program guide - wssra.net

SPLASHTASTIC FAMILY SWIM (pg. 10) ANNUAL SPORTS BANQUET (pg. 18)

Fall

2011

PROGRAM GUIDE

HOLIDAY HULLABALOO PAGE 27

WINTER ESCAPEPAGE 18

MAKIN’ TRACKS

PAGE 5

ADULT TRIPMINNESOTA

PAGE 23

HABLAMOS ESPAÑOL

2 WSSRA.NET

WEST SUBURBAN SPECIAL RECREATION ASSOCIATION2915 Maple Street, Franklin Park, IL 60131

847.455.2100 (voice or TTY)Office Hours: 8:30 AM - 5:00 PM

Monday through Friday

The West Suburban Special Recreation Association is a part of your local park district or village recreation program. We provide recreation programs for adults and children who have a physical impairment, a mental disability, or any other type of disability. Your park district or village governs the operation of the Association. The partner districts and villages and their representative to our Board of Directors are listed below:

BOARD OF DIRECTORSBerwyn Park District ............................................................ Jeff JandaClyde Park District ............................................................. Alex RuedaVillage of Elmwood Park .......................................... John LannefeldPark District of Forest Park .............................................. Larry PiekarzPark District of Franklin Park ............................... Joseph D. ModrichVillage of Harwood Heights .................................Michael GadzinskiHawthorne Park District ............................................. Dennis RaleighNorridge Park District ................................................... Mark DeSalvoNorth Berwyn Park District ...................................... Joseph C. VallezPark District of Oak Park ...............................................Marty BraccoRiver Forest Park District .................................................. Mike Sletten

BOARD MEETINGSThe Board of Directors of the Association meets on the second Tuesday of the month 8 times per year at 7:00 PM. Call the office at 847.455.2100 for the location of the meetings. The public is invited to attend.

REGISTRATION UPDATEALL FALL 2011 REGISTRATIONS TAKEN ON AFIRST-COME, FIRST-SERVED BASIS, AS SOON AS YOU RECEIVE A BROCHUREFALL PHONE-IN REGISTRATION BEGINS ....................August 15, 2011FALL REGISTRATION ENDS ..................................September 15, 2011WINTER 2012 BROCHURES DISTRIBUTED ....after December 5, 2011The quickest way to register is by visiting wssra.net. Download the registration form, sign it and fax/scan/email to WSSRA.

Fall 2011 Photo by David Kindler

WSSRA and WHOLE FOODS MARKET join forces with

“ONE DIME AT A TIME” Visit the River Forest Whole Foods Market in July, August and September to support the ‘One Dime at a Time!’ program. By providing your own shopping bag at the grocery check-out, Whole Foods shoppers help the environment and support a local nonprofit agency. During July, August and September, Whole Foods will donate 10 cents to West Suburban Special Recreation Association for each bag a shopper brings to the check-out line. This donation to WSSRA supports therapeutic recreation services for individuals of any age with a disability or special education need from Oak Park, Forest Park, River Forest and eight other communities. Join us on Sunday, August 28 at 6pm for a FREE yoga class with CorePower Yoga. WSSRA and Whole Foods will be there to pass out FREE reusable shopping bags to increase awareness of our “One Dime at a Time” partnership and get people shopping to donate their dime back to WSSRA! Donations outside of the “One Dime at a Time” bag donations can also bemade that day to CorePower Yoga to benefit WSSRA.

BEAT THE PHONE RUSHFAX your registration today at 847.455.2157. Contact your local Park District for use of their FAX machine for your WSSRA registration. Por favor llame a la oficina de WSSRA y pregunte por Noelia o Aileen para Español. Tel: 847.455.2100. INDIVIDUALS WHO HAVE A HEARING IMPAIRMENT OR COMMUNICATION DISORDER CALL 847.455.2100 TO UTILIZE OUR TDD!

3 WSSRA.NET

James Lily enjoys the 2010 Makin Tracks 5K run and walk. Join us this year on September 17 at Concordia University to walk, run or wheel for fitness, fun & fundraising.

Cover photo by Antonio Perez

WSSRA STAFFTO BE ANNOUNCED .....................................................................Executive Director .................................................................................................Marianne Birko, CTRS, CPRP ..........226 ........................... Superintendent of Recreation .............................................. [email protected] A. Foster, APRP ....................238 ...................Superintendent of Safety & Operations ..................................................bobf@wssra.netMaryellen Bilek, MSW .....................228 ................................... Outreach Specialist .......................................................maryellenb@wssra.netSherry Scouffas ................................225 .................................... Outreach Specialist ................................................................sherrys@wssra.netGretchen Dennis, CTRS ..................219 ..................................... Inclusion Manager .........................................................gretchend@wssra.netMatt Barber, CPRP ...........................235 ............................. Human Resource Manager ......................................................... [email protected] Krawiec .................................231 ..................................... Program Manager ................................................................dawnk@wssra.netAhren Hoffman ................................234 .................................Recreation Coordinator ...........................................................ahrenh@wssra.netAnnie Lhotka ....................................230 .................................Recreation Coordinator .............................................................anniel@wssra.netApril Ryan .........................................240 ................................... Recreation Specialist ..................................................................aprilr@wssra.netAmy Mepham, CTRS ......................232 ................................... Recreation Specialist ...............................................................amym@wssra.netKristy Dacanay ................................224 ........................................ Lekotek Leader .....................................................................kristyd@wssra.netLisa Gershak ....................................221 ......................................Finance Manager .....................................................................lisag@wssra.netNoelia Hernandez ...........................222 ...............................................Registrar ............................................................................nolyh@wssra.netAileen Maldonado .........................220 ................................. Administrative Assistant ..........................................................aileenm@wssra.netLuz Rocha-Serrano .........................245 .......................................... WSSRA DriverLarry Feldt .........................................245 .......................................... WSSRA DriverJoe Wolfe ..........................................245 .......................................... WSSRA DriverMike Zych .........................................245 .......................................... WSSRA Driver

WSSRA Staff

TABLE OF CONTENT CHILDREN 8-9 SCHOOL AGE 10-14 SPORTS AND FITNESS 15-19 TEENS & YOUNG ADULTS 20-22 OLDER ADULTS 23 SPECIAL EVENTS 27-28

KEY TO ABBREVIATIONSADD: Attention Deficit Disorder

ADHD: Attention Deficit Hyperactivity Disorder

ALZ: Alzheimer’s

AUT: Autism

BD: Behaviour Disorder

DD: Developmental Disability

EC: Early Childhood

HI: Hearing Impairment

LD: Learning Disability

MI: Mental Impairment

MLH: Mental Health

PI: Physical Impairment

SL: Speech & Language Delay

VI: Visual Impairment

WWW.WSSRA.NETCheck out the WSSRA web site for up to

date program information. E-Mail your comments to us: [email protected]

WSSRA’s FALL program session is 8 – 9 weeks in length for most programs. FALL programs

begin September 26. Please consult each program description in

this brochure for exact times and days.

$PPT WSSRA

Transportation

Transportation by Pick Up Point

Bring Extra Money to Program

FOLLOW US ON:

4 WSSRA.NET

“FUN IN THE SUN”Send a kid to camp campaing!

WSSRA raises funds with the help of local restaurants and bar owners and their customers. This year’s competition raised over $3,600 in scholarship funds to help send a child to camp. The Champion is “Jimmy’s Place” of Forest Park raising $1,000 with Twin Gyros of Harwood Heights a close second bringing in $910. A special thanks to all of the establishments and customers for supporting this year’s fundraiser. It will help fund more kids going to camp next summer!

BERWYNHavlicek School6401 15th St. .......................................708.795.2450Jefferson School7035 16th St. .......................................708.795.2454Liberty Recreation Center6445 W. 27th Pl ...................................708.795.2891Morton West High School 2400 Home .........................................708.222.5700North Berwyn Park District16th & Wesley ....................................708.749.4900PAV Berwyn YMCA2947 S. Oak Park Ave .......................708.749.0606Proksa Park3001 Wisconsin...................................708.795.2892

CICEROCicero Community Center 2250 49th Ave ....................................708.477.6308Cicero West School4937 W. 23rd St. .................................708.780.4487Clyde Park District Stadium1909 S. Laramie .................................708.652.3545Columbus West School 5425 W. 31st........................................708.780.4482Duck Pond Pool5105 31st St .........................................708.863.4112Hawthorne Park District5200 W. 29th Pl ...................................708.863.6511Morton East High School2423 S. Austin Blvd .............................708.222.5264Roosevelt School1500 S. 50th Ave ................................708.652.7833Unity East School 2115 S. 54th Ave ................................708.863.8229Town Hall Bowl5025 25th St. .......................................708.863.0300Warren Park1225 S 60th Ct ....................................708.863.2220

ELMWOOD PARKElmwood Park Recreation Center2 Conti Parkway ................................708.452.3935Elmwood Park Family Aquatic Center2 Conti Pkwy. .....................................708.452.3935

FOREST PARKCircle Lanes7244 Circle ..........................................708.366.2810Field Stevenson School925 Beloit ............................................708.366.5703Park District of Forest Park7501 Harrison ......................................708.366.7500Forest Park Middle School925 Beloit ............................................708.366.5703

FRANKLIN PARKCentre at North Park Banquet Hall10040 Addison St. ..............................847.928.8478Enger School10401 W Grand ................................847.455.5299Franklin Park Community Center9560 Franklin ......................................847.455.2852Franklin Park Ice Arena9711 Waveland ................................847.671.4755Karate for Kids10125 W. Grand ...............................847.349.5425WSSRA Office2915 Maple St. ..................................847.455.2100

HARWOOD HEIGHTSHarwood Heights Village Hall7300 Wilson ........................................708.867.7200

NORRIDGENorridge Park District4631 N. Overhill .................................708.457.1244

OAK PARKAscension Church601 Van Buren ...................................708.848.2703Barrie Recreation CenterGarfield & Lombard .........................708.383.6905Carroll Recreation Center1125 S. Kenilworth .............................708.383.6906Field Recreation Center935 Woodbine Ave. .........................708.383.6907Fox Recreation CenterOak Park & Jackson .........................708.383.6908Irving School1125 S. Cuyler Ave ............................708.524.3090Longfellow Recreation CenterRidgeland & Adams .........................708.383.6909Longfellow School610 Highland ......................................708.524.3060Mann School921 N. Kenilworth ...............................708.524.3084Oak Park River Forest High School Lake & Scoville ..................................708.383.0700Rehm Pool515 Garfield St ...................................708.848.9661Whittier School715 N. Harvey ...................................708.524.3080

OTHERBushwood Golf in Maywood30 W Madison ....................................708.344.2700Mannheim Middle School2600 Hyde Park Avenue ..................847.455.5020

See www.wssra.net for directions.

Program Locations

5 WSSRA.NET

YOU CAN SUPPORT WSSRA WHILE HAVING FUN AT THE ANNUAL MAKIN’ TRACKS 5K RUN/WALK:Saturday, September 17 @8:00am @Concordia University, 7400 Augusta Street, River Forest, Illinois 60305

For more information, please visit the River Forest Park District’s website at www.rfparks.com or call 708-366-6660

All net proceeds to support the West Suburban Special Recreation Association to provide superior recreation services for adults and children who have a physical impairment, developmental delay or any other type of disability.

