SRSNLC Fall 2013 Brochure (web).indd

Transcription

SRSNLC Fall 2013 Brochure (web).indd
Special Recreation Services of
Northern Lake County
e
d
i
u
G
m
a
r
g
o
r
P
l
l
a
2013 F
Providing Recreation Programs
and Services for Individuals with
Special Needs for the Residents of
Lindenhurst, Round Lake,
Waukegan, & Zion Park Districts
SRSNLC Information
2
Meet
the Staff
Mission Statement
Lindenhurst
L
PARK DISTRICT
Community Center
2200 E. Grass Lake Rd. • Lindenhurst, IL 60046
847-356-6011 phone • 847-356-6063 fax
Table of Contents
Julie Rushmeyer, CPRP – Program Manager • Ext. 108
[email protected]
Round Lake Area
PARK DISTRICT
Robert W. Rolek Community Center
814 Hart Road • Round Lake, IL 60073
847-546-8558 phone • 847-740-8180 fax
RL
Jessica Jeffery-Findley – Program Manager • 847-740-9828
[email protected]
Lisa Deligio, CTRS – Program Supervisor • 847-740-9828
[email protected]
Waukegan
PARK DISTRICT
Upton Park/Douglas House
2000 Belvidere Street • Waukegan, IL 60085
847-360-4760 phone • 847-662-2577 fax
W
Julie Schneider, CTRS, CPRP, CPP, SRSNLC Safety Coordinator –
Manager • 847-360-4762
[email protected]
Kari Robinson, CTRS, CPRP, CPP – Rec. Supervisor • 847-360-4763
[email protected]
Maria Owens – Rec. Specialist • 847-360-4764
[email protected]
Marilyn Kern – Registration • 847-360-4700
Zion
PARK DISTRICT
Leisure Center
2400 Dowie Memorial Dr. • Zion, IL 60099
847-746-5500 phone • 847-746-5506 fax
It is the MISSION of SRSNLC
to educate our citizens to become responsible,
productive, healthy, and contributing members
of our society by preparing them through recreation
with a dynamic and caring environment,
which excites them and invites them to participate.
Z
*After hours 1-847-746-5500 ext. 446
Teresa Hayhurst – Program Director
[email protected]
PROGRAM GUIDE KEY
BUS – Door to Door
Programs with this symbol offer door to door
transporation with additional fee.
HOUSE – Transportation Home Only
Programs with this symbol offer transportation home
only.
Dollar Sign – Bring Spending Money
Programs with this symbol require additional money
be brought for the purchase of a meal or souvenirs.
SRSNLC Information.......................................................... 2
SRSNLC Policies................................................................. 3
SRSNLC General Information.............................................. 4
Special Events..................................................................... 5
Lindenhurst - Seasonal Programs.................................... 6-8
Lindenhurst - Athletes & Fans............................................. 9
Lindenhurst - Youth & Teen............................................. 10
Round Lake - Sports & Fitness........................................... 11
Round Lake - On The Town............................................... 12
Round Lake - Youth & Teen............................................... 13
Round Lake - Kids on the Go............................................ 14
Waukegan - Art & Crafts and Sports & Fitness.................. 15
Waukegan - Monthly Socials & Outings............................ 16
Waukegan - Just for Kids & Teens...................................... 17
Waukegan - Family Programs............................................ 18
Waukegan - Inclusive Opportunities.................................... 19
Zion - Sports & Fitness & In House Fitness..................... 20
Zion - Out-N-About.......................................................... 21
Zion - Take The Day Off & Kid Fun................................... 22
SRSNLC Code of Conduct & Behavior Expectations.......... 23
SRSNLC Athlete - Sportsmanship Contract....................... 24
Application for Participation in Special Olympics....... 25 &26
SRSNLC - 2013 Registration Form.................................... 27
SRSNLC Seizure Questionnaire........................................... 28
SRSNLC Annual Information Form............................. 29 & 30
Facility Directory............................................................... 31
Contact Us:
Please be aware that you can use the Illinois Relay Center to contact us
during our office hours. To use the service, call 1-800-526-0844 (TDD
ONLY) or 1-800-526-0857 (Voice). If, due to a visual impairment you
need our brochure or other documents in an alternate format, please
contact our office.
Full Access For All - ADA
The Special Recreation Services of Lindenhurst, Round Lake,
Waukegan, and Zion advocates for full participation under the
Americans with Disabilities Act (ADA) which prohibits discrimination
in the provision of programs, services or activities to individuals with
disabilities. Every attempt at reasonable accommodation will be made
so that individuals may participate in a desired program.
SRSNLC and your local park districts are committed to meeting
your unique, individual leisure needs. Please call us if we can assist
you at any time.
LINDENHURST • ROUND LAKE • WAUKEGAN • ZION
SRSNLC Policies
3
Program Cancellations
Transportation
SRSNLC attempts to hold programs whenever possible.
However, inclement weather occasionally makes it difficult for
staff and participants to travel to program locations. SRSNLC
cancellation policies are as follows:
SRSNLC has implemented these transportation procedures to
ensure participants ride safely in our vehicles:
1. Staff look at all circumstances one hour prior to the
starting time of the program or transportation route to
determine if it should be cancelled.
2. If the program is cancelled, program staff attempt to reach
all participants by phone to inform them of the cancellation.
You will only be called if the program is cancelled.
3. SRSNLC attempts to extend programs to make up any
missed dates.
4. SRSNLC sends out a letter informing all participants whether
the program has been extended.
5. Registration deadlines must be adhered to. If there are not
the required minimum participants by the date listed, the
program must be cancelled due to reservation requirements.
Full refunds will be given.
Cancellation by Registrants
A 20% cancellation charge and/or programming expenses
will be assessed for all refund requests made before the first
meeting date of the program. No refund is given once the first
class has met unless a doctor’s request is presented to SRSNLC,
which will then allow a prorated refund.
SRSNLC Resident & Non-Resident Policy
RESIDENT
1. Includes those residing in Lindenhurst, Round Lake,
Waukegan, and Zion Park Districts.
2. Registrants from any of the above listed Park Districts
qualify for a resident rate and are welcome to register
through their home district.
Residents of SRSNLC include those in the Round Lake,
Lindenhurst, Waukegan, and Zion Park Districts. NonResidents residing in communities having active park districts
or recreation departments will pay an additional 50% fee for
all programs. Call the local SRSNLC office to see if this affects you.
LATE PICK UP FEE:
Participants are to be picked up promptly at the
end of a program. A $1.00 per minute late fee will
be assessed for late pick-ups. Late fees are due prior
to attending the next program. Please refer to your
day camp manual for camp specific late fee policies.
1. All passengers must be sitting in seats or wheelchairs with
belts securely fastened. The driver will not proceed until
all seat belts are fastened.
2. All wheelchairs must have brakes that are in good working
order and can stop the chair from moving.
3. Drivers will assist participants to and from their homes,
but driveways and walks must be clear of debris and
obstacles.
4. Staff are responsible for determining whether or not a
participant can be transported safely. If it is determined
that it would be dangerous to transport a participant,
the driver may refuse to transport that participant.
5. Participants riding in Amigo-type wheelchairs must transfer
into a van seat and must use a seat belt.
6. Participants unable to be in a house alone should have
someone meet the vehicle at the designated time of return.
SRSNLC cannot wait more than 10 minutes due to the
demanding transportation schedule.
7. SRSNLC reserves the right to refuse to transport participants.
Please realize that these policies have been developed to
ensure the safety of everyone riding SRSNLC vehicles.
Your cooperation is greatly appreciated.
8. SRSNLC transports in-district participants only.
9. Late registrants may not have transportation during the first
week of programs due to routing changes. Participants
are notified if a problem occurs.
10. Departure times are set and abided by. If changes occur,
participants are notified by phone. Return times may vary
because of traffic and/or weather conditions. However, all
is done to return on time.
Overnight Trip Policies
All participants must submit a complete Overnight Trip
Form, Medication Dispensing Release Form, a copy of a valid
government issued identification card, and a copy of his/her
current medical insurance card one week prior to departure
date. Overnight trip registrations require preapproval
by the SRSNLC Program Manager.
Refund Policy:
No refunds are given unless . . .
1. The trip is cancelled by the park district.
2. The person desiring a refund finds a replacement.
3. The district has a waiting list for the trip.
LINDENHURST • ROUND LAKE • WAUKEGAN • ZION
4
SRSNLC General Information
Wellness Guidelines
Participation Guidelines When Illness Occurs
In consideration of the other participants and staff, to prevent
the spread of contagious illnesses, participants must refrain
from attending programs when any of the following conditions exist:
1. Fever of 100 degrees or higher.
2. Vomiting within the last 24 hours.
3. Persistent diarrhea in conjunction with other symptoms.
4. Contagious rash or a rash of unknown origin.
5. Persistent cough and/or cold symptoms.
6. “Pink Eye” (conjunctivitis) or discharge from the eye.
7. Symptoms of mumps, measles, chicken pox, strep throat,
flu, impetigo, Coxsackie virus, head lice, mites, and ringworm.
8. Runny nose with yellow or green discharge WHICH
INDICATES INFECTION.
9. Fatigue, due to illness, that will hinder participation and
enjoyment in the program.
Please notify the SRSNLC office if the participant contracts any
contagious illness that will affect his/her attendance at the
program. Participants should return to programs at the doctor’s recommendation, or, if not under a doctor’s care, when
the symptoms have clearly passed.
Spanish Interpreters Available
If you need to contact us about program information,
Spanish interpreters are available at our Waukegan office
(847) 360-4700 and our Round Lake office (847) 546-8558.
LINDENHURST
PARK DISTRICT:
Monday - Friday
9:00 am - 5:00 pm
ROUND LAKE
PARK DISTRICT:
Mon.-Fri. – 8:30 am - 7:30 pm
Saturday – 9:00 am - 12:00 noon
Mon.-Fri. – 9:00 am - 9:00 pm
BELVIDERE
RECREATION CENTER Saturday – 9:00 am - 2:00 pm
WAUKEGAN:
ZION
LEISURE CENTER:
Mon.-Fri. – 9:00 am - 6:00 pm
Saturday – 8:00 am - 2:00 pm
Please detach the Registration Form and complete in detail.
The full registration fee is due before the registration deadline.
Call your local office for alternate payment plans. Register in
person or mail the registration with check or money order
payable to your local Park District. Complete the attached
Annual Information Form in the winter season only unless this
is a new registration or information has changed.
Medication Distribution
Parents and guardians are asked to dispense medication on their
own, outside of program hours, if at all possible. If a medication
needs to be administered by district staff, a Permission to Dispense
Medication form must be completed. In all cases, medication
dispensing can only be administered, changed, or modified by
completing a Permission to Dispense Medication form.
All athletes MUST sign
Sportsmanship Contract
Si necesita ponerse en contacto con nosotros para pedir
informaticiõn sobre nuestros programas en español,
tenemos traductores disponibles en la oficina de
Waukegan al (847) 360-4700 la oficina de Round Lake al
(847) 546-8558.
LINDENHURST • ROUND LAKE • WAUKEGAN • ZION
SPECIAL EVENTS
Homecoming Dance
Turkey Twist
Come dressed to impress in your favorite high school attire and
possibly get crowned Homecoming King or Queen at the 2013
Homecoming Dance! Pizza, drinks and dessert will be served.
Twist and shout… It’s Turkey
Twist time for SRSNLC. Celebrate the season in style by
joining your friends for an
evening of dancing, snacks,
raffles, and fun at the
Lindenhurst Park District. It
will be a night to remember;
don’t miss out—register early.
Note: Gym shoes required.
Location: Community Center, Lindenhurst Park District
Event Time: 6:30pm-8:30pm
Age: 13 & Older
Min/Max: 50/150
Fee: $15R / $23NR
Reg. Deadline: October 25, 2013
AGENCY CODE
DAY DATE
TRANS. TIME
L
393401-E
F
11/8
NONE
RL
16797
F
11/8
6:00pm-9:00pm
W
6820
F
11/8
5:45pm-10:00pm
Z
371661-1
F
11/8
5:45pm-9:30pm
Annual SRSNLC
Resource Fair
Looking for answers to questions regarding services for
those with a special need or disability? Come gather information or speak to individuals regarding the following:
-Accessible Transportation
-Day Program Options/Workshops
-Financial Planning/Trust Funds/Beneficiaries
-Guardianship/Legal Matters
-Residential Care
-Recreation Opportunities
-Early Childhood/Specialized Programs
-Schools & Support Groups
Location: Belvidere Recreation Center,
Waukegan Park District
Age: All
Fee: FREE
CODE
DAY DATE TRANSPORT TIME
FREE
W
9/25
5:00pm-7:00pm
AGENCY CODE
L
393401-F
5
Location: Sports Center, Round Lake Area Park District
Event Time: 7:00pm-9:00pm
Age: 13 & Older
Min/Max: 25/125
Fee: $15R / $23NR
Reg. Deadline: September 6, 2013
DAY
DATE
TRANS. TIME
AGENCY CODE
L
393401-B
F
9/20
6:30pm-9:30pm
RL
16801
F
9/20
NONE
W
6817
F
9/20
6:15pm-10:30pm
Z
370891-1
F
9/20
6:00pm-10:30pm
Halloween Bash
Have you heard the rumors about the barn at Renwood Golf
Course? I heard that on cold nights in October you can hear
ghosts and goblins speaking of the scary good
time you will have at the 2013 Halloween Barn
Bash!!! Come and be petrified about the amount
of food you will eat, scare the pants off of other
zombies and vampires with your bloodcurdling
dance moves and do not forget to scream as loud
as you can on our bone chilling haunted hayride!!!!
