the WSSRA
office using the mail, drop-off, fax, or email options above. The
registration form MUST be received by Friday, May 29. If your
signed form is not received by this date, you will lose your spot
in any of your selected programs that have a wait list.
CLOSED PROGRAMS/WAIT LISTS
If a program closes because we have reached its maximum
enrolment, your participant will be placed on a Wait List once we
receive your completed and signed registration form. Wait Lists
are reviewed on a weekly basis. You will be notified if additional
space in the program becomes available.
WSSRA OUTREACH
If you are new to WSSRA and need assistance selecting
programs or completing your registration form, please contact
an Outreach Specialist at the WSSRA office.
PAYMENT
Payment of program fees is due upon registration unless other
arrangements have been made. Billing statements are mailed
out once a month. Call the Finance Manager to arrange for a
payment plan, Monday – Thursday, 8:30am-noon. 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.
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.
CANCELLED PROGRAMS
· If there is low enrolment, a program may be cancelled.
·.A program refund or credit will be issued.
· .If a program is cancelled due to unforeseen circumstances
. you will be contacted at the soonest possible time.
· .A program credit will not be issued for weather-related
cancellations. Programs will be made up at the end of a
season whenever possible.
· .No program credits will be issued for sports tournament
cancellations.
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
Please make sure that you are on time picking up your
participant from program, as well as, home to greet your
participant when the WSSRA vehicle drops them off after
program.
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, after a 10 minute grace period. A notice will be sent to
you indicating the fee being charged to your account.
wssra.net27
registration & policies
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 May 29 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.
28wssra.net
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
31 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.
September 12, 2015
Concordia University Chicago
8:00am
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 go to benefit WSSRa
REGISTRATION IS OPEN!
Go to www.signmeup.com/106242 to learn more
2915 Maple Street, Franklin Park, IL 60131
P 847.455.2100 | F 847.455.2157
www.wssra.net
15
0
2
,
0
3
y
l
u
J
splish splash
summer bash
featuring the
wacky quacky
duck splash
5/person pool party entry fee all wacky quacky ducks $2 each
$
forest park aquatics center, 7501 harrison street

summer 2015 - West Suburban Special Recreation Association

Transcription

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