NEW MEMBERSThe WSSRF welcomes new members. Please consider joining! No one on the Foundation is asked to do more than they can handle, yet by working together, WSSRF raises $20,000 each year to support WSSRA programs. At each meeting, Foundation members have the opportunity to give input and ideas about program offerings. So come join the fun and help WSSRF improve and expand programs for persons of all ages with disabilities. Call Sherry Scouffas at 847.455.2100 ext. 225 to learn more.

The WSSRF needs you!

WSSRA is looking for energetic & caring staff and volunteers to assist in recreation programs for individuals with disabilities. You will:• Meet new people while participating in fun recreation activities. • Enjoy personal growth. • Have a flexible schedule (morning, afternoon, evening & weekend hours available). • Gain leadership skills. • Enhance self-esteem by being part of a team that brings out the best in everyone.

For more information call 847.455.2100 or visit www.wssra.net.

Get Involved

Calendar of Events - Fall 2011SPEC

IAL EVEN

TSM

ON

DAY

TUESDAY

WEDN

ESDAY

THURSDAY

FRIDAY

SATURDA

Y

TRIP TO DISNEYJanuary 15 – 19, 2012

ADULT TRIP TO M

INNESOTASeptem

ber 13 – 16

MAKIN’ TRACKS

September 17

Concord

ia University, 7400 A

ugusta Street, River Forest, Illinois 60305

WSSRF BEARS PARTY

Sun. Nov., tentative

Jimm

y’s, Place, Forest Park

WSSRF BOW

L-A-THON Sund

ay, January 2012

SEASPAR SWIM

MEET

Saturday, N

ov. 19, 20117:30am

– 1:00pmD

owners G

rove South High School

FVSRA SWIM

MEET

Saturday, D

ec.3, 201110:00am

– 2:00pm

Norris Rec. C

enter, St. Charles

SANTA’S POLAR EXPRESSSaturd

ay, Decem

ber 3, 201112:25 – 3:30pm

HOLIDAY HULLABALOO9:00 – 3:00pmM

onday, D

ecember 20

Tuesday, D

ecember 21

Wed

nesday, D

ecember 22

Tuesday, D

ecember 27

Wed

nesday, D

ecember 28

Thursday, D

ecember 29

Carroll Recreation C

enter

BOBCATS SPORTS BANQUET6:00 – 9:00pmFrid

ay, September 16, 2011

Centre at N

orth Park Banquet Hall, Franklin Park

HEALTHY START10:00 – 11:30amFranklin Park C

omm

unity Center

DANCE MANIA

2:45 – 4:00pmC

olumbus W

est School, Cicero

WALK-N-DINE

9:30am – 12:30pm

Weekly location varies

YOGA

10:00 – 11:30amV

illage of Harwood

HeightsSession 1: Sept. 21 – O

ct. 25Session 2: N

ov. 1 – Dec. 6

WILD CARD

WEDNESDAYS

9:30am – 12:30pm

PDFRP

MIGHTY M

OVERS11:45 – 1:15pmEPC

C

HORMIGAS

2:50 – 4:00pmD

rexel

ADAPTED BOWLING

12:00 – 2:00pmBrunsw

ick Zone, River Grove

TOWERS SOCIAL

12:30 – 2:30pmFranklin Tow

ers

SENSATIONAL SATURDAYS9:00 – 11:30amN

orridge Park D

istrict

SATURDAY FUN CLUB9:00 – 11:30amC

arroll Center, O

ak Park

OUTDOOR ADVENTURES9:30am

– 12:30pmPark D

istrict of Forest Park Bldg #4

PARALYMPIC

SPORTS SAMPLER

10:30 – noonLiberty C

enter

TUMBLING INTO FUN

3:15 – 4:30pm

Jefferson School, Berwyn

WE’VE GOT TALENT

2:45 – 4:15pmM

orton West High School

EXPLORE THE ARTS

3:45 – 5:15pmBarrie C

enter

AUTISM M

OVEMENT

THERAPY3:30 – 4:10pmBarrie C

enter

YOGA FOR ALL


enter

LEGACY SPORTS

3:30 – 5:00pm

BERWYN SPORTS

GALORE3:00 – 4:30pmHavlicek School, Berw

yn

WEDNESDAY HI

EXPLORERS CLUB 3:30 – 6:00pmHaw

thorne Park District

¡SALTA!2:50 – 4:00pmW

arren Park School, Cicero

WSSRA’s M

IX IT UP

3:15 – 4:30pm

Enger School

MIGHTY M


C

SUPER BOWLERS

3:45 – 5:15pmC

ircle Bowl

WEST SUBURBAN FC

3:45 – 5:15pmPark D

istrict of Forest Park

CREATIVE MOVEM

ENT3:45 – 4:45pmN

orridge Park D

istrict, G

reen Room

SWIM

LESSONS

3:10 – 3:40pm3:45 – 4:15pm4:20 – 4:50pm4:55 – 5:25pm5:30 – 6:00pmPA

V YM

CA

, Berwyn

JR. BULLS12:00 – 2:00pmA

dd

ison

SUPER SATURDAYS12:15 – 2:45pmC

arroll Center, O

ak Park

SATURDAY BOWLING

LEAGUE1:00 – 3:00pmC

ircle Bowl, Forest Park

SWIM

LESSONS 6:15 – 6:45amO

PRFHS-Girl’s Pool

ADVANCED SWIM

MERS

6:15 – 6:55amO

PRFHS-Girl’s Pool

STINGRAY SWIM

TEAM

7:00 – 8:10pm

(7:05 – 8:10-pool time)

OPRFHS-G

irls Pool

AQUA ATHLETICS

8:15 – 9:00O

PRFHS – Girls pool

BOBCATS PRE-SEASON BASKETBALL7:00 – 8:30pmUnity

WEEKLY W

ORKOUT

7:00 – 8:15pmPark D

istrict of Franklin Park

TAE KWON DO

7:15 – 8:00pm

Karate for Kids, Franklin Park

ZUMBA

7:15 – 8:30pmC

icero Com

munity C

enter

SWIM

LESSONSA

ll ages7:30 – 8:15pm

M

annheim M

idd

le School

WINNER TAKES ALL

6:00 – 8:30pmW

SSRA O

ffice

STAY IN THE GAME

6:15 – 7:15pmBushw

ood G

olf Dom

e

SWIM

LESSONS6:30 – 7:30pm

All ages

Morton East High School

NOW W

E’RE COOKIN’!7:00 – 8:30pmTBA

MANGIAM

O


enter Oak Park

FRIDAY SHOW TIM

E

Barrie Center, O

ak Park

SPLASHTASTIC FAM

ILY SWIM

6:00 – 7:30pmM

annheim Jr High School,

Melrose Park

HOT SHOTS CARROLL CITY SLICKERS BARRIE6:00 – 9:00pm

varies weekly

SOCIALITES CARROLL M

OONLIGHTERS BARRIE6:00 – 9:00pm

varies weekly

7 WSSRA.NET

Calendar of Events - Fall 2011SPEC

IAL EVEN

TSM

ON

DAY

TUESDAY

WEDN

ESDAY

THURSDAY

FRIDAY

SATURDA

Y

TRIP TO DISNEYJanuary 15 – 19, 2012

ADULT TRIP TO M

INNESOTASeptem

ber 13 – 16

MAKIN’ TRACKS

September 17

Concord

ia University, 7400 A

ugusta Street, River Forest, Illinois 60305

WSSRF BEARS PARTY

Sun. Nov., tentative

Jimm

y’s, Place, Forest Park

WSSRF BOW

L-A-THON Sund

ay, January 2012

SEASPAR SWIM

MEET

Saturday, N

ov. 19, 20117:30am

– 1:00pmD

owners G

rove South High School

FVSRA SWIM

MEET

Saturday, D

ec.3, 201110:00am

– 2:00pm

Norris Rec. C

enter, St. Charles

SANTA’S POLAR EXPRESSSaturd

ay, Decem

ber 3, 201112:25 – 3:30pm

HOLIDAY HULLABALOO9:00 – 3:00pmM

onday, D

ecember 20

Tuesday, D

ecember 21

Wed

nesday, D

ecember 22

Tuesday, D

ecember 27

Wed

nesday, D

ecember 28

Thursday, D

ecember 29

Carroll Recreation C

enter

BOBCATS SPORTS BANQUET6:00 – 9:00pmFrid

ay, September 16, 2011

Centre at N

orth Park Banquet Hall, Franklin Park

HEALTHY START10:00 – 11:30amFranklin Park C

omm

unity Center

DANCE MANIA

2:45 – 4:00pmC

olumbus W

est School, Cicero

WALK-N-DINE

9:30am – 12:30pm

Weekly location varies

YOGA

10:00 – 11:30amV

illage of Harwood

HeightsSession 1: Sept. 21 – O

ct. 25Session 2: N

ov. 1 – Dec. 6

WILD CARD

WEDNESDAYS

9:30am – 12:30pm

PDFRP

MIGHTY M


C

HORMIGAS

2:50 – 4:00pmD

rexel

ADAPTED BOWLING

12:00 – 2:00pmBrunsw

ick Zone, River Grove

TOWERS SOCIAL

12:30 – 2:30pmFranklin Tow

ers

SENSATIONAL SATURDAYS9:00 – 11:30amN

orridge Park D

istrict

SATURDAY FUN CLUB9:00 – 11:30amC

arroll Center, O

ak Park

OUTDOOR ADVENTURES9:30am

– 12:30pmPark D

istrict of Forest Park Bldg #4

PARALYMPIC

SPORTS SAMPLER

10:30 – noonLiberty C

enter

TUMBLING INTO FUN

3:15 – 4:30pm

Jefferson School, Berwyn

WE’VE GOT TALENT

2:45 – 4:15pmM

orton West High School

EXPLORE THE ARTS


enter

AUTISM M

OVEMENT

THERAPY3:30 – 4:10pmBarrie C

enter

YOGA FOR ALL


enter

LEGACY SPORTS

3:30 – 5:00pm

BERWYN SPORTS

GALORE3:00 – 4:30pmHavlicek School, Berw

yn

WEDNESDAY HI

EXPLORERS CLUB 3:30 – 6:00pmHaw

thorne Park District

¡SALTA!2:50 – 4:00pmW

arren Park School, Cicero

WSSRA’s M

IX IT UP

3:15 – 4:30pm

Enger School

MIGHTY M


C

SUPER BOWLERS

3:45 – 5:15pmC

ircle Bowl

WEST SUBURBAN FC

3:45 – 5:15pmPark D

istrict of Forest Park

CREATIVE MOVEM

ENT3:45 – 4:45pmN

orridge Park D

istrict, G

reen Room

SWIM

LESSONS

3:10 – 3:40pm3:45 – 4:15pm4:20 – 4:50pm4:55 – 5:25pm5:30 – 6:00pmPA

V YM

CA

, Berwyn

JR. BULLS12:00 – 2:00pmA

dd

ison

SUPER SATURDAYS12:15 – 2:45pmC

arroll Center, O

ak Park

SATURDAY BOWLING

LEAGUE1:00 – 3:00pmC

ircle Bowl, Forest Park

SWIM

LESSONS 6:15 – 6:45amO

PRFHS-Girl’s Pool

ADVANCED SWIM

MERS

6:15 – 6:55amO

PRFHS-Girl’s Pool

STINGRAY SWIM

TEAM

7:00 – 8:10pm

(7:05 – 8:10-pool time)