Location: Renwood Golf Course,
Round Lake Area Park District
Event Time: 7:00pm-9:00pm
Age: 13 & Older
Min/Max: 25/125
Fee: $15R / $23NR
Reg. Deadline: October 4, 2013
AGENCY CODE
L
393401-C
RL
16798
W
6818
Z
371441-1
DAY
F
F
F
F
DATE
10/11
10/11
10/11
10/11
TRANS. TIME
6:30pm-9:30pm
NONE
6:15pm-10:30pm
6:00pm-10:30pm
Holiday Party
T the season to be jolly! Come celebrate the holidays with your
Tis’
pals from SRSNLC! Each participant will receive a gift and visit from
ssomeone special! The night will include dancing and yummy snacks
fit for the Big Guy himself!
Location: Shepherd’s Crook Golf Course, Zion Park District
Event Time: 6:30pm-8:30pm
Age: 8 & Older
Min/Max: 30/130
Fee: $10R / $15NR
Reg. Deadline: November 1, 2013
DAY
DATE
TRANS. TIME
AGENCY CODE DAY
DATE
Th
12/12
5:45pm-9:15pm
W
6821
Th
12/12
Z
370231-1 Th
12/12
TRANS. TIME
5:45pm-9:45pm
NONE
LINDENHURST • ROUND LAKE • WAUKEGAN • ZION
6
LINDENHURST Seasonal Programs
All Aboard
Volo Bog Tour & Lunch
Dave & Buster’s
Head to Roma’s II
Pizza and Pasta in
Waterford, Wisconsin
for a fabulous pizza
lunch before taking a
ride back in time on
the East Troy Electric
Railroad. Take in the
gorgeous Wisconsin landscape on the one
hour relaxing round trip ride with a short
excursion at The Elegant Farmer Depot.
Let’s take an adventure to the Volo Bog State
Natural Area in Ingleside to explore the only
“quaking” bog in Illinois with an open water
center. After our journey, we will go to
Tammy’s in Spring Grove for lunch.
Note: Participants should wear
sturdy walking shoes.
Enjoy lunch and an afternoon playing games
at Dave and Buster’s in Wauwatosa, Wisconsin.
Lunch and a $20 Power Card is included—
participants may bring extra money to reload
their Power Cards.
Location: East Troy, Wisconsin
Age: 13 & Older
Min/Max: 4/12
Fee: $30R / $45NR
Reg. Deadline: September 3, 2013
CODE
DAY
DATE
TRANS. TIME
393403-D
Sa
9/14
9:45am-4:45pm
Location: Ingleside, Illinois
Age: 13 & Older
Min/Max: 4/12
Fee: $25R / $38NR
Reg. Deadline: September 24, 2013
CODE
DAY
DATE
TRANS. TIME
393403-A
Tu
10/8
9:00am-3:00pm
Discovery World
Museum
Jerry Smith’s Pumpkin Farm
If you love autumn, you will absolutely LOVE Jerry Smith’s
Pumpkin Farm. Enjoy a wide display of decorated pumpkins
and scenery, kick back on a hayride, and select your own
pumpkin to bring home for carving. Pack a sack lunch and
beverage.
Location: Kenosha, Wisconsin
Age: 18 & Older
Min/Max: 4/12
Fee: $18R / $27NR
Reg. Deadline: October 4, 2013
CODE
DAY
DATE
TRANS. TIME
393403-E
Sa
10/19
10:15am-1:30pm
Oktoberfest B-I-N-G-O
and Luncheon
Celebrate German heritage with SRSNLC’s
Oktoberfest B-I-N-G-O and Luncheon. Play
some Oktoberfest B-I-N-G-O for a chance to
win cool prizes. Dine on traditional German
dishes including brats, sauerkraut, boiled red
potatoes, brat rolls, apple pie and more. This
catered lunch will be fabulous.
Location: Community Center
Age: 13 & Older
Min/Max: 4/12
Fee: $18R / $27NR
Reg. Deadline: September 20, 2013
CODE
DAY
DATE
TIME
393412-D Sa
10/12
11:00am-1:00pm
Location: Wauwatosa, Wisconsin
Age: 18 & Older
Min/Max: 4/12
Fee: $42R / $63NR
Reg. Deadline: October 9, 2013
CODE
DAY DATE
TRANS. TIME
393403-J
W
10/23
10:00am-4:00pm
Richardson’s Farm
Can you find your way through the Richardson’s
Farm corn maze? Give it your best try on this
fun-filled Saturday exploring Richardson’s
Farm! Program price includes admission to
the maze, observation tower, pedal bikes,
pedal trikes, 50’ tube slide, and much more.
Remember to bring extra money for an early
dinner at a new restaurant in Spring Grove
called the Dill Pickle Grill. Note: Participants
must be comfortable walking and standing
for long periods of time.
Location: Richardson’s Farm, Spring Grove
Age: 13 & Older
Min/Max: 4/12
Fee: $25R / $38NR
Reg. Deadline: September 27, 2013
CODE
DAY
DATE
TRANS. TIME
393403-B
Sa
10/5
10:00am-4:00pm
Discovery World connects innovation, science,
technology and the environment with
exploration and learning through interactive
exhibits and experiential learning programs.
Discover all this museum has to offer and then
enjoy a fancy lunch.
Location: Milwaukee, Wisconsin
Age: 13 & Older
Min/Max: 4/12
Fee: $50R / $75NR
Reg. Deadline: November 1, 2013
CODE
DAY
DATE
TRANS. TIME
393403-G
F
11/22
8:30am-4:00pm
Saturday Nights @
the Teen Center
Looking for something to do on Saturday
night? Kick back and relax at the Teen Center.
Participants will choose between watching a
movie, playing games, or viewing the latest
sports event. This program is offered in
collaboration with the Round Lake Area Park
District. Note: Transportation to the Teen
Center is not provided.
Location: Teen Center, Round Lake
Age: 13 & Older
Min/Max: 4/12
Fee: $8R / $12NR
Reg. Deadline: Two weeks prior
CODE
DAY
DATE
TIME
393414-A Sa
9/28
6:00pm-8:00pm
393414-B
Sa
11/23
6:00pm-8:00pm
ROUND LAKE
• 847-546-8558
• www.rlapd.org
LINDENHURST
• 847-356-6011
• www.lindenhurstparks.org
LINDENHURST Seasonal Programs
SRACLC Winter Wonderland
Winter is upon us and there is no better way to stay warm than to dance the
night away at SRACLC’s Winter Wonderland Dance at the Sullivan Center in
Vernon Hills.
Location: Vernon Hills, Illinois
Event Time: 7:00pm-9:00pm
Age: 13 & Older
Min/Max: 4/12
Fee: $18R / $27NR
Reg. Deadline: November 16, 2013
CODE
DAY
393408-B
F
DATE
1/10
Zion Social Club
Dances
For those who love music, dancing, and
socializing, SRSNLC—Zion hosts regular theme
dances. Fee includes door prize, refreshments,
and a whole lot of dancing.
September—Fall Fling
October—Monster Mash
November—Gobble & Shout
December—Jingle Bell Rock
Location: Leisure Center, Zion
Event Time: 6:30pm-8:30pm
Age: 13 & Older
Min/Max: 4/12
Fee: $12R ($18 door-to-door) / $18NR
Reg. Deadline: One week prior
CODE
DAY
DATE
TRANS. TIME
393404-A
F
9/6
6:00pm-9:00pm
393404-B
F
10/4
6:00pm-9:00pm
393404-C
F
11/1
6:00pm-9:00pm
393404-D
F
12/6
6:00pm-9:00pm
TRANS. TIME
6:15pm-9:45pm
7
Holiday Dinner
Celebrate the holiday season with your friends
from SRSNLC-Zion over a delicious catered
lasagna dinner. This festive dinner is sure to
put you in the holiday spirit.
Location: Leisure Center, Zion
Age: 10 & Older
Min/Max: 4/12
Fee: $12R / $18NR
Reg. Deadline: November 29, 2013
CODE
DAY
DATE
TRANS. TIME
393412-F
W
12/18
4:30pm-6:30pm
Dinner Group
Helping Hearts
Socialize with friends over dinner while
practicing important skills such as ordering,
meal etiquette, and determining gratuity.
All expenses included.
Note: Return transportation time is
approximate. Phone calls will be made
if the time will vary by more than 15
minutes.
Helping Hearts
is a participant-led
service organization. Participants
take an active
role in choosing,
planning, and
implementing service projects that benefit
Lindenhurst and surrounding communities
under the guidance of staff and volunteers.
September—Lake House, Lake Villa
October—Charcoal Grill, Kenosha
November—Stone Creek Grill,
Winthrop Harbor
Location: Varies–Meet at the Lindenhurst
Park District
Age: 16 & Older
Min/Max: 4/12
Fee: $25R ($32 door-to-door) / $38NR
Reg. Deadline: Two weeks prior
CODE
DAY
DATE
TRANS. TIME
393412-A
W
9/18
5:30pm-7:30pm
393412-B Tu
10/15
4:45pm-8:30pm
393412-C M
11/11
4:45pm-8:15pm
Location: Community Center
Age: 13 & Older
Min/Max: 4/12
Fee: $15R / $23NR
Reg. Deadline: October 1, 2013
CODE
DAY
DATE
TIME
393410-A Tu 10/15-10/29 10:00am-11:30am
Monday Movie Club
See it on the big screen. Monday Movie Club
participants enjoy a movie at Marcus Gurnee
Cinema once a month. Price includes movie
ticket. Times and theatre subject to change
based on movie selection.
Location: Gurnee Cinema, Gurnee
Age: 13 & Older
Min/Max: 4/12
Fee: $18R / $27NR
Reg. Deadline: One week prior
CODE
DAY
DATE
TRANS. TIME
393405-A
M
9/16
6:15pm-9:15pm
393405-B
M
10/21
6:15pm-9:15pm
393405-C M
11/18
6:15pm-9:15pm
393405-D M
12/16
6:15pm-9:15pm
ROUND LAKE
• 847-546-8558
• www.rlapd.org
LINDENHURST
• 847-356-6011
• www.lindenhurstparks.org
LINDENHURST Seasonal Programs
Pizza and a Movie
Denny’s
and a Matinee
Friends from SRSNLC Lindenhurst and Zion
meet once a month for brunch at Denny’s
followed by a movie at Gurnee Cinema.
Brunch and movie ticket included.
Location: Gurnee, Illinois
Age: 16 & Older
Min/Max: 2/10
Fee: $28R ($34 door-to-door) / $42NR
Reg. Deadline: One week prior
CODE
DAY
DATE
TRANS. TIME
393406-A
F
9/13
10:00am-3:00pm
393406-B
F
10/18
10:00am-3:00pm
393406-C
F
11/15
10:00am-3:00pm
393406-D
F
12/13
10:00am-3:00pm
It is Friday night and that can only mean
one thing… Pizza and a Movie. Join your
friends for delicious pizza and the latest DVD.
Register for one or all—new movies each date.
This program is offered in collaboration with
the Round Lake Area Park District. Note:
Transportation to the Teen Center is
not provided.
Location: Teen Center, Round Lake
Age: 13 & Older
Min/Max: 4/16
Fee: $12R / $18NR
Reg. Deadline: Two weeks prior
CODE
DAY
DATE
TIME
393402-A
F
10/25
6:00pm-8:00pm
393402-B
F
12/20
6:00pm-8:00pm
Crafty Creations
Crafty Creations is ideal for those who love art
and creativity. Each participant will create a
custom project perfect for display. Each craft
is selected to promote creativity and develop
fine motor skills.
Location: Community Center
Age: 13 & Older
Min/Max: 3/8
Fee: $15R / $23NR
Reg. Deadline: Two weeks prior
CODE
DAY
DATE
TIME
393409-B Tu
10/1
9:00am-10:30am
393409-C Tu
11/19
9:00am-10:30am
Ceramics I
Basic ceramic skills are taught in this introductory clay class including the score and slip
technique and hand building using coils, slabs, and the pinch method. Participants
will create a unique clay piece at the first class and complete the piece with paint and
embellishments at the second class. Note: This class uses air dry and oven fired
clay; no kiln will be used.
Location: Community Center
Age: 13 & Older
Min/Max: 3/8
Fee: $15R / $23NR
Reg. Deadline: November 19, 2013
CODE
DAY
DATE
TIME
393409-A Tu 12/3-12/10 9:15am-10:15am
Register online . . .
it’s fast, easy
and convenient!
For online registration,
please visit the
Lindenhurst Park District website
at www.lindenhurstparks.org
or contact Julie Rushmeyer at
847.356.6011 ext. 108
for more information.
Fancy Night Out
Enjoy a juicy steak at Steven’s in Gurnee.
This is an elegant dining experience, please
dress accordingly. This program is offered
in collaboration with SRSNLC—Zion.
Note: Return transportation time is
approximate. Phone calls will be made
if the time will vary by more than 15
minutes.
Location: Gurnee, Illinois
Age: 13 & Older
Min/Max: 4/12
Fee: $40R / $60NR
Reg. Deadline: November 18, 2013
CODE
DAY
DATE
TRANS. TIME
393412-E
M
12/9
5:00pm-7:30pm
Ceramics II
Do you love painting ceramics? Skip the clay
building and simply select a clay piece to paint.
Each piece will be fired off site and available for
pick-up at a later date. Program fee includes
one professional ceramics piece, paint, and
professional firing. Note: Please bring a
sack lunch for the day.
Location: Teen Center, Round Lake
Age: 8 & Older
Min/Max: 3/8
Fee: $25R / $38NR
Reg. Deadline: October 23, 2013
CODE
DAY
DATE
TRANS. TIME
393409-D Sa
11/9
11:00am-2:00pm
LINDENHURST • 847-356-6011 • www.lindenhurstparks.org
LINDENHURST Athletes & Fans
Northstars Basketball
The Water Works
Recreational Bowling
Learn new or improve your existing basketball
skills, compete against other SRAs, and
participate in both the Special Olympics
District Tournament on January 26 and
the ITRS/PSC Tournament on February 16.
Tournament participation is subject to team’s
eligibility and season record. Program fee
includes transportation to practices/games
from the Community Center. Note: A
current medical application for Special
Olympics must be on file at time of
registration.
Enjoy a leisurely day of swimming at The Water
Works. Take a dip in the zero-depth and lap
pools, brave one of three water slides, plunge
into the diving pool, or simply take a spin
through the rapid channel…at The Water
Works in Schaumburg it can be summer every
day. Please bring a swimsuit, towel, and warm
clothes for the ride home. Lunch is provided.
Spare us the thought
of having to bowl
without you. This
non-competitive
bowling league is
perfect for seasoned
and new bowlers
to improve their
skills. Two games
of bowling and shoe
rental is included.
Note: No bowling
on October 31st
or November 28th.
h
Location: Leisure Center, Zion
Age: 13 & Older
Min/Max: 6/12
Fee: $90R / $135NR
Reg. Deadline: September 20, 2013
CODE
DAY
DATE
TRANS. TIME
393411-C Tu
11/5-3/16 5:30pm-7:30pm
*Practice/Games schedules will be distrubuted at
the first practice. Season length may vary.
Note: No basketball on 12/24 & 12/31.
Walk, Run, & Roll
Walk, run, and roll your way into shape.
Increase your stamina in this three-week
program designed to get you active and
increase your heart rate. Please bring a water
bottle and wear athletic shoes to each class.
Location: Community Center
Age: 13 & Older
Min/Max: 4/12
Fee: $10R / $15NR
Reg. Deadline: September 20, 2013
CODE
DAY
DATE
TIME
393411-A Sa 10/5-10/19 9:00am-10:00am
Location: Water Works, Schaumburg
Age: 18 & Older
Min/Max: 4/12
Fee: $36R / $54NR
Reg. Deadline: November 1, 2013
CODE
DAY
DATE
TRANS. TIME
393403-I
Sa
11/16
10:45am-4:15pm
Northwestern Football
It’s football season in Wildcat territory. Spend
an autumn afternoon cheering on the Wildcats
as they play the Maine Black Bears at Ryan
Field. The group will tailgate prior to the
game. Participants are encouraged to dress
for fluctuating temperatures and bring money
for additional snacks at the stadium.
Location: Ryan Field, Evanston
Age: 13 & Older
Min/Max: 6/12
Fee: $50R / $75NR
Reg. Deadline: August 23, 2013
CODE
DAY
DATE
TRANS. TIME
393403-H Sa
9/21
TBA
Lunch & Mini-Golf
Start your day with lunch at Kaiser’s Pizza in
Gurnee. Then head to People’s Choice to test
your skills at miniature golf.
Location: Gurnee/Waukegan, Illinois
Age: 18 & Older
Min/Max: 4/10
Fee: $25R ($31 door-to-door) / $38NR
Reg. Deadline: November 29, 2013
CODE
DAY
DATE
TRANS. TIME
393403-F
Sa
12/21
10:15am-2:30pm
9
Location: Pinster’s Bowl & Bar, Zion
Age: 13 & Older
Min/Max: 4/12
Fee: $60R / $90NR per session
$12R / $18NR per week
Reg. Deadline: October 3, 2013
CODE
DAY
DATE
TRANS. TIME
393411-B Th 10/17-12/5 3:25pm-6:00pm
NSSRA
Bowling Tournament
Get winter
“rolling” at NSSRA’s
annual bowling
tournament. Spend
your Saturday
improving your
bowling skills
as you compete
against area
bowlers. Lunch
is included.
Participants with
specific dietary needs are encouraged to pack
a sack lunch. Eligibility Requirement:
Participants must participate in a fall
2013 SRSNLC bowling program or submit
a printed 10-game bowling average.
Location: Brunswick Zone, Deerfield
Age: 13 & Older
Min/Max: 4/12
Fee: $22R / $33NR
Reg. Deadline: October 26, 2013
***Late registrations will not be accepted.***
CODE
DAY
DATE
TRANS. TIME
393408-A Sa
12/7
9:15pm-1:45pm
10
LINDENHURST Youth & Teen
Bowling Bash
Goblin Goo
Spend an afternoon enjoying spooky sensory
experiences. Dabble in slime, goop, Oobleck,
and shaving cream. We provide the projects,
materials, and most importantly, the cleanup
while you enjoy making a mess with your child.
Smocks or old clothes are recommended for
both child and parent. Note: Age-appropriate siblings welcome to register.
Location: Community Center
Age: 4-9 Years Old With Parent
Min/Max: 4/8
Fee: $10R / $15NR
Reg. Deadline: October 4, 2013
CODE
DAY
DATE
TIME
393413-A
F
10/11
10:15am-11:15am
Spend an afternoon hitting the lanes at Pinster’s
Bowl at SRSNLC’s Bowling Bash. Teens will
participate in two games of bowling, socialize,
and enjoy pizza. This non-competitive bowling
party is perfect for seasoned and new bowlers
to improve their skills. Shoe rental is included.
Location: Pinster’s Bowl & Bar, Zion
Event Time: 4:00pm-5:30pm
Age: 10-19 Years Old
Min/Max: 4/8
Fee: $15R / $23NR
Reg. Deadline: October 10, 2013
CODE
DAY
DATE
TRANS. TIME
393407-A Th
10/24
3:25pm-6:00pm
Sensory Art
Pumpkin Picking
Gingerbread Workshop
Daily life can
be filled with
numerous nontactile stimuli
such as television,
video games,
ipods, and
computers. In Sensory Art
Art, your child
participates in a variety of art activities
designed to promote tactile stimulation.
Dabble in shaving cream, sprinkle colored rice,
squeeze moist clay, and finger paint—your
senses will thank you. Emphasis is placed
on the art process rather than the finished
product. Note: Age-appropriate siblings
welcome to register.
If you love
autumn, you
will absolutely
LOVE Jerry
Smith’s
Pumpkin Farm.
Enjoy a wide
display of
ki and
d scenery, ki
b k
decorated pumpkins
kickk back
on a hayride, and select your own pumpkin
to bring home for carving. Pack a sack lunch
and beverage.
Your winter season won’t
be complete without a
tasty gingerbread house
decorating your home!
Each child will receive one
pre-baked gingerbread
house to assemble and
decorate along with all
the candy and supplies
needed to make the house
deliciously sweet. Please bring a box or
cookie sheet to transport your tasty creation
home. Gingerbread houses and decorations
may include common food allergens. Note:
Age-appropriate siblings welcome to
register.
Location: Community Center
Age: 3-5 Years Old With Parent
Min/Max: 4/8
Fee: $10R / $15NR
Reg. Deadline: October 4, 2013
CODE
DAY
DATE
TIME
393413-C
F
10/11
9:00am-10:00am
Location: Kenosha, Wisconsin
Age: 10-17 Years Old
Min/Max: 4/12
Fee: $18R / $27NR
Reg. Deadline: October 4, 2013
CODE
DAY
DATE
TRANS. TIME
393407-C Sa
10/19
10:15am-1:30pm
The Water Works
Does your little one like to help in the kitchen?
Learn to create simple snacks and follow ageappropriate recipes. Measure, mix, and do
a little baking. Take home three new recipe
cards so you can recreate the snacks at home.
Recipes may include common food allergens.
Note: Age-appropriate siblings welcome
to register.
Enjoy a
leisurely day
of swimming
at The Water
Works. Take a
dip in the zerodepth and lap
pools, brave
rslides plunge into the diving
one of three waterslides,
pool, or simply take a spin through the rapid
channel…at The Water Works in Schaumburg
it can be summer every day. Please bring a
swimsuit, towel, and warm clothes for the ride
home. Lunch is provided.
Location: Community Center
Age: 5-10 Years Old With Parent
Min/Max: 4/8
Fee: $15R / $23NR
Reg. Deadline: October 21, 2013
CODE
DAY
DATE
TIME
393413-B
M
11/4
4:00pm-5:30pm
Location: Water Works, Schaumburg
Age: 10-17 Years Old
Min/Max: 4/12
Fee: $36R / $54NR
Reg. Deadline: November 1, 2013
CODE
DAY
DATE
TRANS. TIME
393407-D Sa
11/16
10:45am-4:15pm
Snack Factory
Location: Community Center
Age: 5-10 Years Old With Parent
Min/Max: 4/8
Fee: $18R / $27NR
Reg. Deadline: December 2, 2013
CODE
DAY
DATE
TIME
393413-D M
12/23
10:00am-11:30am
Pizza and Putting
Start your day
with lunch at
Kaiser’s Pizza in
Gurnee. Then
head to People’s
Choice to test
your skills at miniature golf.
/W k
Illi
i
Location: Gurnee/Waukegan,
Illinois
Age: 10-17 Years Old
Min/Max: 4/10
Fee: $25R ($31 door-to-door) / $38NR
Reg. Deadline: November 29, 2013
CODE
DAY
DATE
TRANS. TIME
393407-B
Sa
12/21
10:15am-2:30pm
ROUND LAKE
• 847-546-8558
• www.rlapd.org
LINDENHURST
• 847-356-6011
• www.lindenhurstparks.org
ROUND LAKE Sports & Fitness
Special Olympics
Bowling
Special Olympics Basketball
Bowling is perhaps the most popular Special
Olympic Sport in Illinois. Join us for our Fall
sessions of bowling and start training for the
Area 13 bowling tournament in June. Bowlers
of all abilities are welcome. The fee includes
two games of bowling and shoe rental. Games
begin promptly at 6:30pm so please arrive early.
Location: Kristof’s Entertainment Center,
Round Lake
Age: 8 & Older
Min/Max: 4/42
Fee: $52R / $78NR
Fall 1 Reg. Deadline: September 19, 2013
Fall 2 Reg. Deadline: November 21, 2013
FALL 1
CODE
16726
FALL 2
CODE
16727
DAY
DATE
TIME
Th 10/3-11/21 6:30pm-8:30pm
DAY
Th
DATE
12/5-1/30
TIME
6:30pm-8:30pm
NSSRA
Bowling Tournament
Calling all bowlers! We are heading to
Deerfield to compete against area bowlers
in NSSRA’s annual bowling tournament. Fee
includes two games of bowling, lunch and
awards. Registration in fall 1 session of bowling
is required. Must be at least 13 years old on
day of event.
Location: Brunswick Zone, Deerfield
Age: 13 & Older
Min/Max: 4/12
Fee: $22R / $33NR
Reg. Deadline: October 25, 2013
CODE
DAY
DATE
TIME
16725
Sa
12/7
8:30am-2:00pm
Upcoming Special
Olympics Dates
Outdoor Sports Fest:
September 7th & 8th
Sectional Bowling:
November 2nd
State Bowling:
December 7th
11
Basketball is one of the most popular Special Olympics
sports in Illinois and Round Lake has some great
opportunities for everyone to be involved! This fall
SRSNLC Round Lake will be offering an Individual Skills
program, a Junior Level Team, and a Senior Level Team.
All options have the opportunity to compete at Special
Olympics Tournaments.
Individual Skills
(Ages 8 and up)
In this program you will learn the fundamentals
of the game of basketball. This will include
passing, dribbling, and shooting. This
program is perfect for an athlete who is new
to basketball or just needs a bit more work on
their skills before a team program. The option
to compete in the Special Olympics Sectional
Tournament in January 2014 is included in
this program.
No practice 11/25, 12/23, and 12/30.
Location: Robert W. Rolek Comm. Center
Min/Max: 4/12
Fee: $60R / $90NR
Reg. Deadline: October 28, 2013
CODE
DAY
DATE
TIME
16738
M 11/11-1/20 6:00pm-7:00pm
Jr. Superstars Team
(Ages 8 to 14)
In this program you join the Jr. Superstars
Basketball Team and play different SRA’s in
the community. Games will take place on
Saturday afternoons. It is recommended that
you complete a season of Individual Skills
before joining. Athletes must have been born
in 2000 or later.
No practice 11/25, 12/23, and 12/30.
Location: Park School
Min/Max: 8/12
Fee: $70R / $105NR
Reg. Deadline: October 3, 2013
CODE
DAY
DATE
TIME
16737
M 10/14-2/17 6:30pm-7:30pm
Superstars Team (Ages 16 and up)
In this program you join the Superstars
Basketball Team and play different SRA’s in
the community. Games will take place on
Tuesday evenings. It is recommended that
all players have a prior knowledge of the
game of basketball, including playing as a
team. Parents and athletes will be notified
of practice times. Athletes must have been
born in 1998 or earlier.
No practice 11/26, 12/24, and 12/31.
Location: Robert W. Rolak Comm. Center
Min/Max: 8/15
Fee: $70R / $105NR
Reg. Deadline: October 3, 2013
CODE
DAY
DATE
TIME
16739
Tu 10/15-2/11
TBA
PLEASE NOTE THE POLICY ON REGISTERING FOR
SPECIAL OLYMPICS SPORTS!
To compete at Special Olympics tournaments a Special Olympics Medical
Application is needed. If you or your athlete does not have a Special Olympics
Medical Application on file your registration will be held until approval is made
by the SRSNLC Program Supervisor and a completed Special Olympics Medical
Application is submitted. Athletes who wish not to compete at Special Olympics
Tournaments may still participate in our eight week programs without a Special
Olympics Medical Application. If participating without Special Olympics Medical
Application then participant must sign a No Compete Waiver.