OPRFHS-G

irls Pool

AQUA ATHLETICS

8:15 – 9:00O

PRFHS – Girls pool

BOBCATS PRE-SEASON BASKETBALL7:00 – 8:30pmUnity

WEEKLY W

ORKOUT

7:00 – 8:15pmPark D

istrict of Franklin Park

TAE KWON DO

7:15 – 8:00pm

Karate for Kids, Franklin Park

ZUMBA

7:15 – 8:30pmC

icero Com

munity C

enter

SWIM

LESSONSA

ll ages7:30 – 8:15pm

M

annheim M

idd

le School

WINNER TAKES ALL

6:00 – 8:30pmW

SSRA O

ffice

STAY IN THE GAME

6:15 – 7:15pmBushw

ood G

olf Dom

e

SWIM

LESSONS6:30 – 7:30pm

All ages

Morton East High School

NOW W

E’RE COOKIN’!7:00 – 8:30pmTBA

MANGIAM

O


enter Oak Park

FRIDAY SHOW TIM

E

Barrie Center, O

ak Park

SPLASHTASTIC FAM

ILY SWIM

6:00 – 7:30pmM

annheim Jr High School,

Melrose Park

HOT SHOTS CARROLL CITY SLICKERS BARRIE6:00 – 9:00pm

varies weekly

SOCIALITES CARROLL M

OONLIGHTERS BARRIE6:00 – 9:00pm

varies weekly

REGISTRATIONAny cancellations for FALL programs will be accepted through September 15, 2011 and credit will be issued. Any cancellations after September 15, 2011 participants will be charged full program fee. Any unpaid balance will restrict participation in future programs.

CLOSED PROGRAMSIf a program closes because we have reached maximum enrollment, you will be put on a waiting list once we receive your signed registration form and contacted if additional space is available.

CANCELLED PROGRAMSA. If there is low enrollment, a program may be cancelled. A program reimbursement or credit will be issued.B. If a program is cancelled because of unforeseen circumstances you

will be contacted at the soonest possible time.C. A program credit will not be issued for weather related cancellations.

Programs will be made up at the end of season whenever possible.D. No program credits issued for sports tournament cancellations.

REFUNDSRefunds will only be issued when the registrant cannot participate for extended medical reasons and/or hospitalization verified by a physician. For the majority of the season the refund/credit will be prorated. Call for more information. 847.455.2100.

PAYMENT POLICYPayment of program fees is due upon registration unless other arrangements are made. Statements are mailed out the first week of the program season (4 times per year). Call the Finance Manager to arrange a payment plan, Monday through Thursday, 8:30 AM to noon. A participant cannot register for the next season until balance from previous season is paid.

RETURNED CHECK POLICYA $20.00 fee will be charged for any checks returned to WSSRA. The $20.00 fee, as well as the balance, will need to be paid before registering for future programs.

SCHOLARSHIP REQUESTWSSRA is in a position to offer scholarships to WSSRA residents for a percentage of fees for two programs each season. Persons requesting a scholarship must complete a scholarship application, which will be mailed to you upon request. Scholarship applications need to be filled out once a year. If you are interested in a scholarship, check the box on the registration form: Request Scholarship. All scholarship applications must be completed and in the WSSRA office by September 15, 2011.

NON-RESIDENT POLICYWSSRA programs are limited to people who live in the WSSRA partner districts and villages. If you live outside the WSSRA communities and are interested in participating in a special recreation program, call your park district or village recreation department. Call the WSSRA Outreach Specialists for more information.

PARTICIPANT ABSENCEIf you or your child are not going to attend a recreation program that you are registered for, please notify WSSRA office 847.455.2100 AS SOON AS POSSIBLE! Please leave a message on Voice Mail after hours.

PARTICIPANT ILLNESSFor the protection of all the participants in programs, you/your child must be kept at home or will be sent home if he/she shows any of the following symptoms:• A temperature of over 100.3.• Stomach ache accompanied by diarrhea or vomiting.• Any undiagnosed rash.• Sore or discharging eyes or ears.• Profuse nasal discharge (green or yellow). Please keep children with

active colds home.• Have a highly contagious condition such as chicken pox, measles,

lice, etc.

MEDICATIONIt is the parent/guardian and participant’s responsibility to inform WSSRA of any medication a participant is taking. This information is very important in case of an emergency. Medication information should be noted on the registration forms, as well as the Annual Information Form. Any changes in medication should be communicated to WSSRA.

INSURANCEThe Association takes every reasonable precaution to prevent injuries and accidents from occurring. However, if an accident does occur or if you or your child is injured, you are solely responsible for any costs incurred or caused by an injury that happens in an Association program.

SAFETY PRECAUTIONSSome participants in WSSRA programs and special events may be carriers of infectious disease(s). Staff and volunteers have been provided in-service training concerning proper hygienic procedures. WSSRA seeks to provide a safe environment for all of our participants, staff volunteers and the public. If you have any specific questions, please call the WSSRA Executive Director or Superintendent of Safety & Operations at 847.455.2100.

REVISED LATE PICK-UP/DROP-OFF POLICYIn order to be fair to our participants, program staff and drivers, WSSRA has enacted a Late Pick-up/Drop-off Policy. Many of our program staff and drivers need to get to a program immediately after the program your child is in. We ask that you make sure you are on time picking up your child from program, as well as, home to greet your child when the WSSRA van drops them off.

A $10.00 fee will be charged for every 15 minutes or portion thereof, a participant is picked up late, or a van is delayed, after a 10 minute grace period. A notice will be sent to you indicating the fee being charged to your account.

Also, participants must be dropped off on time for programs that are travelling, including over night trips. Vans will not wait more than 5 minutes for participants who are late for the program.

Saturday morning programs - Parents must drop off their child by 9:30 AM or call the emergency phone. If the program is travelling, the van will not wait longer than 5 minutes past the program start time.

WSSRA Program Policies

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SATURDAY FUN CLUBAge: 3-6 yearsTime: 9:00-11:30 AMLocation: Carroll CenterFee: $10.40 week / $83.20 season

SENSATIONAL SATURDAYS Age: 3-11 yearsTime: 9:00-11:30 AMLocation: Norridge Park District Fee: $10.40 week / $83.20 season

SUPER SATURDAYSAge: 7-11 yearsTime: 12:15-2:45 PMLocation: Carroll CenterFee: $10.40 week / $83.20 season

Children

Date: SATURDAY FUN CLUB:October 1 ........................................404-01October 8 ........................................ 404-02October 15 .......................................404-03October 22 ......................................404-04October 29 ......................................404-05November 5 .................................... 404-06November 12 ...................................404-07November 19 ...................................404-08

SENSATIONAL SATURDAYS:......................................................................405-01......................................................................405-02......................................................................405-03......................................................................405-04......................................................................405-05......................................................................405-06......................................................................405-07......................................................................405-08

SUPER SATURDAYS:................................................................. 406-01................................................................. 406-02................................................................. 406-03................................................................. 406-04................................................................. 406-05................................................................. 406-06................................................................. 406-07................................................................. 406-08

ALL ABILITIESParticipants will enjoy Saturdays filled with music, games, crafts and much more. Register for one or all eight weeks. Dress for indoor & outdoor play.

REGISTRATIONNUMBER DATE ACTIVITY

-01 10/01 Planes, Trains, & Automobiles- Choo! Choo! All aboard - today it’s all about modes of transportation with planes, trains & cars!

-02 10/08 Messy/Goopey Day- We’re getting messy today! Let’s finger paint, plant some flowers and make something fun & gooey. Special Notes: dress for mess

-03 10/15 Ocean, Earth, & Outer Space- Learn about our atmosphere. We’ll be doing all sorts of ocean, earth &

space crafts & games!

-04 10/22 All Fun & Games- Let’s get active. We’re going to be playing fun games & learning new sports.

-05 10/29 Hallowscream Party- Wear your costume & go trick or treating at program! We’ll end with a Halloween pinata! Special Notes: wear a costume; you may bring a sealed treat

-06 11/05 Sensory Station- Jump, roll & skip through an obstacle course that we’ll make! Today will be packed

with sensory stimulations!

-07 11/12 The Circus is Coming to Town- Let’s walk the tightrope and tame wild lions! Today - we’ll sing & play the circus way! Special Notes: dress for mess

-08 11/19 Superheros- Grab your cape & help clean up the city! We’ll be using our superpowers to create a

sensational Saturday!

9 WSSRA.NET

LEKOTEKALL ABILITIESWSSRA’s Lekotek is a toy lending library and resource for family play. Families meet for a one hour play session each month guided by a certified Lekotek leader. Families have the opportunity to borrow from our inventory of over 2,000 toys including adapted toys which makes play possible for all kids. Lekotek offers:• Relaxing, guided play sessions. • Home loan of up to six toys monthly.• Opportunities to focus on the abilities of children.• Positive parent/child interactions that increase skills.• Self-esteem building.• Sibling play and fun.Monthly play sessions take place at the WSSRA office, North Berwyn Park District, or Irving School in Berwyn. Call Kristy(Spanish speaking) or Ahren at 847.455.2100 for details and to schedule your first play session. Schedule now for play sessions beginning in September.Age: birth to 6 yearsFee: $60–$175 based on family size and income (this includes 6 toys per session, up to 9 play sessions and toy deposit)Registration Number: 400

ChildrenMIGHTY MOVERS

ALL ABILITIESLASEC and Elmwood Park Early Childhood students can get movin’ at Mighty Movers! This program will provide your child with lots of fun through active games, songs, and crafts. A snack will be provided at program.

Transportation to the program may be available. WSSRA staff will walk EPECC students to program.Upon the conclusion of the program parents will pick-up their children at the Elmwood Park Recreation Center.

Age: 3-7 YearsDate: Thursdays, Sept 29 - Nov 17Times: 418-01 11:45-1:15 PM 418-02 3:45-5:15 PMLocation: Elmwood Park Recreation CenterFee: $3.10 each week ($24.80 / 8 week session)Pick Up Point Trans: $1.40 each week($11.20 / 8 week session)Registration Number: 418

CREATIVE MOVEMENTALL ABILITIES - ELMWOOD PARK AND LASEC STUDENTS ONLYDon’t miss this opportunity to have your child enjoy some fun with friends after school. Participants will run, jump and tumble to music.

This program is only offered to Elmwood Park & LASEC students. The program will begin immediately following your child’s school day. Transportation may be available to the program. Upon the conclusion of the program parents will pick-up their children at the Norridge Park District.

Age: 3 - 7 YearsDate: Fridays, Sept 30 - Nov 18Time: 3:45-4:45 PMLocation: Norridge Park District, Green RoomFee: $20.00 Trans to Program: $11.00Registration Number: 411

TUMBLING INTO FUNALL ABILITIESLog rolls, crab walks, cartwheels, somersaults, running, jumping and playing are all a part of the fun at Tumbling Into Fun! Participants will enjoy a craft and snack while at program too.

Upon the conclusion of the program parents will pick-up their children at Jefferson school.