ROUND LAKE • 847-740-9828 • www.rlapd.org
12
ROUND LAKE On The Town
Five Guys and a Flick
What’s Cooking
Lake County
You have just been designated SRSNLC’s
newest food critic; let’s see how our Lake
County area restaurants measure up. Try
out specialty dishes and rate the restaurant
and food based on your experience. Door to
door transportation provided for Round Lake,
Fox Lake and Lake Villa residents only. Please
remember to bring money for dinner.
Location: Round Lake Area Park District
Teen Center
Age: 13 & Older
Min/Max: 4/12
Fee: $10R ($6 door-to-door) / $15NR
Reg. Deadline: One week before each outing
Mrs. V’s Restaurant, Round Lake Beach
CODE
DAY
DATE
TIME
16717
W
9/18
6:00pm-8:30pm
Buffalo Wild Wings, Round Lake Beach
CODE
DAY
DATE
TIME
16718
W
10/16
6:00pm-8:30pm
Henny Penny, McHenry
CODE
DAY
DATE
16719
W
11/13
TIME
6:00pm-8:30pm
Olive Garden, Gurnee
CODE
DAY
DATE
16720
W
12/18
TIME
6:00pm-8:30pm
Oktoberfest Lunch
Celebrate German
heritage at SRSNLC’s
Oktoberfest
B-I-N-G-O and
Luncheon. Play some
Oktoberfest
B-I-N-G-O for a
chance to win cool
prizes. Dine on traditional German dishes
including brats, sauerkraut, boiled red potatoes,
brat rolls, apple pie and more. This catered
lunch will be fabulous.
Meet Location: Round Lake Area Park District
Teen Center
Location: Lindenhurst Park District
Age: 13 & Older
Min/Max: 4/12
Fee: $18R / $27NR
Reg. Deadline: September 20, 2013
CODE
DAY
DATE
TIME
16724
Sa
10/12
10:30am-1:30pm
Come dive into
awesome hot
dogs, burgers
and amazing
fries at Five
Guys Burgers
in Gurnee then
catch the new movie Cloudy with a Chance
of Meatballs #2 at the nearby theatre. Lunch
and movie are included in the fee.
Meet Location: Round Lake Area Park District
Teen Center
Location: Gurnee, IL
Age: 13 & Older
Min/Max: 4/12
Fee: $27R / $41NR
Reg. Deadline: October 9, 2013
CODE
DAY
DATE
TIME
16722
Sa
10/26
11:00am-3:00pm
All Aboard
Head to Roma’s II Pizza and Pasta in Waterford
for a fabulous pizza lunch before taking a ride
back in time on the East Troy Electric Railroad.
Take in the gorgeous Wisconsin landscape on
the one hour relaxing round trip ride with a
short excursion at The Elegant Farmer Depot.
Meet Location: Round Lake Area Park District
Teen Center
Location: East Troy, WI
Age: 13 & Older
Min/Max: 4/12
Fee: $30R / $45NR
Reg. Deadline: September 3, 2013
CODE
DAY
DATE
TIME
16723
Sa
9/14
9:45am-5:00pm
Corn Maze Frenzy -
Can you find your way through the Richardson’s Farm Corn Maze? Come give it a try with
a fun filled Saturday visiting Richardson’s Farm!
Program price includes admissions to the maze,
observation tower, pedal bikes, pedal trikes,
50’ tube slide and much more. Remember
to bring extra money for an early dinner at a
new restaurant in Spring Grove called the Dill
Pickle Grill.
***Physical requirements: Participants must
be comfortable walking and standing for long
periods of time.
Meet Location: Round Lake Area Park District
Teen Center
Location: Richardson’s Farm, Spring Grove
Age: 13 & Older
Min/Max: 4/12
Fee: $25R / $38NR
Reg. Deadline: September 27, 2013
CODE
DAY
DATE
TIME
16801
Sa
10/5
10:00am-4:00pm
Northwestern Wildcats Football
Come see Chicago’s Big Ten team play at Ryan Field. Cost includes
ticket and food for our tailgate; please remember to bring money
for souvenirs. GO CATS!!!!
Meet Location: Round Lake Area
Park District Teen Center
Location: Ryan Field, Evanston
Age: 13 & Older
Min/Max: 4/12
Fee: $50R / $75NR
Reg. Deadline: August 23, 2013
CODE
DAY
DATE
TIME
16721
Sa
9/21
TBD
ROUND LAKE • 847-740-9828 • www.rlapd.org
ROUND LAKE Youth & Teen
Sensory Station
At Sensory Station, you and your child will
participate in a variety of activities designed to
promote tactile stimulation. Dabble in shaving
cream, sprinkle colored rice, squeeze moist clay or
relax on our bean bag chairs. Emphasis is placed
on having fun in a calm environment. Each week
we will offer different activities for you and your
child to choose from while socializing with other
families. Please come dressed to get messy.
Meet Location: Round Lake Area Park District
Teen Center
Age: 2-6 Years
Saturday Nights @
the Teen Center
Looking for something to do on Saturday
night? Kick back and relax at the Teen Center.
Participants will choose between watching
a movie, playing games, or viewing the
latest sports event. This program is offered
in collaboration with the Lindenhurst Park
District.
Meet Location: Round Lake Area Park District
Teen Center
Age: 13 & Older
Min/Max: 4/12
Fee: $8R / $12NR
Reg. Deadline: One week before each
program
CODE
DAY
DATE
TIME
16740
Sa
9/28
6:00pm-8:00pm
16741
Sa
11/23
6:00pm-8:00pm
Min/Max: 4/12
Fee: $5 for 1st Child / $3 for add’l children (Res) /
$8 for 1st Child / $5 for add’l children (NRes)
Reg. Deadline: One week prior
CODE
DAY
DATE
TIME
16744
W
9/18
5:00pm-5:45pm
16745
W
10/16
5:00pm-5:45pm
16746
W
11/13
5:00pm-5:45pm
16747
W
12/18
5:00pm-5:45pm
16748
Tu
9/17
10:00am-10:45am
16749
Tu
10/15
10:00am-10:45am
16750
Tu
11/12
10:00am-10:45am
16751
Tu
12/17
10:00am-10:45am
Pizza and a Movie
It is Friday night and that can only mean one
thing … Pizza and a Movie. Join your friends
for delicious pizza and the latest DVD. Register
for one or all — new movie each date. This
program is offered in collaboration with the
Lindenhurst Park District.
Meet Location: Round Lake Area Park District
Teen Center
Age: 13 & Older
Fee: $12R / $18NR
Reg. Deadline: One week before each
program
CODE
DAY
DATE
TIME
16742
F
10/25
6:00pm-8:00pm
16743
F
12/20
6:00pm-8:00pm
Ceramics for You
Pick an item to paint and have fun while you create a one of a kind masterpiece. Come out and show
your artistic talents while you get to socialize with friends and hang out at the Teen Center. Please
bring a sack lunch for the day. ***Program fee includes: painting supplies, one ceramic item to paint
and professional firing to finish item before it is returned to the participants to keep.
Meet Location: Round Lake Area Park District Teen Center
Age: 8 & Older
Min/Max: 4/20
Fee: $25R / $38NR
Reg. Deadline: October 21, 2013
CODE
DAY
DATE
TIME
16810
Sa
11/9
11:00am-2:00pm
ROUND LAKE • 847-740-9828 • www.rlapd.org
13
ROUND LAKE Kids on the Go!
14
The
Club
T.O.D.A.Y. Club - Together Opening Doors Around You, is a program designed
for adults, ages 18 and older, looking to enrich their lives in a safe and nurturing
environment. As an alternative to the work place, the T.O.D.A.Y. Club will provide a
safe environment for life skill education and social development through innovative
activities, hands on learning and peer interaction. We will celebrate each day by
exploring the participant’s community, resources, and personal potential. The
program runs from 10:00am-3:00pm.
Location: Round Lake Area Park District Teen Center
Reg. Deadline: One week prior
SEPTEMBER (No Club 9/2)
DAYS
CODE
PRICE
M/W/F
16732
$360/$375
OCTOBER
DAYS
M/W/F
CODE
16733
PRICE
$390/$405
NOVEMBER (No Club 11/29)
DAYS
CODE
PRICE
M/W/F
16734
$360/$375
DECEMBER (No Club 12/25)
DAYS
CODE
PRICE
M/W/F
16735
$360/$375
Power Play!
T.O.D.A.Y. Club Jr.
Not old enough for T.O.D.A.Y. Club? That’s
alright, come join us on Saturdays while
we provide a safe environment for life skill
education and social development through
innovative activities, hands on learning and
peer interaction. Each month will have a
different theme but our focus will be on
encouraging healthy active lifestyles. Please
send a lunch with your child.
Meet Location: Round Lake Area Park District
Teen Center
Age: 12-17 Years
Program Time: 11:00am-2:00pm
Min/Max: 4/24
Fee: $20
Reg. Deadline: One week prior
CODE MONTH
DATE
TIME
16758 September
7 & 21 11:00am-2:00pm
16759
October
5 & 19 11:00am-2:00pm
16760 November
2 & 16 11:00am-2:00pm
16761 December
7 & 21 11:00am-2:00pm
Kids on the Go! After School Program
The Special Recreation Services of Northern Lake County at Round Lake is dedicated to
providing participants with disabilities recreational and leisure opportunities in a safe and fun
environment. Our staff is dedicated to working with people with all disabilities. This program
offers a variety of different activities such as structured games, sports, nature programs, as well
as arts and crafts. A variety of theme-related activities will be planned for the participants.
The activities will be based on age and ability levels of the participants. Accommodations
will be available for those requiring structured quiet time for homework, relaxing or reading.
With staff to participant ratios of 1:4, parents can be assured that their child will be in a safe
and nurturing environment.
Schedule: The Round Lake Area Park District and Special Recreation Services of Northern
Lake County are closed on legal holidays. Kids on the Go follows Round Lake Area Schools
CUSD #116 School Calendar; the program will only run on days that school is in session. All
school holidays (Legal School Holidays, Teacher Institute, P/T Conf., Non Attendance days,
etc.) there will be no program. Please request a calendar to see specific days.
Registration: Registration will take place monthly, two weeks prior to start date.
Transportation: You must notify your child’s bus company/school to arrange transportation to this program. The program will be held at the Round Lake Area Park District Youth/
Teen Center at 2071 Orchard Lane, Round Lake Beach.
Time: 2:00pm-6:00pm
AUGUST (Starts August 20th)
DAYS
CODE
PRICE
M-F
16837
$180/$270
SEPTEMBER (No Program 9/2)
DAYS
CODE
PRICE
M-F
16838
$400/$600
OCTOBER (No Program 10/14, 10/21,
10/28 & 10/29)
DAYS
CODE
PRICE
M-F
16839
$380/$570
NOVEMBER (No Program 11/11, 11/27,
11/28 & 11/29)
DAYS
CODE
PRICE
M-F
16840
$340/$510
DECEMBER (No Program 12/23-12/31)
DAYS
CODE
PRICE
M-F
16841
$300/$450
ROUND LAKE • 847-740-9828 • www.rlapd.org
WAUKEGAN Arts & Crafts
PROGRAM GUIDE KEY
BUS – Door to Door
Programs with this symbol offer
door to door transporation with
additional fee.
HOUSE – Transportation
Home Only
Programs with this symbol offer
transportation home only.
HeART for Art
Chef Masters
Let your creativity reign supreme as we dive
into the art world. Find your creativity while
crafting your own piece of artwork, or dance
off a few calories. The benefits of arts are
endless. Each month is a new activity.
Whatcha Got Cookin’? In a 3 week session you
will prepare your own dinner that includes all
five food groups as well as learn about safety,
hygiene and etiquette.
Location: Douglas House
Age: 13 & Older
Min/Max: 4/10
Reg. Deadline: One week before program
DOLLAR SIGN – Bring
Spending Money
Programs with this symbol
require additional money be
brought for the purchase of a
meal or souvenirs.
Transportation applies
to Waukegan In-district
residents only.
15
– ART –
CODE
DAY
6019
Th
Fee: $15R / $23NR
DATE
TIME
10/10
6:00pm-7:00pm
– DANCE –
CODE
DAY
6020
Th
Fee: $10R / $15NR
DATE
TIME
11/21
6:00pm-7:00pm
Cookie Creations
Let the aroma of sweets and cookies fill your senses in the baking class. Make sweet treats for
your friends and family. All participants will take home one dozen of our homemade treats!
Location: Douglas House
Age: 13 & Older
Min/Max: 4/8
Fee: $10 / $15NR
Reg. Deadline: December 9, 2013
CODE
DAY
DATE
TIME
6721
M
12/16 approx. 6:00pm-7:30pm
Location: Douglas House
Age: 13 & Older
Min/Max: 4/8
Fee: $25R ($37 w/transportation) / $38NR
Reg. Deadline: November 18, 2013
CODE
DAY
DATE
TIME
6018
M 11/25-12/9 5:30pm-7:00pm
Craft Connoisseurs
“Art activates the creative part of our brain
– the part that works without words and can
only be expressed nonverbally.”- Grant Eckert.
Activate your brain in this three-week session.
Art materials will be provided. Experience the
benefits of art each week!
Location: Douglas House
Age: 13 & Older
Min/Max: 4/10
Fee: $25R ($37 w/transportation) / $38NR
Reg. Deadline: October 28, 2013
CODE
DAY
DATE
TIME
6017
M 11/4-11/18 6:00pm-7:00pm
WAUKEGAN Sports & Fitness
Time to Spare
Bowling
All-Star Basketball
Gather the skills taught and compete against other Special Recreation
Associations in the Special Olympics and ITRS/PSC Tournaments.