Age: 3 - 6 YearsDate: Mondays, Sept 26 - Nov 21 (no program Oct 10)Time: 3:15-4:30 PMLocation: Jefferson School, BerwynFee: $20.00Registration Number: 414

10 WSSRA.NET

School-AgedAUTISM MOVEMENT

THERAPY® ALL ABILITIESJoin this innovative and creative program that is all the rage! Participants will use movement and music to dance while developing skills like balancing, coordination, sequencing, and much more without even knowing it! WSSRA’s April Ryan, is a certified Autism Movement therapist. Go to autismmovementtherapy.com for more insight on this program. STAY FOR YOGA AFTER THIS PROGRAM!

Age: 7-15 YearsDate: Tuesdays, Sep 27 - Nov 22 (no program Nov 8)Time: 3:30-4:10 PMLocation: Barrie Center, Oak ParkFee: $22.50Transportation to program only: $24.20Registration Number: 412

SIGN UP FOR YOGA FOR ALL TOO!

YOGA FOR ALLALL ABILITIESParticipants will be introduced to simple yoga positions, meditative practice & stretching exercises in a fun, playful environment. The program’s focus will be on:• Body control• Gaining flexibility• Gaining strength

Age: 7-15 YearsDate: Tuesdays, Sept 27 - Nov 22 (no program Nov 8)Time: 4:15-5:00 PMLocation: Barrie Center, Oak ParkFee: $22.50Transportation to home only: $24.20Registration Number: 409

TAE KWON DO ALL ABILITIESThis introductory class is designed to captivate the interest of our youngest student. Karate for Kids teaches the American Tae Kwon Do Association curriculum. It is based on the concepts of positive mental attitude and high goal setting. Building blocks for this system include the following:

•Goals •Self-control •Courtesy •Integrity •Friendship •Confidence •Self-awareness •Self-Esteem •Perseverance •Self Improvement •Respect •Dedication

A uniform is required for all new students. (Additional one time fee of $40 for uniform) Age: 9-14 YearsDate: Tuesdays, Sept 27 - Nov 29 (no program Oct 25)Time: 7:15-8:00 PMLocation: Karate for Kids 10125 W. Grand Avenue, Franklin ParkPick up Point: North Berwyn Park DistrictDrop off time: 6:30 PM Pick up time: 8:30 PMFee: $60.00 Pick up Point Trans: $22.00Registration Number: 413

SPLASHTASTIC FAMILY SWIMATTENTION! MOMS, DADS, SIBLINGS- GRAB YOUR SWIMSUITS AND TOWELS!One adult (18 years +) per 2 children must accompany them in the pool.

Join us for a splash-tastic time in the water! This is a great opportunity for water interaction and family fun!

Dates: Fridays Sept 30, Oct 14, 28, Nov 4, 18Time: 6:00-7:30 PMLocation: Mannheim Middle School PoolFee: $5 per family of 4 ($2/additional person) each swim sessionRegistration Number: 493

The purpose of this phone number is to allow access to WSSRA for emergencies only during non-office hours.

1. The phone may be called Monday through Friday, from 5:00 PM to 11:00 PM, Saturday, 7:00 AM to 11:00 PM when programs are in session only.

2. Leave a message with your phone number at 847.833.9611 and a WSSRA staff will return your call.

3. The emergency phone should not be a substitute for calling the office for non-emergency questions, such as pick up times.

EMERGENCYPHONE

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SWIM LESSONSALL ABILITIESWSSRA Swim Lessons are based on a skill development program through the American Red Cross. All skills will be taught in a progression. Bring suit and towel. Parents are responsible for changing child before and after lesson. Participants are limited to one lesson per season. Lessons are designed to be appropriate for specific age groups as well as skill level.

PLEASE NOTE: ANYONE WITH POSSIBLE INCONTINENCE MUST WEAR PROTECTIVE PANTS UNDERNEATH THEIR SWIMSUITS. This is for everyone’s health & safety. If your child is wearing a swim diaper, the public health code requires them to wear rubber pants in addition to the diaper. Any problems in this area with your child could risk your child’s ability to participate in this program. If you have any questions, please contact us at 847.455.2100. Thank you for your attention and support.

Age: 3 years & older, Preschoolers are welcome!

REGISTRATION NUMBER DAY TIME DATES AGE FEE

OAK PARK RIVER FOREST HIGH SCHOOL, OAK PARK

451-01 Mondays 6:15-6:55 PM Sept 26 - Nov 21(no program Oct 10)

advanced swimmers only - must swim 1 length of pool

$36.00

451-02 Mondays 6:15-6:45 PM Sept 26 - Nov 21(no program Oct 10)

all ages $30.00

MANNHEIM MIDDLE SCHOOL, MELROSE PARK

451-03 Wednesdays 7:30-8:15 PM Sept 28 - Nov 16 all ages $37.50

MORTON EAST HIGH SCHOOL, CICERO (NOT ACCESSIBLE)

451-04 Thursdays 6:30-7:00 PM Oct 13 - Dec 8(no program Nov 24)

all ages $30.00

451-05 Thursdays 7:00-7:30 PM Oct 13 - Dec 8(no program Nov 24)

all ages $30.00

PAV YMCA, BERWYN

451-06 Fridays 3:10-3:40 PM Sept 30 - Nov 18(no program Oct 28)

3-4 years old $28.00


6 & under $28.00


6 & under $28.00


7 & up $28.00


7 & up $28.00

School-Aged

12 WSSRA.NET

School-Aged

REGISTRATIONNUMBER DATE DROP OFF &

PICK UP TIMES ACTIVITY DESTINATION FEE

431-01 10/01 9:30am-12:30pm

No Couch Potatoes!- Let’s celebrate Child Health Day and get active! We will have a nutritious snack and play active games to keep us moving during Outdoor Adventures.

Forest Park, Building #4

$13.70

Special Notes: dress for the weather431-02 10/08 9:30am-

12:30pmFall into the Season- We are taking a trip to Cantigny for their Fall Festival. Celebrate Autumn with harvest time fun.

Cantigny,Wheaton, IL

$13.70

Special Notes: dress for the weather431-03 10/15 9:30am-

12:30pmSweet Tooth- Happy Sweetest Day! We are going to celebrate Willy Wonka style and make and eat our own candy.

Forest Park,Building #4

$13.70

Special Notes: note allergies 431-04 10/22 9:30am-

12:30pmMaze ‘N Seek- Ready or not, here we come... to the Morton Arboretum! Take a walk through the many mazes and check out the awesome children’s garden!

Morton Arboretum,Lisle

$13.70

Special Notes: dress for the weather; wear comfortable walking shoes431-05 10/29 9:30am-

12:30pmWhy did the ghost need a bandaid?- ‘Cause he had a boo boo! Wear your favorite Halloween costume and practice your ‘Monster Mash’ for the spook-tacular Halloween party!


$13.70

Special Notes: wear your favorite Halloween Costume!431-06 11/05 9:30am-

12:30pmPonies, Pumpkins and Hayrides, Oh My!- Today we are traveling to Sonny Acres to explore all of the fun things to do... petting zoo, dizzy zone, haunted barn, kiddie koral, wagon ride and so much more!

Sonny Acres,West Chicago

$13.70

Special Notes: dress for the weather; wear comfortable walking shoes431-07 11/12 9:30am-

12:30pmStrrrrrriiiiiiiiiike!- Get your arm ready ‘cause we’are goin’ bowlin’ at Brunswick Zone!

Brunswick Zone,River Grove

$13.70

Optional: Bring your bowling ball and shoes. Bring money for concession stand.431-08 11/19 9:30am-

12:30pmCornucopia of Fun- Join us in an early Thanksgiving celebration of food, friends and fun. Of course we’ll take a walk following our feast.


$13.70

Special Notes: note any food allergies

Registration Number: OUTDOOR ADVENTURESMI, DD, LD, VIJoin us for a Saturday morning of thrills and excitement as we explore our communities with a special focus on our environment! Register for one or all exciting events. Van will not wait longer than 5 minutes past start time for travelling programs.

Age: 12-22 yearsDate: SaturdaysLocation: Park District of Forest Park, Building #4

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EXPLORE THE ARTSALL ABILITIESGrab a brush, sponge or even use your fingers to paint! Build a pot with clay or create a collage. Add some music and we’ll be dancing, there’s no limit to the elements we will explore including art, music & dance.

Age: 3-11 YearsDate: Mondays, Sept 26 - Nov 21 (no program Oct 10)Time: 3:45-5:15 PMProjected Location: Barrie Center, Oak ParkFee: $24.00 Trans: $48.40Registration Number: 407

¡SALTA!LD, BD¡Saltamos! Everybody jump! Jump, dance, run, and play along to music and games after school. Participants will also enjoy a light snack.

Students will be bussed home by District 99 at 4:00 PM. Participation numbers are limited. Call for registration information.

Age: 6-10 YearsLocation: Warren Park School, CiceroTime: 2:50-4:00 PMDate: Wednesdays, Oct 12 - Nov 30 (no program Nov 2, 23)Fee: $12.10Registration Number: 421

WE’VE GOT TALENT!ALL ABILITIESThe WSSRA talent search has begun! Come join us for some fun. We’ll be learning new dance moves, enjoying karaoke & creating through improvisation. A light snack will be provided. Door to door transportation available home only.

Age: 11-22 YearsLocation: Morton West High SchoolTime: 2:45-4:15 PMDate: Mondays, Oct 17 - Dec 5Fee: $16.15 Trans: $16.15Registration Number: 416

DANCE MANIAColumbus West Students Only - MI, AUT, DDCome join us after a long day at school as we get up and DANCE! We’ll learn new moves and play games. Come prepared for crafts & dancing. A light snack will be provided.

Students will be transported home by District 99 at 4:00 PM.Age: 7-14 YearsLocation: Columbus West School, CiceroTime: 2:45-4:00 PMDate: Mondays, Oct 17 - Dec 5Fee: $16.15Registration Number: 420

WEST SUBURBAN FCTMI, AUT, MI, DDLove the game of soccer? Then come play with us. We will follow the rules of Special Olympic soccer in this training program. The participants will have the opportunity to learn:• Eye, hand and foot coordination• Ball handling• Kicking techniques• Stretching and strength training• Basic rules of soccerWe will put our skills to the test in a scrimmage at the end of each practice.

Age: 13 years and upProjected Location: Park District of Forest ParkTime: 3:45-5:15 PMDate: Thursdays, Sep 29 - Nov 17Fee: $24.00 Trans: $48.40Registration Number: 424

HORMIGASALL ABILITIESCan’t stop moving cause you’ve got ants in your pants? Come jump, dance, run, and play along to music and games after school. Participants will also enjoy a light snack.Students will be bussed home by District 99 at 4:00 PM. Participation numbers are limited. Call for registration information.

Age: 3-10 YearsProjected Location: Drexel School, CiceroTime: 2:50-4:00 PMDate: Thursdays, Oct 13 - Dec 8 (no program Nov 24)Fee: $12.10Registration Number: 422

School-Aged

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SUPER BOWLERSALL ABILITIESEnjoy an afternoon of bowling fun! Participants will:• Be taught bowling skills in a progression • Learn techniques• Learn basic scoringBumpers and adaptive equipment will be available if needed. Door to door transportation is available.

Age: 7-22 YearsLocation: Circle Lanes, Forest Park Time: 3:45-5:15 PMDate: Thursdays, Sept 29 - Nov 17Fee: $40.00 Trans: $48.40Registration Number: 427

BERWYN SPORTS GALORELD, BD, VI, PIJoin us after school to have fun and make friends through sports and games.

Transportation home is available.

Age: 7-14 yearsLocation: Havlicek School, BerwynTime: 3:00-4:30 PMDate: Wednesdays, Sept 28 - Nov 16 (no program Oct 26)Fee: $16.15 Trans: $24.20Registration Number: 415

LEGACY SPORTSALL ABILITIESWSSRA is teaming up with Legacy Sports in an exciting new program! Start your child off on the right foot in the world of sports with Caleb Fields and Dan Kane, owners of Legacy Sports and skilled athletes. WSSRA will provide the support staff needed for your child’s success. For more information go tolegacysportscamp.com

Age: 4-8 yearsDate: Tuesdays, Sept 27 - Nov 22 (no program Nov 8)Time: 3:30-5:00 PM Location: TBAFee: $45.00Registration Number: 435

WEDNESDAY EXPLORER’S CLUBHI, DEAF, HARD OF HEARINGJoin us for an afternoon of fun & games. Participants will have opportunities to:• Be challenged in team building activities• Learn team rules to games and about good sportsmanship• Enjoy expressing themselves through drama and art activities.This program is partially funded by a Town of Cicero grant.

Age: 7-22 yearsLocation: Hawthorne Park District, CiceroTime: 3:30-6:00 PMDate: Wednesdays, TBDFee: $TBDRegistration Number: 425

School-Aged

“ I value WSSRA

programs for Gabby because

they keep her moving!

WSSRA provides her

with excellent care.”Gabby

Resendez’smom

T

YOU’RE INVITED TO A GOLF “PAR-TEE”

FUNDRAISERJanuary 2012 @ White Pines Golf Dome at the White Pines

Golf Course 500 W Jefferson St., Bensenville

Enjoy 3 hours of golf fun: driving range, swing evaluation, longest drive competition, virtual golf, drinks, refreshments & tips from a pro. Funds raised support WSSRA programs. Check website for updates (wssra.net) Call

847.455.2100 to RSVP.Registration Number: 197

APPLIC

ATION

FOR

PAR

TICIPATIO

N IN

SPECIA

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LYMPIC

S ILLINO

ISValid A

pplication for Participation is m

andatory for all competitors

605 E. W

illow St.

Norm

al, IL61761-2682

309-888-2551

ATHLETE

INFO

RM

ATION

MED

ICA

LC

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CE

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LTH IN

SUR

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CE &

EMER

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PAR

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/OR

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UTH

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IZATION

AN

D M

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Athlete N

ame (last nam

e, space, first name)

Athlete’s M

ailing Address

StateZip C

ode

-

Birthdate

M M

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YY

Sex (M

or F)

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Athlete’s C

ity

Parent’s/G

uardian’s (Please C

ircle One) H

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ddress

Parent’s/G

uardian’s H

ome Telephone

Agency N

ame

Person to be contactedin case of em

ergencyM

edical Insurance Com

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Emergency

Contact Phone ( )

Policy Num

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I, on my ow

n behalf or as the undersigned parent and/or legal guardian of the above named applicant (hereafter referred to as the “E

ntrant”), hereby request permission for the

Entrant to participate in Special O

lympics program

s. I acknowledge that Special O

lympics w

ill screen all entrants using the Sex O

ffender Public R

egistry and the Child M

urder andViolent O

ffender Against Youth R

egistry and understand that entrants listed on either Registry w

ill be denied participation. I affirm that this

Entrant has never been on said R

egistriesor, if E

ntrant was listed on either R

egistry but has since been removed, I w

ill contact SpecialOlym

pics Illinois for instructions before submitting this application.

I represent and warrant to you that the Entrant is physically and m

entally able to participate in Special Olym

pics, and I submit herew

ith a subscribed medical certificate. I understand that

if the athlete has Dow

n Syndrome, he/she cannot participate in sports or events w

hich, by their nature result in hyper-extension, radical flexion or direct pressure on the neck or upperspine unless a full radiological exam

ination establishes the absence of Atlantoaxial Instability. I am aw

are that the sports and events for which this radiological exam

ination is requiredare equestrian sports, artistic gym

nastics, diving, pentathlon, high jump, alpine skiing, soccer, soccer skills, pow

erlifting squat and butterfly stroke and diving starts in swim

ming.

On behalf of the E

ntrant and myself, I acknow

ledge that the Entrant w

ill be using facilities at his/her own risk and I, on m

y own behalf, herby release, discharge and indem

nifySpecial O

lympics from

all liability for injury to person or damage to property of m

yself and Entrant.

In permitting the E

ntrant to participate, I am specifically granting perm

ission to Special Olym

pics Illinois to use the likeness, voice and words of the E

ntrant in television, radio, films,

newspapers, m

agazines and other media, and in any form

not heretofore described, for the purpose of advertising or comm

unicating the purposes and activities of SpecialO

lympics 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 O

lympics H

ealthy Athletes

Program

that provides individual screening assessments of health status and health care needs. The E

ntrant has no obligation to participate and I understand the Entrant should

seek his/her own m

edical advice and assistance and Special Olym

pics is not responsible for the Entrant’s health.

If I am not personally present at Special O

lympics activities in w

hich the Entrant is to com

pete, so as to be consulted in case of necessity, you are authorized on my behalf and at

my account to take such m

easures and arrange for such medical and hospital treatm

ent as you may deem

advisable for the health and well-being of the E

ntrant.I, TH

E UN

DER

SIGN

ED A

DU

LT ENTR

AN

T,have read and fully understand the provisions of the above release and/or have had them

explained. I hereby agree that Iw

ill be bound thereby and I shall defend Special Olym

pics Illinois and hold it harmless

from disaffirm

ation thereof.

Entrant

Witness

Date

Athlete’s E

mail A

ddress

I, THE U

ND

ERSIG

NED

PAR

ENT A

ND

/OR

GU

AR

DIA

Nof the above specified

Entrant, have read and fully understand the provisions of the above release and have

explained them to said E

ntrant. I hereby agree that I and said minor w

ill be boundthereby, and I shall defend Special O

lympics Illinois and hold it harm

less from any

disaffirmation thereof by said m

inor.S

ignature of Parent

and/or Legal Guardian

(Check appropriate box)

Print N

ame

Date

Parent’s E

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ddress

PLEASE C

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Does athlete have D

own S

yndrome?

YesN

oIf yes, have x-rays of the C

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YesN

oD

ate of x-rayIs the athlete clear

of Atlantoaxial Instability?Yes

No

Does the athlete have or is the athlete:H

eart Problem

sYes

No

Diabetic

YesN

oE

pileptic/Seizures

YesN

oB

lindYes

No

Deaf

YesN

oH

epatitisYes

No

Other

Current M

edicationD

osage

Allergies to m

edication, if any:

Date of last Tetanus shot:

I have examined the above-nam

ed Entrant

and, in my opinion, there is no m

ental or physical reason w

hy he or she should not participate in the Special O

lympics sports

training and competition program

. Further inform

ation will be forw

arded if required.C

urrent medication, if any, is specified w

ith dosage on this application.

Exam

ination Date

Doctor’s S

ignature

Print N

ame

Address

City

State Zip

Phone ( )

SOILL

OFFIC

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Zip Code

-

State

Parent’s/G

uardian’s City

EthnicityW

hiteB

lack/African A

merican

Hispanic/Latino

Other

Asian

Original parent/guardian and doctor signatures are required by the office of Special O

lympics Illinois. Faxed signatures w

illnotbe accepted.

SOILL

Rev. 8-1-10

16 WSSRA.NET

Sports & FitnessSPECIAL OLYMPICSIllinois Special Olympics provides year round sports training in a variety of Olympic-type sports for children and adults with mental impairments or closely related developmental disabilities who are 8 years of age or older. The program gives athletes opportunities to develop physical fitness, demonstrate courage, experience joy and participate in the sharing of skills and friendship with their families and other athletes. WSSRA supports the mission of Special Olympics through the participation in the following sports:Track & Field, Softball, Aquatics, Basketball, Bowling, Volleyball, and Golf

CRITERIA FOR PARTICIPATIONAll Special Olympic athletes must have a current, completed Application for Participation in Illinois Special Olympics form on file with the Special Olympic coordinator at WSSRA. This form contains four sections:1. Athlete Information2. Parent and/or Guardian Authorization & Medical

Authorization3. Health Insurance and Emergency Information4. Medical Clearance (This MUST be completed by a

physician).

Applications for Participation in Illinois Special Olympics are valid for 2 years based on the earliest signed date on the medical application form. We can FAX the medical application form to you today. Anyone interested in participating, starting a new sport, or volunteering, please contact: WSSRA Special Olympics Coordinator, 2915 Maple Street, Franklin Park, IL 60131, 847.455.2100.

WSSRA STINGRAY SWIM TEAM Stingray Swim Team is a training program for participants who are comfortable in the water. Participants will be expected to swim consecutive laps throughout a majority of the program. Those wishing to compete in Special Olympics can receive their training in the program but are not obligated to compete with WSSRA. Bring a suit and towel. Transportation is available on a limited basis. Please Note: Due to the limited swim lessons available, swim team members are not eligible for swim lessons.Age: 13 years and upDate: Mondays, Sept 26 - Nov 21 (No Program Oct 10)Time: 7:00 - 8:10 PM (Pool time 7:05-8:10)Location: Oak Park River Forest High School, Girls PoolFee: $45.00 Trans: $48.40Registration Number: 441

TEEN & ADULT AQUA ATHLETICSMLH, MI, AUT, DDEnjoy one of the greatest modes of exercise. Through water, participants may increase their:• cardiovascular system• strength• flexibility• mobility• range of motionAll while having fun in the pool with friends.

Age: 15 years & olderDate: Mondays, Sept 26 - Nov 21 (No Program Oct 10)Time: 8:15 - 9:00 PMLocation: Oak Park River Forest High School, Girls PoolFee: $37.50 Trans: $48.40Registration Number: 448

HEALTHY STARTALL ABILITIESGet your week off to a great start with healthy exercise on Monday mornings! If you need a special type of exercise, this program is for you. We’ll emphasize:• stretching and flexibility• moderate aerobics• use of exercise equipmentAll exercise routines will be closely monitored by staff to meet your individual needs.

Age: 21 years & olderDate: Mondays, Sept 26 - Nov 21 (No Program Oct 10)Time: 10:00 - 11:30 AMLocation: Franklin Park Community CenterFee: $43.20 Trans: $48.40Registration Number: 445

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Sports & FitnessBOBCATS PRESEASON BASKETBALL

MI, AUT, DDTeens and adults, we want you to join the Bobcats Basketball Team. Register now! Practices and games will be held on Tuesday evenings. During the FALL season participants will practice and prepare for the game season which begins at the end of December and goes through the end of March. All participants must participate in the practice season in order to be a part of the game season.

Bobcat Basketball Philosophy: In establishing the Bobcat’s basketball program, WSSRA has set criteria the program will follow. WSSRA will emphasize teamwork, good sportsmanship, and giving one’s best in a safe and healthy environment. Competitiveness will come from the game itself and not from emphasis on the score. Each player will:• Learn the fundamentals of basketball and have fun doing so.• Be a part of a team and learn the importance of teamwork.• Learn and play different positions.