Basketball will help improve motor skills, hand-eye coordination,
balance, strength, speed, flexibility, and endurance. Athletes will receive
skill training on ball handling, shooting, rebounding, defensive and
offensive teamwork, as well as good sportsmanship. The Team will be
competing in the Special Olympics District Tournament in January and the ITRS Tournament
in February. *NO practice on 12/24 or 12/31*
Location: The Field House
Age: 13 & Older
Min/Max: 5/12
Skills Fee: $55R / $83NR
Team Fee: $70R / $105NR
Reg. Deadline: October 1, 2013
Bowling can help improve hand-eye
coordination, strength, flexibility, and gross
motor skills. Socialize while you wait for your
turn. Fee will include two games of bowling
and rental shoes for 8 weeks. Bowlers will
receive refreshments, snacks, and a prize on
the last day of program.
Location: Sunset Lanes
Age: 13 & Older
Min/Max: 6/24
Fee: $75R ($87 w/transportation) / $112NR
Reg. Deadline: September 3, 2013
CODE
DAY
DATE
TIME
6103
M
9/9-10/28 4:45pm-6:00pm
WAUKEGAN
CODE
6150
Basketball: SKILLS
DAY
DATE
TIME
Tu 11/5-1/21/14 4:00pm-5:00pm
CODE
6151
Basketball: TEAM
DAY
DATE
TIME
Tu 11/5-2/11/14 7:00pm-8:30pm
Shake It Up
Shake It Up is your opportunity for a total body work-out! At the Field House at Hinkston Park,
there’s plenty of ways to exercise. Come learn about the fitness equipment, use the walking
track or get an aerobic work-out. We’ll also provide you with a healthy snack.
Location: The Field House
Age: 13 & Older
Min/Max: 4/10
Fee: $30R ($42 w/transportation) / $45NR
Reg. Deadline: November 6, 2013
CODE
DAY
DATE
TIME
6204
W 11/13-12/18 5:15pm-6:15pm
•
847-360-4760
•
www.waukeganparks.org
16
WAUKEGAN Monthly Socials & Outings
All Aboard
Restauranteurs
Develop your sense of taste as we sample local eateries in the Waukegan area. Enjoy the
company of other diners in a relaxed atmosphere as we dine on the local cuisine. Fee
includes your meal and transportation to and from the establishment.
Location: Varies
CODE
6753
6754
6755
6756
DAY
Th
Th
Th
Th
Age: 13 & Older
DATE
9/12
10/3
11/14
12/5
Min/Max: 5/10
Fee: $26R / $39NR per outing
TIME
LOCATION
REG. DEADLINE
5:30pm-7:00pm
CHILI’S BAR & GRILL
Sept. 3, 2013
5:30pm-7:00pm
TIMMY OTOOLE’S
Sept. 24, 2013
5:30pm-7:00pm
PARAGON REST.
Nov. 5, 2013
5:30pm-7:00pm PEACOCK FAMILY REST. Nov. 26, 2013
Octoberfest BINGO
and Luncheon
Movie Review Crew
Watch the latest flick on the big screen! We will
travel to Gurnee Cinemas for an evening out at
the movies. Admission and drink are included
in the price. Moviegoers will be called the day
of the program with pick-up time.
Location: Gurnee Cinemas
Age: 13 & Older
Min/Max: 6/10
Fee: $20R / $30NR
Reg. Deadline: One week prior
CODE
DAY
DATE
TIME
6759
Th
9/19 approx. 7:00pm-9:00pm
6760
Th
10/17 approx. 7:00pm-9:00pm
Celebrate German heritage with SRSNLC’s
Oktoberfest B-I-N-G-O and Luncheon. Play
some Oktoberfest B-I-N-G-O for a chance to
win cool prizes. Dine on traditional German
dishes including brats, sauerkraut, boiled red
potatoes, brat rolls, apple pie and more. This
catered lunch will be fabulous.
Location: East Troy, Wisconsin
Age: 13 & Older
Min/Max: 4/10
Fee: $30R / $45NR
Reg. Deadline: September 3, 2013
CODE
DAY
DATE
TIME
6704
Sa
9/14
9:45am-4:45pm
Location: Community Center, Lindenhurst
Age: 13 & Older
Min/Max: 4/10
Fee: $18R / $27NR
Reg. Deadline: September 20, 2013
CODE
DAY
DATE
TIME
6707
Sa
10/12
10:15am-2:00pm
Out & About
Dinner and a Movie
Spend your evening with friends at the
Douglas House as we watch and critique the
hottest and most up to date releases or an
older classic. Movies are rated G through
PG-13 and are age appropriate.
Location: Douglas House
Age: 13 & Older
Min/Max: 4/10
Fee: $15R / $23NR
Reg. Deadline: A week prior to the program
CODE
DAY
DATE
TIME
6757
Th
9/26 approx. 6:00pm-8:00pm
6758
Th
12/19 approx. 6:00pm-8:00pm
WAUKEGAN
Head to Roma’s
II Pizza and Pasta
in Waterford,
Wisconsin for a
fabulous pizza
lunch before
taking a ride back
in time on the
East Troy Electric
Railroad. Take
in the gorgeous
Wisconsin
landscape on the one hour relaxing round
trip ride with a short excursion to the Elegant
Farmer Depot.
•
The average American watches 4½ hours of television everyday. That is way too much!
Get out and about to enjoy the community. Once a month programs offer the chance to
increase your social skills.
Location: Vaires: Meet at the Douglas House
Age: 13 & Older
Reg. Deadline: One month before program
CODE
6700
6701
6702
6703
DAY DATE
Sa
10/5
F
11/1
Sa
12/7
F 1/10/14
847-360-4760
•
TIME
LOCATION
10:30am-2:00pm RICHARDSON’S FARM
6:00pm-9:30pm
ZION SOCIAL DANCE
8:30am-1:00pm NSSRA BOWLING TOURN.
6:00pm-10:00pm SRACLC WINTER DANCE
www.waukeganparks.org
Min/Max: 4/10
FEE
$25R / $38NR
$9R / $14NR
$22R / $33NR
$18R / $27NR
WAUKEGAN Just for Kids & Teens
Saturday Socialites
Snowflake Camp
Have some fun this fall.
Spend your Saturdays
with some friends from
SRSNLC. We’ll help you
meet new friends and
socialize with other kids.
In September introduce
yourself to healthy living
with Worldwide Day of Play. Invite
I it your family
f il tto jjoin
i us
for a trip to Jerry Smith’s Pumpkin Farm in October. Then
finish the year baking some holiday goodies with Kids in the
Kitchen in December.
9/21 – Worldwide Day of Play
10/19 – Jerry Smith’s Pumpkin Farm
12/14 – Kids in the Kitchen
Location: Varies: Meet at the Douglas House
Age: 5-12 Years
Min/Max: 4/10
Reg. Deadline: Two weeks before program
CODE
DAY DATE
TIME
6557
Sa
9/21 approx. 11:00am-12:30pm
6558
Sa
10/19
10:00am-12:30pm
6559
Sa
12/14 approx. 10:00am-11:00am
Winter blahs put you in a freeze? SRSNLC will
help you thaw. Join in the winter fun at our
camp. Children go on field trips, have fun in the
snow, and meet new friends. Don’t waste your
winter break. Spend it with SRSNLC for a chilling
good time. Send a bag lunch each day. A
medication release must be on file before
the start of camp.
*No camp on
12/24 & 12/25 or 12/31 & 1/1/14*
Location: Douglas House
Age: 5-12 Years
Min/Max: 4/10
Fee: $65R / $98NR
Reg. Deadline: December 9, 2013
CODE DAY
DATE
TIME
6404 M&Th-Fr 12/23,26 & 27 9:30am-4:00pm
6405 M&Th-Fr 12/30,1/2 & 3 9:30am-4:00pm
Blizzard Camp
Tired of being stuck inside all winter?
Break through the barriers of ice that
keep you from having fun! Join SRSNLC
as they offer winter break camp for
teens with developmental disabilities.
Go on great field trips, play games,
and keep your social life from freezing
over during the winter break! Send a
bag lunch each day. A medication
release must be on file before the
start of camp.
*No camp on 12/24 & 12/25 or 12/31 & 1/1/14*
Location: Douglas House
Age: 13-22 Years
Min/Max: 4/10
Fee: $65R / $98NR
Reg. Deadline: December 9, 2013
CODE DAY
DATE
TIME
6406 M&Th-Fr 12/23,26 & 27 9:30am-4:00pm
6407 M&Th-Fr 12/30,1/2 & 3 9:30am-4:00pm
FEE
$9R / $14NR
$15R / $22NR
$10R / $15NR
Teen Scene
Stop hanging out in your house this fall! Get out and enjoy
what the community has to offer. Teen Scene is your chance
to make new friends and develop new skills. The first night is
the Homecoming Dance, then a Halloween Costume Party. In
November we’ll go to the Turkey Twist Dance. Then end the
year with a holiday party! Sign up for one session or all four!
P2K2
9/20 – Homecoming Dance
10/29 – Costume Party
11/8 – Turkey Twist
12/12 – Holiday Party
Location: Varies
Age: 13-22 Years
Min/Max: 4/10
Reg. Deadline: Two weeks before the event
CODE
DAY
DATE
TIME
6817
F
9/20
6:15pm-10:30pm
6561
Tu
10/29
6:00pm-8:00pm
6820
F
11/8
5:45pm-9:30pm
6821
Th
12/12
5:45pm-9:45pm
WAUKEGAN
•
17
Come join P2K2 and get active and healthy! Power Playing Kalenisthenics
Kids is a free program for children ages 5-12 years old with a disability.
This program focuses on making wise choices regarding health, wellness,
and nutrition. Topics to be covered are energy balance, the food pyramid,
calories, food labels, the heart and body, healthy activities, and other wellness
and safety topics.
No program on 11/8 or 11/29
Location: Douglas House
Age: 5-12 Years
Min/Max: 4/10
Fee: FREE
Reg. Deadline: August 30, 2013
CODE
DAY
DATE
TIME
6560
F
9/6-12/20 4:00pm-6:00pm
FEE
$15R / $23NR
$10R / $20NR
$15R / $23NR
$10R / $15NR
847-360-4760
•
www.waukeganparks.org
18
WAUKEGAN Family Programs
Family Zumba - No trans. Live It Up
Make a commitment to get healthy with your
family! Zumba combines Latin American
music and dance to create one great class that
feels more like a party than a work-out. We’ll
begin with the basics, so everyone can join
with or without previous dance experience.
The fee is a family rate for up to four people;
each additional member will be charged $5.
At least one member of the family must have
a disability. One member of the family
must also be over 18 and not a regular
SRSNLC participant.
*No program on 9/25 or 10/23*
Location: Jane Addams Center
Age: 10 & Older
Min/Max: 12/30
Fee: $20R / $30NR
Reg. Deadline: September 4, 2013
CODE
DAY
DATE
TIME
6206
W
9/11-11/6
TBA
Do you want to increase independence in
some important activities of daily living? Live It
Up will be an on-going program that will focus
on helping you learn a new skill each session.
This three week session is for females
ONLY. The focus is on helping females
with disabilities learn how to define and
protect themselves from sexual abuse,
and what to do if they are ever abused.
Parents and guardians are welcome to join
these sessions; however for the comfort and
safety of the group the parent/guardian
must also be female. Parents and guardians
are welcome to preview the material but must
request it a week prior to the first session.
*SRSNLC reserves the right to evaluate a
participant’s functioning level to determine
appropriateness for the program. To discuss
placement for this program contact Kari
Robinson prior to registration at 847-360-4763.
Location: Douglas House
Age: 18 & Older
Min/Max: 3/6
Fee: $ FREE R / $5NR
Reg. Deadline: October 10, 2013
CODE DAY DATE
TIME
6503
Th 10/24-11/7 approx.6:00pm-7:30pm
Annual SRSNLC
Resource Fair
Looking for answers to questions regarding
services for those with a special need or
disability? Come gather information or speak
to individuals regarding the following:
-Accessible Transportation
-Day Program Options/Workshops
-Financial Planning/Trust Funds/
Beneficiaries
-Guardianship/Legal Matters
-Residential Care
-Recreation Opportunities
-Early Childhood/Specialized Programs
-Schools & Support Groups
Eat Well to Be Well
“Eat food. Not too much. Mostly plants.”
–Michael Pollan
Is this all you know about eating healthy?
Let SRSNLC help you and your family get
more information about how to eat well.
A knowledgeable staff will be on hand to
lead you through an interactive nutritional
experience.
Location: Belvidere Recreation Center,
Waukegan
Age: All
Fee: FREE
CODE
DAY
DATE
TIME
FREE
W
9/25
5:00pm-7:00pm
Please register each family member
separately. At least one member of the
family must be over 18.
No transportation is provided.
Groove with the Beat:
A Family Event
Does your family march to the beat of their
own drum? Get your rhythms in sync. Enjoy
this unique experience while learning about
West Africa. Helen Bond from Medusa’s
Musical Mysteries will lead an interactive
session with your family to teach you about
West African Drumming. Participants will get
to play and enjoy a totally new experience.
One member of the family must also
be over 18 and not a regular SRSNLC
participant.
Location: Jane Addams Center, Waukegan
Age: 6 & Older
Min/Max: 4/15
Fee: $5 per person
Reg. Deadline: October 18, 2013
CODE
DAY
DATE
TIME
6719
Sa
11/2
10:00am-11:00am
Family Frames
SRSNLC has some time to spare for your family!
Enjoy an afternoon of bowling with other
SRSNLC families at Sunset Lanes. Help your
kids work on their coordination as they bowl
two games and meet new friends.
Please register each family member
separately. At least one member of the
family must be over 18. No transportation
is provided.
*Includes two games, shoe rental
and snacks*
Location: Sunset Lanes, Waukegan
Age: All
Min/Max: 6/24
Fee: $7R per person / $11NR per person
Reg. Deadline: November 15, 2013
CODE
DAY
DATE
TIME
6741
Sa
11/23
1:00pm-2:30pm
Location: Field House
Age: 10 & Older
Min/Max: 6/24
Fee: $ FREE R / $5NR per family
Reg. Deadline: October 1, 2013
CODE
DAY
DATE
TIME
6504
Tu
10/8
7:00pm-8:00pm
WAUKEGAN
•
847-360-4760
•
www.waukeganparks.org
WAUKEGAN Inclusive Opportunities
19
To learn more about programs SRSNLC is offering in cooperation with
the Waukegan Park District CALL THE SRSNLC OFFICE at 847•360•4760
WorldWide Day of Play
Kids and Families join us as the Waukegan Park District
celebrates “Go Healthy Month” by getting active. This is a free
event for the whole family. Don’t miss out! Call 847-782-3300
ffor more information or visit www.waukeganparks.org
Activities include: Dodgeball, Volleyball, Basketball,
A
JJump Rope, Cup Stacking, Free Throw Contests, Open
Gym, & Climbing Wall.
Location: The Field House
Age: All
Fee: FREE
CODE
DAY
DATE
TIME
FREE
Sa
9/21
11:00am-2:00pm
Halloweenfest
Child Safety Day
Join the Waukegan Park District for Child Safety Day to learn how to keep your
child safe and what to do if you child is missing!
The Waukegan Park District
will be hosting its Annual
Halloweenfest at Bowen
Park. There will be a haunted
trail, haunted house, and
an enchanted walk for your
children, bonfire filled with
spooky stories and lots of
games. Concession stands will be available.
Parents must provide supervision.
Your child can:
-Get fingerprinted.
-Receive an identification Card * $5 fee*
-Meet with local firefighters, police,
and other community agencies!
Location: Belvidere Recreation Center
Age: All
Fee: FREE
CODE
DAY
DATE
TIME
FREE
Sa
10/12
2:00pm-4:00pm
Location: Bowen Park
Age: All
Fee: FREE
CODE
DAY
DATE
TIME
FREE
Sa
10/26
3:00pm-7:00pm
15th Annual Polar Bear Plunge
“What’s your reason for freezing?” Waukegan Park District
will hold its 15th Annual Polar Bear Plunge at the Waukegan
Municipal Beach. Start 2014 off wet or watch the action
from the sidelines. Proceeds will benefit Waukegan Athletic
and Scholarship programs for Special Recreation Services of
Northern Lake County. The first five hundred participants
will receive an event shirt. Be brave, take the Plunge!
Location: Waukegan Municipal Beach
Fee: $10 pre-registration / $15 day of event
CODE
0410
WAUKEGAN
•
DAY
W
DATE
TIME
1/1/2014 10:00am-11:00am
847-360-4760
•
www.waukeganparks.org
ZION Sports & Fitness
20
Bowling
Aerobics
Basketball
Come join a great group of people once a
week for a fun, non-competitive evening
of bowling. Bowling includes 2 games of
bowling and shoes.
This class is taught by a certified aerobics
instructor. You will work out to fun music
while working on balance, muscle strength,
flexibility, & endurance. This class is even
great for those with mobility issues. Different
instruments will be used to help everyone be
successful in this class!
Anyone for a game of hoops? Come join
the Northstars for an exciting and fun-filled
season of basketball. We will work on basic
skills, rules of the game, and learn how to play
the different positions involved in the game.
*No Aerobics 11/27*
*No Basketball on 12/24 & 12/31*
*NO BOWLING 10/31, 11/28, 12/12*
Location: Pinsters Bowl & Bar, Zion, IL
Age: 8 & Older
Min/Max: 10/50
Fee: $6.50R per day / $9.75NR per day
$75R per session / $112.50NR per session
Reg. Deadline: August 30, 2013
CODE
DAY
DATE
TIME
370401-1 Th 9/12-12/19 4:00pm-5:30pm
Location: Rooms 3 & 4, Leisure Center
Age: 13 & Older
Min/Max: 10/30
Fee: $40R / $60NR
Reg. Deadline: September 11, 2013
CODE
DAY
DATE
TIME
370691-1
W
9/25-12/4 5:00pm-6:00pm
*Must have a current Special Olympics
Application on file*
Location: Leisure Center, Sports Arena
Age: 13 & Older
Min/Max: 7/15
Fee: $70R / $105NR
Reg. Deadline: September 20, 2013
CODE
DAY
DATE
TIME
370351-1 Tu
11/5-3/16 6:00pm-7:00pm
NSSRA Bowling Tournament
Are you involved in the SRSNLC bowling program? How about trying the NSSRA bowling
tournament! This is a fun filled day of meeting new people and bowling.
**Must be involved in SRSNLC bowling program to attend**
Meet at: Special Rec Activity Room, Leisure Center
Age: 13 & Older
Min/Max: 5/10
Fee: $22R / $33NR
Reg. Deadline: October 18, 2013
CODE
DAY
DATE
TIME
370421-1
Sa
12/7
8:30am-2:00pm
Social Club
NEW
TIME
ZION In House Fun
Do you love music, dancing, and socializing
with friends? This is a great Friday night get
away once a month! Each month is a different
themed dance. Fee includes door prize,
refreshments, and a whole lot of dancing.
9/6 – Fall Fling
10/4 – Monster Mash
11/1 – Gobble & Shout
12/6 – Jingle Bell Rock
Location: Leisure Center Gym
Age: 10 & Older
Min/Max: 25/100
Fee: $6R per dance / $9NR per dance
CODE
DAY
DATE
TIME
370601-1
F
9/6
6:30pm-8:30pm
Registration Deadline: August 23, 2013
370601-2
F
10/4
6:30pm-8:30pm
Registration Deadline: September 20, 2013
370601-3
F
11/1
6:30pm-8:30pm
Registration Deadline: October 18, 2013
370601-4
F
12/6
6:30pm-8:30pm
Registration Deadline: November 22, 2013
Bingo Nights
Everybody loves
BINGO! Join us
twice a month for a
fun filled evening of
Bingo and prizes.
ts you are available
**Register for nights
or just drop on in with your $3**
Location: Special Rec Room, Leisure Center
Age: 10 & Older
Min/Max: 5/30
Fee: $3R per session / $5NR per session
CODE
DAY
DATE
TIME
371581-1 Tu
9/10
5:30pm-6:30pm
371581-2 Tu
9/24
5:30pm-6:30pm
371581-3 Tu
10/8
5:30pm-6:30pm
371581-4 Tu
10/22
5:30pm-6:30pm
371581-5 Tu
11/5
5:30pm-6:30pm
371581-6 Tu
11/19
5:30pm-6:30pm
371581-7 Tu
12/3
5:30pm-6:30pm
371581-8 Tu
12/17
5:30pm-6:30pm
371581-9 All 8 sessions $21R / $32NR
Lasagna
Christmas Dinner
Come celebrate the holiday season with a
delicious catered meal and great friends!
Please be on time for this event,
dinner will be served promptly
at 5:00 p.m.
Location: Rooms 3 & 4, Leisure Center
Age: 8 & Older
Min/Max: 10/50
Fee: $10R / $15NR
Reg. Deadline: November 30, 2013
CODE
DAY
DATE
TIME
371681-1
W
12/18
5:00pm
ZION • 847-746-5500 • www.zionparkdistrict.com
ZION Out-N-About
Diner’s Club
Take the evening off, get out of the house,
and come on out for great food at local restaurants!
9/18 – Lake House, Lake Villa, IL.
10/15 – Charcoal Grill, Kenosha, WI.
11/11 – Stone Creek Grill, Winthrop Harbor, IL.
Meet at: Special Rec Activity Room,Leisue Center
Age: 13 & Older
Min/Max: 6/12
Fee: $25R per outing / $37NR per outing
CODE
DAY
DATE
TIME
371041-1
W
9/18
5:00pm-9:00pm
Registration Deadline: September 4, 2013
371041-2 Tu
10/15
5:00pm-9:00pm
Registration Deadline: October 1, 2013
371041-3
M
11/11
5:00pm-9:00pm
Registration Deadline: November 1, 2013
All Aboard
Jerry Smith’s
Pumpkin Farm
Head to Roma’s II Pizza and Pasta in Waterford,
Wisconsin for a fabulous pizza lunch before
taking a ride back in time on the East Troy
Electric Railroad. Take in the gorgeous
Wisconsin landscape on the one hour relaxing
round trip ride with a short excursion at The
Elegant Farmer Depot.
Let’s go pick out a pumpkin to decorate for
the Halloween holiday. Come enjoy a wide
display of pumpkins decorated as some of your
favorite characters and a hayride.
Meet at: Special Rec Activity Room,
Leisure Center
Age: 13 & Older
Min/Max: 4/12
Fee: $30R / $45NR
Reg. Deadline: September 3, 2013
CODE
DAY
DATE
TIME
370611-1
Sa
9/14
9:15am-5:00pm
Meet at: Special Rec Activity Room,
Leisure Center
Age: 13 & Older
Min/Max: 6/12
Fee: $18R / $27NR
Reg. Deadline: September 27, 2013
CODE
DAY
DATE
TIME
370181-1
Sa
10/19
10:00am-1:00pm
Please bring a sack lunch with you.
Octoberfest
B-I-N-G-O & Luncheon The Water Works
Celebrate German heritage with SRSNLC’s
Oktoberfest B-I-N-G-O and Luncheon
at Lindenhurst Park District. Play some
Oktoberfest B-I-N-G-O for a chance to win
cool prizes. Dine on traditional German
dishes including brats, sauerkraut, boiled red
potatoes, brat rolls, apple pie and more. This
catered lunch will be fabulous.
Enjoy a leisurely day of swimming at The Water
Works. Take a dip in the zero-depth and lap
pools, brave one of three water slides, plunge
into the diving pool, or simply take a spin
through the rapid channel…at The Water
Works in Schaumburg it can be summer every
day. Please bring a swimsuit, towel and warm
clothes for the ride home. Lunch is included.
Meet at: Special Rec Activity Room,
Leisure Center
Age: 13 & Older
Min/Max: 4/12
Fee: $18R / $27NR
Reg. Deadline: September 20, 2013
CODE
DAY
DATE
TIME
370751-1
Sa
10/12
10:15am-2:00pm
Meet at: Special Rec Activity Room,
Leisure Center
Age: 13 & Older
Min/Max: 4/12
Fee: $36R / $54NR
Reg. Deadline: November 1, 2013
CODE
DAY
DATE
TIME
370771-1
Sa
11/16
10:00am-5:00pm
21
Fancy Night Out
Get gussied up and have an elegant steak
dinner at Steven’s in Gurnee, IL.
Meet at: Special Rec Activity Room,
Leisure Center
Age: 13 & Older
Min/Max: 6/12
Fee: $40R / $60NR
Reg. Deadline: November 18, 2013
CODE
DAY
DATE
TIME
370171-1
M
12/9
5:00pm-9:00pm
SRACLC Winter
Wonderland
Winter is upon us and there is no better way
to stay warm than to dance the night away
at SRACLC’s Winter Wonderland Dance at the
Sullivan Center in Vernon Hills.
Meet at: Special Rec Activity Room,
Leisure Center
Age: 13 & Older
Min/Max: 4/12
Fee: $18R / $27NR
Reg. Deadline: November 16, 2013
CODE
DAY
DATE
TIME
370631-1
F
1/10
6:00pm-10:00pm
Lunch & Mini Golf
Let’s hit Kaiser’s Pizza for great pizza and then
head over to People’s Choice and get in a
round of mini-golf.
Meet at: Special Rec Activity Room,
Leisure Center
Age: 13 & Older
Min/Max: 6/12
Fee: $25R / $38NR
Reg. Deadline: November 29, 2013
CODE
DAY
DATE
TIME
371711-1
Sa
12/21
11:00am-3:00pm
ZION • 847-746-5500 • www.zionparkdistrict.com
22
ZION Take The Day Off
Denny’s & Matinee
Dave & Busters
Join us for a great breakfast at Denny’s in
Gurnee and then after go catch a flick at
Gurnee Cinema.
Enjoy lunch and an afternoon playing games
at Dave and Buster’s in Wauwatosa, Wisconsin.
Lunch and a $20 Power Card is included—
participants may bring extra money to reload
their Power Card.
Meet at: Special Rec Activity Room,
Leisure Center
Age: 16 & Older
Min/Max: 4/8
Fee: $28R / $42NR
CODE
DAY
DATE
TIME
371611-1
F
9/13
10:00am-3:00pm
Registration Dealine: August 30, 2013
371611-2
F
10/18
10:00am-3:00pm
Registration Dealine: October 4, 2013
371611-3
F
11/15
10:00am-3:00pm
Registration Dealine: November 1, 2013
371611-4
F
12/13
10:00am-3:00pm
Registration Dealine: November 29, 2013
Meet at: Special Rec Activity Room,
Leisure Center
Age: 18 & Older
Min/Max: 4/8
Fee: $42R / $63NR
Reg. Deadline: October 9, 2013
CODE
DAY
DATE
TIME
370791-1
W
10/23
10:00am-4:00pm
Discovery World
Museum
Discovery World connects innovation, science,
technology and the environment with
exploration and learning through interactive
exhibits and experiential learning programs.
Discover all this museum has to offer and then
enjoy a fancy lunch.