More information about the game schedule and locations will be available upon registration. NOTE: YOU MUST BE IN THE 1ST SESSION TO BE ABLE TO JOIN AND COMPETE IN GAMES IN THE 2ND SESSION.New players must purchase a uniform before being able to compete on the Bobcats basketball team.

Age: 15 years & olderTime: 6:30-8:00 PM499 Practice Season: September 27 - November 1, 2011199 Game Season: November 29 - February 14, 2012Fee: $110.00 for practice and game seasonsRegistration Number: 499/199

WEEKLY WORKOUTMI, AUT, DD, MLHLet’s work out! It’s a great way to end your day and improve your physical condition through:• exercise stations• light weight lifting• low impact aerobicsWSSRA will provide door to door transportation.

Age: 13 years & olderDate: Tuesdays, Sept 27 - Nov 22 (no program Nov 8)Time: 7:00-8:15 PMLocation: Franklin Park Community CenterFee: $36.00 Trans: $48.40Registration Number: 447

FVSRA SWIM MEETSTINGRAY SWIM TEAM MEMBERS ONLYStingray Swim Team members are invited to compete at the FVSRA Swim Meet. Register today. More information will come after registration. Pick up point transportation will be available.

Date: Saturday, December 3Time: 10:00 AM - 2:00 PMLocation: Norris Recreation Center, St. CharlesFee: $15.00 Trans: $2.75Registration Number: 443

SEASPAR SWIM MEETSTINGRAY SWIM TEAM MEMBERS ONLYMembers are invited to participate in the SEASPAR annual swim meet. Pick up point transportation.

Date: Saturday, November 19Time: 7:30 AM - 1:00 PM (9:00 AM Swim Meet starts)Location: Downers Grove South High SchoolFee: $15.00 Trans: $2.75Registration Number: 442

GOOD SPORTSMANSHIPWSSRA encourages parents and families to attend games and tournaments and cheer the teens/young adults on! We expect coaches, players and parents to demonstrate good sportsmanship during these events. This includes respect and support of coaching staff and officials who are working on behalf of your player. Any person not demonstrating good sportsmanship including behavior outbursts towards a player or coaching staff and/or officials, that is deemed threatening, will not be tolerated. You may be asked to leave and your future participation and attendance at events will be in jeopardy. By registering your son/daughter/dependent for these programs you are agreeing to follow these guidelines as written. Please refer any concerns or questions to the Superintendent of Recreation. We look forward to a safe and successful season.

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Sports & Fitness

“ I like WSSRA’s Bobcats

basketball because of the competition.”

Chris Nakatsuka

WSSRA ANNUAL SPORTS BANQUET

This evening is an opportunity to recognize WSSRA athletes and their accomplishments throughout the year. WSSRA sports being recognized are:• Bobcats Basketball Team• Bobcats Softball Team• Bobcats Volleyball Team• Stingray Swim Team• Bowling League• Golf Participants• Special Olympic Track & Field Team• Adapted Sports Program

Date: Friday, September 16Time: 6:00 - 9:00 PMLocation: Centre at North Park Banquet Hall 10040 W Addison, Franklin ParkFee: $5 WSSRA Athletes $20 GuestsThe fee includes a buffet-style dinner, pop, coffee & tea. A cash bar is available. This event is being supported by the Iron Workers Union. A special thanks to Perry and Mickey Misso.Registration Number: 440

WINTER ESCAPEMI, DDPlan ahead and register for a lively winter overnight experience. Participants will have the opportunity to:• horseback ride• hike• camp fire• orienteer

Participants must be:• toilet trained• responsible for independent personal care

including feeding, dressing & toileting• devoid of emotional outbursts that require 1:1

staffing• participant is successful socially within 1 staff per

person per 4 participants staffing ratio

More information will be sent upon registration.Date: March 23 - 25, 2012Depart & return from WSSRA OfficeLocation: White Pines Ranch, Oregon, ILFee: $225Registration Number: 146

SATURDAY BOWLING LEAGUE MI, AUT, DD, SP, MHSpend your Saturdays with friends while sharpening your bowling skills through practice and instruction. An adaptive ball and bowling ramp will be available. Age: 13 years & olderLocation/Pick Up/Drop off:WSSRA Office, Franklin Park/11:55 AM/3:55 PMHarwood Heights Village Halll/12:10 PM/3:15 PMElmwood Park Recreation Center/12:30 PM/3:20 PMMcDonalds, 5500 Cermak, Cicero/12:30 PM/3:20 PMDate: Saturdays, Oct 1 - Nov 19 Time: 1:00-3:00 PM Location: Circle Lanes, Forest Park Fee: $60.00 Pick up Point Trans: $22.00 Registration Number: 410

On July 17, 2011 WSSRA, along with the Berwyn Park District, hosted the 13th annual Wacky Quacky Duck Splash. 511 persons attended the event. $7,600 was raised. We would like to thank the following sponsors:GOLD: Children’s Dentistry, Kiwanis Club of Berwyn, R.A. James Construction, Hawthorne Park District, Ann Treimer, Mr & Mrs Ed Dieschbourg, Mr Steven Fruth, Northwest MailingSILVER: Robert R Andreas & Sons Inc, Berwyn Development Corp, Amaro Family, Clover’s Garden Center, Adolf Funeral Home, I.A.C.O.B., Donald J Swiatek D.D.S., Berwyn Oak Park Family Dental, Norridge Jewelers, Clyde Park District, La Majade Restaurant, Blue House Institute, Community Physical Therapy, Mr & Mrs Joe Milburn, Ms Kathy Robbins, Ms Roberta FruthMEDIA: The Mark News Online, Benny’s Pizza, Domino’s Pizza, Michael Anthony’s, Pizza Platter

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WHEELCHAIR BASKETBALLOPPORTUNITIES FOR EVERYONEThis program is open to anyone with a physical disability who is ambulatory or uses a wheelchair. All players must play from a sports chair for games and practices, but don’t worry, NEDSRA has plenty of sports chairs available for use. New players are always welcome – call today for more information.Contact: Adam Kramer, 630.576.4037Location: NEDSRA

JR BULLSWHEELCHAIR BASKETBALLYOUTH WITH A PHYSICAL DISABILITYJunior Varsity Team - Basketball season is BACK, WSSRA joins the NEDSRA to offer adapted sports opportunities for anyone with a physical disability. Participants will compete in a number of tournaments throughout the Midwest.Age: 12-21 years

Preparatory Team- The JR Bulls Prep team is perfect for our newcomers and younger athletes! We will start with basic skills at practices, and put them to the test as we play games throughout the Midwest.Age: 5-12 years

Contact April Ryan for more information [email protected] You must provide your own transportation to and from the program. A practice and tournament schedule will be sent out prior to the start of the season.

Date: Saturday, Oct 1 - March 3 (no practice Nov 26, Dec 24 or 31)Time: 12:00-2:00 PMFee: $310Location: NEDSRA, 1770 W Centennial Place, AddisonRegistration Number: 449

PARALYMPICS SPORT SAMPLERDo you like to play sports like soccer, boccia ball, basketball, goalball, or volleyball? Than you need to join our Sports Sampler. This program is for people with physical challenges, but anyone is welcome if they are willing to participate using a sport wheelchair. Come join the fun and learn the rules to a variety of Paralympic sports!

Age: 7-22 yearsDate: October 8, 22 and November 12Time: 10:30 AM - 12:00 PMProjected Location: Liberty CenterRegistration Number: 450

Adaptive Sports

“Melissa now feels a part

of a team. We are grateful for meeting

other parents and having

their insight and support. We are really pleased that

we live in Norridge to

experience all that WSSRA has to offer.

The future seems filled with endless

possibilities!”

Kim, MelissaSchaefer’s mom

WSSRA

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SOCIALITES: pick up & drop off @Carroll Center, 1125 S Kenilworth, Oak Park

MINUTE TO WIN ITJust like on the game show, we’ll compete in challenges that you will have to finish in just one minute! Do you have what it takes?Date: 10/1/11 Time: 5:30 – 8:30pm Registration Number: 473-01Destination: Carroll Center, Oak Park Fee: $12.00

WILLIS TOWERView Chicago from the 103rd floor of the tallest building. Be adventerous & step out onto the glass sky deck... IF YOU DARE!Date: 10/8/11 Time: 6:00 – 9:00pm Registration Number: 473-02Destination: Willis Tower, Chicago Fee: $18.00

TOP BAKERToday we’ll celebrate sweetest day by having a bake-off. Bring on the competition!Date: 10/15/11 Time: 6:00 – 9:00pm Registration Number: 473-03Destination: Carroll Center, Oak Park Fee: $15.00

SAFELY SPOOKYWear your best costume & join us for a spooktacular time! Enjoy a night of candy, hot cocoa, hayrides & fun. Dress for the weather.Date: 10/22/11 Time: 6:00 – 9:00pm Registration Number: 473-04Destination: Proksa Park, Berwyn Fee: $15.00

TALENT SEARCHDo you sing, dance, tell awesome jokes, do magic or have a hidden talent? Tonight, we’re going to unleash our abilities and practice for our BIG SHOW. Come and join the fun!Date: 10/29/11 Time: 6:00 – 9:00pm Registration Number: 473-05Destination: Carroll Center, Oak Park Fee: $12.00

MAYAN ADVENTURERelax on the lazy river, zip down a tube slide or shoot some pool hoops. This 24,000 square foot water park of wet & wild fun awaits you! Bring your swimsuit and towel.Date: 11/5/11 Time: 6:00 – 9:00pm Registration Number: 473-06Destination: Mayan Adventure Water Park, Elmhurst Fee: $18.00

WSSRA’S GOT TALENTShow us what you’ve got! It’s your time to shine. Join us for an All-Social Talent Show. Participants should meet at Park District of Forest Park @6 PM. Friends and family are invited to sit & watch. Doors open @6:30 PM, show starts @7 PM.Date: 11/12/11 Time: 6:00 – 9:00pm Registration Number: 473-07Destination: Park District of Forest Park Fee: $5.00

FEAR FACTORCome dressed to be a mess! Tonight you’ll face your fears with a variety of ooey gooey games.Date: 11/19/11 Time: 6:00 – 9:00pm Registration Number: 473-08Destination: Carroll Center, Oak Park Fee: $12.00

HOT SHOTS: pick up & drop off @Carroll Center, 1125 S Kenilworth, Oak Park

BIKE IT OR NOTWe’re heading to Navy Pier to rent some quad-cycles & bike our way around the lakefront. Bike it or not, we’re going to have fun!Date: 10/1/11 Time: 5:30 – 8:30pm Registration Number: 472-01Destination: Navy Pier, Chicago Fee: $18.00

VIVA ITALIATonight we’re tossing dough & making our very own pizza from scratch.Date: 10/8/11 Time: 6:00 – 9:00pm Registration Number: 472-02Destination: Carroll Center, Oak Park Fee: $12.00

YOU SAY WILLIS, I SAY SEARS... TOWERView Chicago from the 103rd floor of the tallest building. Be adventerous & step out onto the glass sky deck... IF YOU DARE!Date: 10/15/11 Time: 6:00 – 9:00pm Registration Number: 472-03Destination: Willis Tower, Chicago Fee: $18.00