Meet at: Special Rec Activity Room,
..Leisure Center
Age: 16 & Older
Min/Max: 4/12
Fee: $50R / $75NR
Reg. Deadline: November 1, 2013
CODE
DAY
DATE
TIME
370971-1
F
11/22
8:30am-4:00pm
Volo Bog
Let’s take an adventure to the Volo Bog State Natural
Area in Ingleside, IL. to explore the only “quaking” bog
in Illinois to have an open water center & also enjoy the
trees in their gorgeous fall colors. After our journey, we
will go to Tammy’s in Spring Grove for lunch.
*Please wear good walking shoes*
Meet at: Special Rec Activity Room,Leisure Center
Age: 13 & Older
Min/Max: 4/12
Fee: $25R / $38NR
Reg. Deadline: September 24, 2013
CODE
DAY
370901-1 Tu
DATE
10/8
TIME
9:00am-3:00pm
ZION Kid Fun
Bowling Bash
Pumpkin’ Pickin’
Spend an afternoon hitting the lanes at
Pinster’s Bowl at SRSNLC’s Bowling Bash.
Teens will participate in two games of
bowling, socialize, and enjoy pizza. This
non-competitive bowling party is perfect for
seasoned and new bowlers to improve their
skills. Shoe rental is included.
Location: Pinster’s Bowl & Bar, Zion
Age: 10-19 Years Older
Min/Max: 4/8
Fee: $15R / $23NR
Reg. Deadline: October 10, 2013
CODE
DAY
DATE
TIME
370641-1 Th
10/24
4:00pm-5:30pm
Let’s to Jerry Smith’s Pumpkin Farm and pick out a pumpkin to decorate for the
Halloween holiday. Come enjoy a wide display of pumpkins decorated as some
of your favorite characters and a hayride.
Please bring a sack lunch with you.
Meet at: Special Rec Activity Room, Leisure Center
Age: 10-19 Years Older
Min/Max: 6/12
Fee: $18R / $27NR
Reg. Deadline: September 27, 2013
CODE
DAY
DATE
TIME
370641-2
Sa
10/19
10:00am-1:00pm
ZION • 847-746-5500 • www.zionparkdistrict.com
SRSNLC Code of Conduct & Behavior Expectations
Behavior Expectations
SRSNLC promotes the concept of “equal fun for everyone.” However, certain rules have been established to
ensure the safety and enjoyment of all people. The following guidelines have been developed to help make
SRSNLC programs safe and enjoyable for all participants. SRSNLC participants are expected to demonstrate
appropriate behavior during programs. The basic behavior code of conduct insists that participants shall:
1. Show respect to all participants and staff, and take direction from staff.
2. Refrain from using abusive or foul language.
3. Refrain from causing bodily harm to self, other participants, or staff.
4. Show respect to equipment, supplies, and facilities.
A positive approach will be utilized regarding discipline. Individual behavior management plans may be
developed on the advice of parents, staff or other professionals. If inappropriate behavior occurs, prompt
resolution will be sought, specific to each individual situation. SRSNLC reserves the right to dismiss a
participant whose behavior endangers the safety of him/her self or others.
Consequences of Unacceptable Behavior
Participants may be subject to any of the following actions for unacceptable behavior. Below is a guideline
for progressive discipline; however, the progression may be accelerated or slowed based on the severity and
frequency of the unacceptable behavior.
Unacceptable Behavior
Warning
Time Out
Conference
Loss of Privileges Suspension
Expulsion
Improper use of materials
✔
✔
✔
✔
✔
❑
❑
❑
❑
❑
or equipment.
__________________________________________________________________________________________
Disrespect of participants,
✔
✔
✔
✔
✔
❑
❑
❑
❑
❑
staff, or the public.
__________________________________________________________________________________________
Objectionable gestures;
profane, vulgar or
✔
✔
✔
✔
❑
❑
❑
❑
objectionable
language.
__________________________________________________________________________________________
✔
✔
✔
Fighting
✔
❑
❑
❑
___________________________________________________________________________________________
❑
Damage or destruction of
Park District property or
✔
✔
✔
❑
❑
❑
property
of
others.
__________________________________________________________________________________________
Theft
✔
✔
✔
__________________________________________________________________________________________
❑
❑
❑
Smoking; possession or use
✔
✔
✔
❑
❑
❑
of alcohol or illegal drugs.
___________________________________________________________________________________________
Harassment or abuse of
✔
✔
✔
❑
❑
❑
fellow participants or staff
__________________________________________________________________________________________
Possession of weapons
✔
✔
___________________________________________________________________________________________
❑
❑
Other acts which may be
determined to be
✔
✔
✔
✔
❑
❑
❑
❑
unacceptable by the
program supervisor
For issues that are not major we may issue a participant progress report. This is in no way a behavioral warning;
it is simply to inform you of something that may have happened during a program. For example, a participant
may soil their pants. We will issue a progress report to inform the parent/guardian of the incident and how it
was handled.
LINDENHURST • ROUND LAKE • WAUKEGAN • ZION
23
24
SRSNLC Athlete-Sportsmanship Contract
General Information
The following Sportsmanship Contract is to be signed by
all SRSNLC - Athletes for all Special Olympic sport seasons.
The Sportsmanship Contract is a code of conduct that all
athletes must follow while participating in all Special Olympic
sports. This contract must be signed and dated by the
athlete and returned to the coach at the beginning
of EACH sport season. The athlete will not be
allowed to compete/participate until the contract
is signed. Coaches will document any violations of
the contract on a tracking form for each athlete.
SRSNLC Athlete - SPORTSMANSHIP CONTRACT
The Sportsmanship Contract is an agreement of sportsmanlike conduct that athletes will follow while participating in
SRSNLC Special Olympics. Please take a moment to review this form, sign it and return to your coach. This contract is
in place to ensure that all athletes are treated with respect and so that they feel like an important part of the team.
1. I will respect others, including my teammates, coaches, and
opponents. This means I will treat others the way I would
want to be treated.
2. I will encourage my teammates on the court, on the bench,
and on the van/bus. I will encourage them with kind words
and cheer on my team on the court, on the bench, and on the
van/bus.
3. I will listen when the coaches speak and will not question
their coaching decisions (i.e. player positions). This means
I will pay attention when a coach is speaking or explaining
directions. I will ask a coach if I have any questions.
4. I will try my best while on the court, giving 100% at all
times. This means I will pay attention and take the game/
practice seriously (i.e. no goofing off).
5. I will trust in my teammates and my own playing abilities
on and off the court. This means that I will not talk bad
about their playing abilities or yell at them if they have a
“bad game” or “bad play.”
6. I will tell the coaches if I hear or see unsportsman-like
conduct from other teammates. I will not be considered a
“tattle teller” if I do this. I must be honest when telling the
coaches about what I have seen or heard.
7. I will return my entire uniform within two weeks of the end
of the sports season. Failure to do so will result in a fine of
$60 per uniform and potential suspension from future
SRSNLC programs.
“Positives” of following this contract are as
follows:
• Team has better chance of winning
• You and your team will have more fun
1.
2.
3.
4.
5.
6.
The consequences for not following
contract are as follows:
If any unsportsman-like conduct is seen/reported during a
game, on the van/bus or at practice, the athlete will receive
a warning and a brief time out.
If unsportsman-like conduct is seen/reported for a 2nd time
during a game, practice or van/bus ride, the athlete will be
benched for the rest of the game (or half of the next game
he/she is present at, if during a practice or on bus).
If unsportsman-like conduct is seen/reported for a 3rd time
in a game, practice or on the van/bus, the athlete will be
benched for the entire next game he/she is present at. The
athlete will be encouraged to cheer on the team, but is
otherwise expected to sit in silence.
If the athlete continues to show unsportsman-like conduct
after the 1st game suspension, he/she will continue to be
suspended from play until the undesired conduct has
stopped.
If the athlete is suspended from more than 3 games, he/she
will be suspended for the rest of the Season.
If several athletes do not follow the Sportsmanship Contract,
the coaches have the authority and right to forfeit games
and tournaments.
I agree to follow the above Sportsmanship Contract.
Athlete’s Signature:_________________________________________________
Date___________________
LINDENHURST • ROUND LAKE • WAUKEGAN • ZION
Valid Application for Participation is mandatory for all competitors
605 E. Willow St. Normal, IL 61761-2682 309-888-2551
Zip Code
-
Y
Y
SO ILL Rev. 8-1-10
D
Sex (M or F)
Birthdate
M
M
D
APPLICATION FOR PARTICIPATION IN SPECIAL OLYMPICS ILLINOIS
ATHLETE INFORMATION
Athlete Name (last name, space, first name)
Agency Name
State
Parent’s/Guardian’s
Home Telephone
Emergency
Contact Phone (
-
Parent’s/Guardian’s (Please Circle One) Home Address
Asian
Athlete’s Mailing Address
Black/African American
Other
Parent’s/Guardian’s City
Zip Code
White
Hispanic/Latino
Policy Number
)
Athlete’s City
State
Ethnicity
Person to be contacted
in case of emergency
HEALTH INSURANCE & EMERGENCY INFORMATION (Required for Processing)
Medical Insurance Company
PARENT AND/OR GUARDIAN AUTHORIZATION AND MEDIA RELEASE
Date
Parent’s Email Address
Signature of Parent
and/or Legal Guardian
(Check appropriate box)
Print Name
Date
I, on my own behalf or as the undersigned parent and/or legal guardian of the above named applicant (hereafter referred to as the “Entrant”), hereby request permission for the
Entrant to participate in Special Olympics programs. I acknowledge that Special Olympics will screen all entrants using the Sex Offender Public Registry and the Child Murder and
Violent Offender Against Youth Registry and understand that entrants listed on either Registry will be denied participation. I affirm that this Entrant has never been on said Registries
or, if Entrant was listed on either Registry but has since been removed, I will contact Special Olympics Illinois for instructions before submitting this application.
I represent and warrant to you that the Entrant is physically and mentally able to participate in Special Olympics, and I submit herewith a subscribed medical certificate. I understand that
if the athlete has Down Syndrome, he/she cannot participate in sports or events which, by their nature result in hyper-extension, radical flexion or direct pressure on the neck or upper
spine unless a full radiological examination establishes the absence of Atlantoaxial Instability. I am aware that the sports and events for which this radiological examination is required
are equestrian sports, artistic gymnastics, diving, pentathlon, high jump, alpine skiing, soccer, soccer skills, powerlifting squat and butterfly stroke and diving starts in swimming.
On behalf of the Entrant and myself, I acknowledge that the Entrant will be using facilities at his/her own risk and I, on my own behalf, herby release, discharge and indemnify
Special Olympics from all liability for injury to person or damage to property of myself and Entrant.
In permitting the Entrant to participate, I am specifically granting permission to Special Olympics Illinois to use the likeness, voice and words of the Entrant in television, radio, films,
newspapers, magazines and other media, and in any form not heretofore described, for the purpose of advertising or communicating the purposes and activities of Special
Olympics and in appealing for funds to support such activities. I understand that by signing below I consent for the Entrant to participate in the Special Olympics Healthy Athletes
Program that provides individual screening assessments of health status and health care needs. The Entrant has no obligation to participate and I understand the Entrant should
seek his/her own medical advice and assistance and Special Olympics is not responsible for the Entrant’s health.
If I am not personally present at Special Olympics activities in which the Entrant is to compete, so as to be consulted in case of necessity, you are authorized on my behalf and at
my account to take such measures and arrange for such medical and hospital treatment as you may deem advisable for the health and well-being of the Entrant.
I, THE UNDERSIGNED ADULT ENTRANT, have read and fully understand the
I, THE UNDERSIGNED PARENT AND/OR GUARDIAN of the above specified
provisions of the above release and/or have had them explained. I hereby agree that I
Entrant, have read and fully understand the provisions of the above release and have
will be bound thereby and I shall defend Special Olympics Illinois and hold it harmless
explained them to said Entrant. I hereby agree that I and said minor will be bound
from disaffirmation thereof.
thereby, and I shall defend Special Olympics Illinois and hold it harmless from any
disaffirmation thereof by said minor.
Entrant
Witness
Athlete’s Email Address
SO ILL OFFICE ONLY
MEDICAL CLEARANCE
PLEASE CHECK MEDICAL INFORMATION
Does athlete have Down Syndrome?
Yes
No
If yes, have x-rays of the C1-C2 vertebrae
been taken and examined?
Yes
No
Date of x-ray
Is the athlete clear of Atlantoaxial Instability?
Yes
No
No
No
No
No
No
No
Dosage
Does the athlete have or is the athlete:
Heart Problems
Yes
Diabetic
Yes
Epileptic/Seizures
Yes
Blind
Yes
Deaf
Yes
Hepatitis
Yes
Other
Current Medication
Allergies to medication, if any:
Date of last Tetanus shot:
State
Zip
I have examined the above-named Entrant
and, in my opinion, there is no mental or
physical reason why he or she should not
participate in the Special Olympics sports
training and competition program. Further
information will be forwarded if required.
Current medication, if any, is specified with
dosage on this application.
Examination Date
)
Doctor’s Signature
Print Name
Address
City
Phone (
Original parent/guardian and doctor signatures are required by the office of Special Olympics Illinois. Faxed signatures will not be accepted.
SRSNLC - 2013 Registration Form
Name:
Age:
Birthdate:
Address:
House/Apt. #
City:
Zip:
Home Phone: (
Gender:
OFFICIAL
REGISTRATION
INFORMATION
)
Emergency Phone: (
)
E-mail:
PROGRAM NAME
NUMBER/LOCATION CODE
FEE* GUARD. PAYMENT ENT. COMP AMT. PAID
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Office
use
only
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
______________________________________________________________________________________________________
_______________________________________________________________________________________________________
______________________________________________________________________________________________________
_______________________________________________________________________________________________________
______________________________________________________________________________________________________
PARTICIPATION WILL BE DENIED – If the signature of adult participant or
parent/guardian and date are not on this waiver.
READ CAREFULLY
IMPORTANT INFORMATION
The Special Recreation Services of Lindenhurst, Round Lake,
Waukegan and Zion Park Districts is committed to conducting its
recreation programs and activities in a safe manner and holds
the safety of participants in high regard. The Special Recreation
Services of Northern Lake County continually strives to reduce
such risks and insists 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 the below listed programs/activities must
recognize that there is an inherent risk of injury when choosing
to participate in recreational activities/programs.
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 recently suffered an illness, injury or impairment,
to consult a physician before undertaking any physical activity.
WARNING OF RISK
Recreational activities/programs are intended to challenge
and engage the physical, mental and emotional resources of
each participant. Despite careful and proper preparation,
instruction, medical advice, 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. Depending on the
particular activity, participants must understand that certain
risks, dangers and injuries due to inclement weather, slipping,
falling, poor skill level or conditioning, carelessness, horseplay,
unsportsmanlike conduct, premises defects, inadequate or
defective equipment, inadequate supervision, instruction or
officiating, and all other circumstances inherent to indoor and
outdoor recreational activities/programs exist. In this regard,
it must be recognized that it is impossible for the Special
* Non-resident Fee add 50% (see reg. policies)
Recreation Services of Northern Lake County to guarantee
absolute safety.
WAIVER AND RELEASE OF ALL CLAIMS
AND ASSUMPTION OF RISK
TOTAL DUE:
TOTAL ENCLOSED:
In the event of an emergency, I authorize SRSNLC Staff
to secure from any licensed hospital, physician and/or
medical personnel any treatment deemed necessary for
my minor child/ward and agree that I will be responsible
for the payment of any and all medical services rendered.
I have read and fully understand the above important
information, warning of risk, assumption or risk and
waiver and release of all claims. If registering on-line or
via fax, your on-line or facsimile signature shall substitute
for the and have the same legal effect as an original form
signature.
Please read this form carefully and be aware that in signing up
and participating in the identified programs/activities (above),
you will be expressly 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 said programs/activities (including
transportation services/vehicle operation, when provided).
_______________________________________
I recognize and acknowledge that there are certain risks
Parent / Adult Guardian Signature
of physical injury to participants in these programs/activities,
and I voluntarily agree to assume the full risk of any and all ____________________________________________
injuries, damages or loss, regardless of severity, that my minor
Date
child/ward or I may sustain as a result of said participation.
I further agree to waive and relinquish all claims I or my minor _____________________________________________
child/ward may have (or accrue to me or my child/ward) as a Participant Signature (participant must sign if he/she is own legal guardian)
result of participating in these programs/activities against the
Special Recreation Services of Northern Lake County including ____________________________________________
Date
Lindenhurst, Round Lake, Waukegan and Zion Park Districts,
its officials, agents, volunteers and
FOR CREDIT CARD PAYMENT
employees (hereinafter collectively
referred as SRSNLC).
❑ Visa
❑ MasterCard
I do hereby fully release and
forever discharge the SRSNLC Card Holder’s Name________________________________________________
from any and all claims for Credit Card Number________________________________________________
injuries, damages, or loss that Expiration Date__________________ 3 Digit Security Code______________
my minor child/ward or I may
have or which may accrue to Billing Zip Code___________________________
me or my minor child/ward and ❑ Charge Full Fee $_________________ ❑ Charge Deposit Only $_________________
arising out of, connected with, or
in any way associated with these
Signature________________________________________________________
programs/activities.
28
SRSNLC Seizure Questionnaire
Please complete this form if the participant has ever experienced a seizure. 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.
Participant’s name: ______________________________________
Parent/Guardian: ____________________________
Phone _____/ ______/______
Emergency Contact: __________________________
Phone _____/ ______/______
Current Medication: Name
(including dosage)
________________________
Dosage
____________
Time of intake
____________
________________________
____________
____________
Please note: SRSNLC will not administer rectal diastat.
Seizure type:
o Absence (staring spell)
o Simple Partial
o Complex Partial
o Atonic (drop)
o Generalized (grand-mal)
o Other (Explain): _________________
When was the date of your/your child’s last seizure? ____/____/____
How long does the seizure last? ____________________
How long was the longest seizure? __________________
Are there any triggers that cause the onset of your/your child’s seizures? (I.e. strobe lights, heat,
sudden movements, noise)
Explain: _______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Are there any symptoms prior to the onset of your/your child’s seizure? (I.e. smells, stomach
pain, fear, sounds)
Explain: ______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Seizure Plan
Please list below the necessary steps you would like SRSNLC to take in the event of a seizure:
1. Call 911 for a seizure over _____minutes.
2. __________________________________________________________________
3. __________________________________________________________________
Parent/Guardian Signature: ____________________________
Date: ____________
It is important that we follow a consistent procedure for responses to seizures, therefore if your child has a
seizure plan in place for school/workshop/prescribed by a doctor, a copy of that should be submitted in
addition to this form.
LINDENHURST • ROUND LAKE • WAUKEGAN • ZION
SRSNLC Annual Information Form
2013
❑ Lindenhurst
❑ Round Lake
❑ Waukegan
❑
Zion
This information will be used for all programs during 2013.
Please contact your local office if any information changes throughout the year.
Name:______________________________________________________________
Address:______________________________________________
Age:______
City:_____________________
Parent/Guardian Name:____________________________________
Birth Date:_______________
State____
Zip:__________
E-mail:_________________________________________
(
)
(
)
Home Phone:_______________________________________
Cell Phone:______________________________________________
(
)
Mother’s Work Phone:_______________________________
Sex:
❑ Male ❑ Female
(
)
Father’s Work Phone:____________________________________
T-Shirt Size_________________________
School/
Teacher/
(
)
Workshop:_______________________ Supervisor:___________________________ Phone:____________________________
(
)
Physician’s Name:_____________________________________________ Physican’s Phone:______________________________
Address:______________________________________________
City:______________________
State____
Zip:_________
EMERGENCY CONTACT (Within 20 mile radius) Other than parent/guardian
Name:_______________________________________________
Relationship:__________________________________________
Address:______________________________________________
(
)
Home Phone:________________________________________
City:_____________________________ State:____ Zip_________
(
)
Work/Cell Phone: ___________________________________
PARTICIPANT DISABILITY (Please check all that apply)
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
Attention Deficit Disorder: (ADD).................................
❑ Emotionally Distressed (ED)........................................
Autism (A)..................................................................
❑ Learning Disorder (LD)...............................................
Behavior Disorder (BD)...............................................
❑ Multiply Challenged (MC)...........................................
BiPolar (BP)..............................................................
❑ Physically Challenged (PC).........................................
Brain Injury (BI)..........................................................
• are orthopedic devices worn?__________________
Yes / No
Deaf/Hard of Hearing (D/HH).....................................
• can transfer into van seat or stadium seat.............
Yes / No
Developmental Disability (DD).....................................
❑ Severe Mental Handicap (SMH).................................
Down Syndrome (DS).................................................
❑ Trainable Mental Handicap (TMH)...............................
Early Childhood (EC)...................................................
❑ Visually Impaired (VI).................................................
Educable Mental Handicap (EMH)...............................
If Down Syndrome, has participant been tested for atlanto axial instability? Yes / No
Does your participant have atlanto axial instability? Yes / No
P HOTO /V IDEO A UTHORIZATION
AND
C ONSENT & E MERGENCY T REATMENT P ERMISSION :
I hereby authorize and give my consent to SRSNLC to photograph/video my child (or me), and without limitation, to use such photographs/video
in connection with promoting/advertising the services, programs, and facilities of SRSNLC, including, but not limited to its website, Facebook page,
promotional materials, brochures, fliers and other publications without consideration of any kind. I have read and fully understand the above
photo/video authorization and consent.
I acknowledge that SRSNLC does not carry medical insurance. My family’s own health insurance must assume responsibility in the event of injury.
I understand that every precaution is taken to protect the safety of every participant. I agree to emergency treatment by a physician or hospital in the
event that I cannot be reached. I hereby acknowledge that the above information is accurate and I understand that it is my responsibility to inform
the SRSNLC staff of any changes in the above information.
Medical Insurance Company____________________________________________________
Policy Number_______________________________
Signature of Parent/Guardian_________________________________________________________
❑ I do not authorize or give photo consent.
Date_____________________________
MEDICATION
Does the participant receive any medication?
Medication
Dosage
❑ Yes ❑ No
Purpose
Side Effects
______________ _____________ ___________________________________
_________________________________
______________ _____________ ___________________________________
_________________________________
______________ _____________ ___________________________________
_________________________________
______________ _____________ ___________________________________
_________________________________
HEALTH ISSUES
Does the participant seizure?
❑ Yes ❑ No
Does the participant have asthma?
Comments:_________________________________________________
❑ Yes ❑ No
__________________________________________________________
❑ Yes ❑ No
Does the participant have allergies?
__________________________________________________________
__________________________________________________________
DIETARY ISSUES
Does participant require assistance eating or drinking?
• have any food restrictions?
• have any food dislikes?
• have any specific food likes?
• is participant Diabetic?
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
❑ No
❑ Yes ❑ No
Comments:________________________________
Comments:_________________________________________________
Comments:_______________________________________________
Comments:_________________________________________________
Comments:_________________________________________________
BEHAVIOR ISSUES
Comments:_______________________________________________
❑ Yes ❑ No
• comply with verbal requests?
❑ Yes ❑ No Comments:______________________________________________
• respond to specific directions?
❑ Yes ❑ No Comments:______________________________________________
• have any known situations that cause behaviors? ❑ Yes ❑ No
Comments:____________________________________
Does participant display unusual fears?
What actions are to be taken if a particular behavior is presented?_______________________________________________
______________________________________________________________________________________________________
• respond to any reinforcement devices?
❑ Yes ❑ No
Comments:___________________________________
______________________________________________________________________________________________________
_______________________________________________________________________________________________________
• respond to any behavior improvement techniques?
❑ Yes ❑ No
Comments:___________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
SAFETY ISSUES
GENERAL ISSUES
Does participant need assistance orientating to:
people_______
place_______
Does participant use:
time_______
Does participant need assistance protecting:
self_______
anticipating safety needs_______
Does participant need assistance toileting:
independent_______
monitor_______
diapering_______
other:___________________
__________________________________________________
wheelchair_______
cane_______
stroller_______
walker_______
canadian crutches_______
If participant is non-verbal do they use: sign language_______
communication board/book_______
Does participant swim/enjoy water?
❑ Yes ❑ No
Facility Directory
Lindenhurst Facilities
Lindenhurst Park District . . . . . . . . . . . . . . . . . . . . . . . . . .2200 East Grass Lake Rd., Lindenhurst
Mallard Ridge Park . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Robincrest Lane, Lindenhurst
Millennium Park . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201 Country Place Lane, Lindenhurst
Round Lake Facilities
Indian Hill Elementary / Park District Gym. . . . . . . . . . . . . . . . . . . 1920 Lotus Drive, Round Lake Heights
Kristof’s Entertainment Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .421 Rollins Road, Round Lake Beach
Renwood Golf Course. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 701 E. Shorewood Road, Round Lake Beach
Robert W. Rolek Community Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 814 Hart Road, Round Lake
Round Lake Area Park District Teen Center / Youth Center . . . . . . . . . 2071 N. Orchard Lane, Round Lake Beach
Round Lake Area Park District Site II (Dell House). . . . . . . . . . . . .2041 N. Orchard Lane, Round Lake Beach
Round Lake Area Park District Sports Center. . . . . . . . . . . . . . . . .2004 N. Municipal Way, Round Lake Beach
Park School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 400 W. Townline Road, Round Lake
Washington Street Tennis Courts . . . . . . . . . . . . . . . . . . . . . .22415 East Washington Street, Round Lake
Waukegan Facilities
Belvidere Recreation Center/Park Place Senior Center. . . . . . . . . . . . . . . . .412 South Lewis Street, Waukegan
Douglas House . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .732 N. Genesee Street, Waukegan
Jane Addams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Jack Benny Drive, Waukegan
Sunset Bowl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2015 North Lewis Avenue, Waukegan
The Field House @ Hinkston Park. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .800 N. Baldwin Avenue, Waukegan
Bonnie Brook Golf Course. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2800 N. Lewis Avenue, Waukegan
Greenshire Golf Course. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38727 N. Lewis Avenue, Waukegan
Zion Facilities
Shiloh Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Emmaus and 27th Street, Zion
Zion Leisure Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2400 Dowie Memorial Drive, Zion
Shiloh Park Golf Course. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23rd fStreet & Bethesda Boulevard, Zion
Hermon Park Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2700 29th Street, Zion
Pinsters Bowl & Bar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1646 Sheridan Road, Zion
Port Shiloh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1523 Shiloh Blvd., Zion
Shepherds Crook Golf Course . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .351 Greenbay Road, Zion
LINDENHURST • ROUND LAKE • WAUKEGAN • ZION
31
Special Recreation Services
of Northern Lake County
Lindenhurst Park District
Community Center
2200 E. Grass Lake Road
Lindenhurst, IL 60046
847-356-6011
847-356-6063 Fax
Round Lake Area Park District
Community Center
814 Hart Road
Round Lake, IL 60073
847-546-8558
847-740-8180 Fax
Waukegan Park District
Upton Park/Douglas House
2000 Belvidere Street
Waukegan, IL 60085
847-360-4760
847-662-2577 Fax
Zion Park District
Leisure Center
2400 Dowie Memorial Drive
Zion, IL 60099
847-746-5500
847-746-5506 Fax
PRST STD
US POSTAGE PAID
Gurnee, IL
Permit No. 60