MINUTE TO WIN ITJust like on the game show, we’ll compete in challenges that you will have to finish in just one minute! Do you have what it takes?Date: 10/22/11 Time: 6:00 – 9:00pm Registration Number: 472-04Destination: Carroll Center, Oak Park Fee: $12.00

SPOOK-TACULARLet’s celebrate Halloween & go to Sonny Acres!!! We’ll check out a Haunted House, go on a hay ride & pick out pumpkins. Bring $ for snacks. Dress for the weather.Date: 10/29/11 Time: 6:00 – 9:00pm Registration Number: 472-05Destination: Sonny Acres, West Chicago Fee: $15.00

SHOW STOPPERSDo you sing, dance, tell awesome jokes, do magic or have a hidden talent? Tonight, we’re going to unleash our abilities and practice for our BIG SHOW. Come and join the fun!Date: 11/5/11 Time: 6:00 – 9:00pm Registration Number: 472-06Destination: Carroll Center, Oak Park Fee: $12.00


DIP, DIVE OR SLIDERelax on the lazy river, zip down a tube slide or shoot some pool hoops. this 24,000 square foot water park of wet & wild fun awaits you! Bring your swimsuit and towel.Date: 11/19/11 Time: 6:00 – 9:00pm Registration Number: 472-08Destination: Mayan Adventure Water Park, Elmhurst Fee: $18.00

Teens & Young Adults

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CITY SLICKERS: pick up & drop off @Barrie Center, Garfield & Lombard, Oak Park

BIKE IT OR NOTWe’re heading to Navy Pier to rent some quad-cycles & bike our way around the lakefront. Bike it or not, we’re going to have fun!Date: 10/1/11 Time: 5:30 – 8:30pm Registration Number: 474-01Destination: Navy Pier, Chicago Fee: $18.00

VIVA ITALIATonight we’re tossing dough & making our very own pizza from scratch.Date: 10/8/11 Time: 6:00 – 9:00pm Registration Number: 474-02Destination: Barrie Center, Oak Park Fee: $12.00

YOU SAY WILLIS, I SAY SEARS... TOWERView Chicago from the 103rd floor of the tallest building. Be adventerous & step out onto the glass sky deck... IF YOU DARE!Date: 10/15/11 Time: 6:00 – 9:00pm Registration Number: 474-03Destination: Willis Tower, Chicago Fee: $18.00

MINUTE TO WIN ITJust like on the game show, we’ll compete in challenges that you will have to finish in just one minute! Do you have what it takes?Date: 10/22/11 Time: 6:00 – 9:00pm Registration Number: 474-04Destination: Barrie Center, Oak Park Fee: $12.00

SPOOK-TACULARLet’s celebrate Halloween & go to Sonny Acres!!! We’ll check out a Haunted House, go on a hay ride & pick out pumpkins. Bring $ for snacks. Dress for the weather.Date: 10/29/11 Time: 6:00 – 9:00pm Registration Number: 474-05Destination: Sonny Acres, West Chicago Fee: $15.00

SHOW STOPPERSDo you sing, dance, tell awesome jokes, do magic or have a hidden talent? Tonight, we’re going to unleash our abilities and practice for our BIG SHOW. Come and join the fun!Date: 11/5/11 Time: 6:00 – 9:00pm Registration Number: 474-06Destination: Barrie Center, Oak Park Fee: $12.00


DIP, DIVE OR SLIDERelax on the lazy river, zip down a tube slide or shoot some pool hoops. this 24,000 square foot water park of wet & wild fun awaits you! Bring your swimsuit and towel.Date: 11/19/11 Time: 6:00 – 9:00pm Registration Number: 474-08Destination: Mayan Adventure Water Park, Elmhurst Fee: $18.00

MOONLIGHTERS:pick up & drop off @Barrie Center, Garfield & Lombard, Oak Park

MINUTE TO WIN ITJust like on the game show, we’ll compete in challenges that you will have to finish in just one minute! Do you have what it takes?Date: 10/1/11 Time: 5:30 – 8:30pm Registration Number: 475-01Destination: Barrie Center, Oak Park Fee: $12.00

WILLIS TOWERView Chicago from the 103rd floor of the tallest building. Be adventerous & step out onto the glass sky deck... IF YOU DARE!Date: 10/8/11 Time: 6:00 – 9:00pm Registration Number: 475-02Destination: Willis Tower, Chicago Fee: $18.00

TOP BAKERToday we’ll celebrate sweetest day by having a bake-off. Bring on the competition!Date: 10/15/11 Time: 6:00 – 9:00pm Registration Number: 475-03Destination: Barrie Center, Oak Park Fee: $15.00

SAFELY SPOOKYWear your best costume & join us for a spooktacular time! Enjoy a night of candy, hot cocoa, hayrides & fun. Dress for the weather.Date: 10/22/11 Time: 6:00 – 9:00pm Registration Number: 475-04Destination: Proksa Park, Berwyn Fee: $15.00

TALENT SEARCHDo you sing, dance, tell awesome jokes, do magic or have a hidden talent? Tonight, we’re going to unleash our abilities and practice for our BIG SHOW. Come and join the fun!Date: 10/29/11 Time: 6:00 – 9:00pm Registration Number: 475-05Destination: Barrie Center, Oak Park Fee: $12.00

MAYAN ADVENTURERelax on the lazy river, zip down a tube slide or shoot some pool hoops. This 24,000 square foot water park of wet & wild fun awaits you! Bring your swimsuit and towel.Date: 11/5/11 Time: 6:00 – 9:00pm Registration Number: 475-06Destination: Mayan Adventure Water Park, Elmhurst Fee: $18.00


FEAR FACTORCome dressed to be a mess! Tonight you’ll face your fears with a variety of ooey gooey games.Date: 11/19/11 Time: 6:00 – 9:00pm Registration Number: 475-08Destination: Barrie Center, Oak Park Fee: $12.00

Pick Up Point: WSSRA Office, 2915 Maple Street, Franklin Park or McDonalds, 5500 Cermak (West of Laramie), Cicero Pick up Point Transportation: $2.75 per week Ability Group: DD, MI Age: 15 years and older

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NOW WE’RE COOKIN’!MLH, MI, DDMove over Top Chef, Kathy’s taking over. Participants will enjoy making their own healthy creations through instruction by Kathy Burke of Twisted Dish. Check out Kathy’s food blog at twisteddish.wordpress.com

Age: 19 years & olderDate: Thursdays, Sept 29 - Nov 17Time: 7:00-8:30 PMLocation: TBAFee: $45.00 Trans: $48.40Registration Number: 434

SHOW TIMEMI, AUT, DDEnjoy a night at the movies with friends. Participants need to bring $20.00 to pay for the show and snacks. Meeting time will be based on local show schedule. Call the office the Wednesday before program for information on show time. Participants need to be able to focus on a movie two hours in length with limited breaks. This is to minimize the disturbance of other audience members. Participants will see movies rated: G, PG & PG13.

Age: 15 years & olderLocation: Barrie Center, Oak ParkPick up Points available: WSSRA Office: 5:15 PM, 10:00 PMCicero McDonalds: 6:15 PM, 9:15 PMRegistration Number: 460-01 Friday, September 30Registration Number: 460-02 Friday, October 21Registration Number: 460-03 Friday, November 11Fee: $12.50 Trans: $2.75

ZUMBAZUMBA is a fusion of Latin and international dance-fitness that will have you groovin’ at your own pace. Every class feels like a party! Come join professional Zumba instructor, Meagan Mepham and see what we mean. You don’t even have to know how to dance. Just move your body and follow along. It’s easy!

Age: 15 years & upDate: Wednesdays, Sept 28 - Nov 16Time: 7:15-8:30 PMProjected Location: Cicero Community CenterFee: $36.00 Trans: $48.40Registration Number: 476

MANGIAMO!MLH, MI, AUT, DDThis fall’s culinary tour of Italy will determine whose spaghetti reigns supremo and whose fettucini is fantastico! Lively discussion about what we liked best each week is all part of the fun. Bring $20-$25 to cover your food and share of the tip. Participants need to be able to sit for a meal with minimal interruptions to others.

Age: 15 years & olderDate: Fridays, Oct 7, 14, 28; Nov 4, 18Time: 6:30-9:15 PM Location: Barrie Center, Oak ParkFee: $12.00 per weekTransportation: $2.75 per week/ $13.75 for 5 weeksPick up points:WSSRA Office: 5:15 PM, 10:00 PMCicero McDonalds: 6:15 PM, 9:15 PM

Regist # Date Restaurant Location461-01 Oct 7 Armand’s Elmhurst461-02 Oct 14 Trattoria Peppino Elmwood Park461-03 Oct 28 Mancini’s Oak Park461-04 Nov 4 Caponie’s Chicago461-05 Nov 18 Freddy’s Cicero

STAY IN THE GAMEEMH, THM, AUT, DDThe Chicago District Golfing Foundation, CDGF is sponsoring this opportunity to keep your golf game in check. Participants will continue to work with the OPCC golf pros to focus on: stance, swing and hitting the ball. We will enjoy this practice time under the Bushwood Golf dome in Maywood. Participants must have completed Intro to Golf or Advanced golf to participate in this program.

Age: 12 years & upDate: TBA Time: 6:15-7:15 PMLocation: Bushwood Golf Dome, MaywoodFee: $25.00 Trans: $30.25Registration Number: 463

Teens & Young Adults

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WALK N DINEHI, VI, PI, MLHJoin the club and get walking to a healthier heart with friends at WSSRA! The group will walk or wheel at different locations and end with lunch together at a local restaurant. Participants will be responsible for buying their own lunch. Participants must be independent in mobility. Sign up for the weeks that fit your schedule!

Date: Tuesdays, Sept 27 - Nov 22Time: 9:30 AM-12:30 PMLocation: Varies (HIP = Harlem Irving Plaza)Fee: $11.00 week / $99.00 9 weeksTrans: $6.05 week / $54.45 9 weeksProgram Number: Date/Outdoor Location/Indoor Location 467-01: Sept 27/Proksa Park, Berwyn/North Riverside Mall467-02: Oct 4/Lindberg Park, Oak Park/HIP467-03: Oct 11/Center at North Park, Franklin Park/HIP467-04: Oct 18/Commons Park, North Riverside/North Riverside Mall467-05: Oct 25/Lindberg Park, Oak Park/North Riverside Mall467-06: Nov 1/Scoville Park, Oak Park/North Riverside Mall467-07: Nov 8/Dominican Neighborhood, River Forest/North Riverside Mall467-08: Nov 15/Proksa Park, Berwyn/North Riverside Mall467-09: Nov 22/Commons Park, North Riverside/North Riverside Mall

WILD CARD WEDNESDAYSHI, VI, PI, MLHJoin us for an early morning of socializing and card shuffling fun! Light & healthy refreshments will be served. Participants can register for one or all of the weeks.

Time: 9:30 AM-12:30 PMLocation: Franklin Park Community CenterFee: $83.20 / 8 weeks ($10.40 per week) Trans: $48.40 / 8 weeks ($6.05 per week) Date: Wednesdays 465-01: September 28 465-02: October 5 465-03: October 12465-04: October 19 465-05: October 26 465-06: November 2465-07: November 9 465-08: November 16

WINNER TAKES ALLHI, VI, PI, MLHJoin us for a night of socializing, laughter & games. We will learn new games as well as play some old favorites. Each week we will order dinner “take-out” from a local favorite. Bring $10 for dinner.

Date: Thursdays, Sept 29 - Nov 17 Time: 6:00-8:30 PMLocation: WSSRA Office, Franklin ParkFee: $7.50 per week / $60.00 8 weeksTrans: $6.05 per week / $48.40 8 weeksRegistration Number: 462

ADAPTED BOWLERSPI, VI, MLHJoin us for a lively round of bowling with friends. Adults with MS are especially welcome. WSSRA will provide adaptive equipment for those in need. Door to door transportation is available for WSSRA residents. There must be a minimum of 3 participants for a transportation route.

Date: Fridays468-01: October 21 468-02: November 11 468-03: December 2Time: 12:00-2:00 PM Location: Brunswick Zone, River GroveFee: $7.95/week Trans: $6.05/week

TOWERS SOCIALPI VI, MLH Join us for socializing, games/trivia, and a light snack with your coffee while we play cards, “Garbage” style.

Location: Community Room, Franklin Towers, Franklin ParkFee: FREE/week Trans: $6.05/weekTime: 12:30-2:30 PM Date: Fridays479-01: Sept. 30 479-02: Oct. 28 479-03: Nov.18

Older Adults

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WE’RE GOING TO MINNESOTA, AY’Enjoy a 4 day vacation to Tomah, WI and Bloomington, MN. You will stay one night in Tomah and two nights in Bloomington in semi-private rooms. On this trip you will have the option to explore the following:

• Ho-Chunk Casino in Tomah • Mall of America • Normandale Japanese Garden• Cathedral of St. Paul • “Hairspray” the Musical dinner show • Boat cruise • Dining at popular restaurants

Dates: September 13 – 16 Fee: $370.00 (recommended amount to bring for meals is $125)

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WSSRA TRANSPORTATION1. Door to door transportation is available for all programs noted with

the transportation symbol. This extra service is available if you pay a $6.05 per round trip fee, for each day the program meets.

2. Transportation to programs from designated pick up points is available for a fee of $2.75 per round trip, for each day the program meets. You must pay at time of registration.

3. All participants being transported in WSSRA vehicles must abide by WSSRA guidelines. Failure to do so will result in suspension from transportation. Repeat offenders will not be transported by WSSRA.

4. Parents or participants must notify the Association in regard to any change in transportation.

5. If an Association vehicle cannot complete a route and family members must pick up riders, a credit will be issued for the participant’s later use.

6. Any registration received after June 3, 2011 may result in a late program start or no transportation.

7. Parents are requested to notify their child’s school on days students are being picked up by a WSSRA van.

8. A participant under the age of 16 must be taken off the van by a responsible person over 12 years old.

PLAYING IT SAFEDue to new state legislation, car seats or booster seats must be provided for all children ages seven and under. For more information contact Bob Foster.

WAIVER OF LIABILITYWSSRA is insured through a self insurance pool with other Special Recreation Associations and Park Districts. Our pool is known as the Park District Risk Management Agency (PDRMA). As a loss prevention measure, PDRMA is requiring participants to execute a release of liability for programs. The reverse side of the registration forms contains the WSSRA waiver release form. This must be signed and returned to the WSSRA office before participants can be in programs.

Since we do not carry medical or accident insurance for program participants, the release of liability is necessary. The cost of such coverage would make our program fees too high for most to afford. Please review your personal health plan to be certain that you and your family have coverage in instances like these.

Our objective is to offer a high quality program at a reasonable cost. The use of a release of liability when appropriate is but one way we are trying to meet that objective. If you have any questions, call Sandra Gbur at 847.455.2100. We appreciate your continued involvement and support.

WALK-IN OR MAIL-IN OR FAXED REGISTRATION PROCEDURES1. Complete the enclosed registration form with correct program

selection, day, program fee, transportation and payment option. 2. Contact your local park district or village for use of their fax machine

to fax your registration.3. All signed registration forms received by September 15, 2011 will be

processed by the WSSRA Registrar and approved for program and transportation information.

4. All registrations will be accepted on a first-come, first served basis until we reach our maximum enrolment for each program.

5. Mail-in or walk-in registrations received AFTER 5:00 PM September 15, 2011 may result in a late program start and transportation may not be available.

6. If a program is closed you will be added to a wait list once we have received a signed registration form. We will contact you when an opening is available.

7. Recreation Specialists MAY NOT accept program payment or registration forms at programs. This must be done by mail or at the office only.

8. Anyone registering MUST have a working phone number.9. A participant cannot register for the next season until balance from

previous season is paid.

PHONE-IN REGISTRATION PROCEDURES ONLY1. Phone-in registration begins August 15, 2011 and will be accepted

until September 15, 2011. Any mail-in and faxed registrations received prior to August 15, 2011 will be processed in the order they are received).

2. Calls will be accepted Monday through Friday from 9:00 until 4:30 PM.3. The WSSRA Registrar will assist you in completing the registration

form. She will be sure the programs selected are age and ability appropriate.

4. A confirmation letter will be sent to you. Sign the attached waiver form and return to WSSRA by September 15, 2011 .

5. The registration will be on hold until we receive the signed registration form. No participation can take place without this signature.

6. Phone-in registration WILL NOT BE ACCEPTED after September 15, 2011.7. Faxed, mail-in or walk-in registrations will be accepted after September 15, 2011 but may result in a late program start and

transportation may not be available.8. All registrations will be accepted on a first-come, first-served basis until

we reach our maximum enrolment for each program.9. If a program is closed you will be added to a wait list once we have

received a signed registration form. We will contact you when an opening is available.

10. Recreation Specialists MAY NOT accept program payment or registration forms at programs. This must be done by mail or at the office only. We can accept credit card payments over the phone during business hours.

11. Anyone registering MUST have a working phone number.12. A participant cannot register for the next season until balance from

previous season is paid.

FALL 2011 REGISTRATION FORMMAIL TO: WSSRA, 2915 Maple Street, Franklin Park, IL 60131 FAX TO: 847.455.2157 SIGNED REGISTRATION MUST BE RECEIVED BY SEPT 15, 2011

Participant’s Name: __________________________________________ Birth Date: __________________

Address: __________________________________________ City/State: ______________________/ _______ Zip: _______________________

Park District/Village: ________________________________________ Home Phone: _______________________________________________

Parent Or Guardian Name: ______________________________________________________________________________________________

e-mail address:

Parent/Guardian Work Phone: __________________________________ Parent/Guardian Cell Phone: _________________________________

Who Should We Contact If Parent/Guardian Is Unavailable? Name: __________________________________ Phone: ______________________

Doctor’s Name: ___________________________________________ Doctor’s Phone: ______________________________________________

Present School/ Workshop/Other: ________________________________________________________________________________________

Teacher/Supervisor Name: _____________________________________ Dismissal Time: ___________________________________________

Participant’s Disability: ________________________________________________________________________________________________

Can Participant Transfer? □Yes □No Does Participant Use Wheelchair/Walker? Specify: _____________________________________________

Is Participant Subject To Seizures: □Yes □No List Any Medication: ______________________________________________________________

Is Medication Taken At Program? □Yes □No

List Any Allergies: ____________________________________________________________________________________________________

Does Participant Have A Communicable Disease? □Yes □No If Yes, Please Explain _________________________________________________

___________________________________________________________________________________________________________________

Program # Program Name Day Fee TranspSubtotal

Program & Transport FEES

TOTAL DUE:

FEE PAYMENT OPTION - CHECK ONE(payment is expected at registration unless other arrangements are made)□ Total Payment Enclosed□ Total Payment to Follow (if FAXED)□ Request Scholarship□ Payment Plan – Arranged with Finance Manager□ Credit Card □ Visa □ Master Card □ Discover Exp. Date: ___________ Card Number:

I have read the Waiver Release of All Claims and Hold Harmless Agreement on the reverse and unless I have checked NO under the three authorizations, I approve them.

___________________________________________________ ___________________________Parent/Participant/Guardian Signature Date

HOLD HARMLESS RELEASE ON

REVERSE SIDE

West Suburban Special Recreation Association

WAIVER RELEASE OF ALL CLAIMS AND HOLD HARMLESS AGREEMENT(Read Carefully)

Please read this form carefully and be aware that in signing up and participating in West Suburban Special Recreation Association programs, you will be waiving and releasing all claims for injuries arising out of these programs that you or the named participant might sustain. The terms “I”, “me” and “my” also refer to parents or guardians as well as participants in the programs. In registering for these programs, you are agreeing as follows:

As a participant in these programs, I recognize and acknowledge that there are certain risks of physical injury, and I agree to assume the full risk of any injuries, damages or loss which I may sustain as a result of participating in any manner, in any and all activities connected with or associated with such activities and involve substantial risks of injury.

I agree to waive and relinquish any and all claims I may have as a result of participating in these programs against the West Suburban Special Recreation Association, any and all participating governmental units, any and all independent contractors, officers, agents, servants and employees of the governmental bodies and independent contractors, and any and all other persons and entities of whatever nature that might be directly or indirectly liable for any injuries, that I might sustain while participating in these programs.

I do hereby fully release and discharge the West Suburban Special Recreation Association and the other released parties from any and all claims for injuries, damages or loss, which I may have or which may accrue to me on account of my participation in these programs.

I further agree to indemnify, hold harmless and defend, the West Suburban Special Recreation Association and any and all other parties from any and all claims resulting from injuries, damages and losses sustained by anyone, and arising out of, connected with, or in any way associated with my conduct and the activities of these programs.

I further understand and agree that the terms such as “participation”, and “activities”, referred to in this Agreement, include all exercises and physical movements of any nature while I am participating in these programs and further include the provision, of or failure to provide proper instructions or supervision, the use and adjustment of any and all machinery, equipment, and apparatus, and anything related to my use of the services, facilities, or premises, involved in these programs, and transportation to and from events.

I understand the nature of these programs for which I am registering, and have read and fully understand this Waiver, Release and Hold Harmless Agreement. I further understand that any advisement or warnings of the particular risks of these programs that I subsequently receive will be incorporated by reference into and become a part of this Agreement.

In case of emergency, I give my permission for the participant to receive any first aid, transportation or medical attention that may be required.

You may return this waiver and release of all claims by mail or fax. You may mail this release to 2915 Maple St., Franklin Park, IL 60131 or send by facsimile transmission to 847.455.2157. When forwarding by fax, it is mutually understood that the facsimile document shall substitute for and have the same legal effect as the original form.

To Communicate with School/Health Care Personnel*I authorize counsellors, teachers, case workers, therapists, or physicians to communicate with WSSRA about the participant’s needs as they relate to WSSRA’s provision of recreation services to the participant. WSSRA will keep confidential all information obtained through such communications.□ yes □ no

To Disclose Information to WSSRA Member Partners*WSSRA may disclose to my home park district or municipality information about the participant’s and my involvement in WSSRA programs or activities, including our names, telephone number, address, program registrations, and the participant’s age and disability, provided that my home park district or municipality shall not redisclose that information without my express written consent. □ yes □ no

To Release Information for Publicity Purposes*I authorize the use of photographs or descriptions of the participant or of me in publicity materials about WSSRA programs and services, which may appear in newspapers, member partner brochures, video presentations, web sites and other similar mediums or displays.□ yes □ no

*I understand that I can change my decisions regarding the statements above at any time for any reason by delivering a written notice to WSSRA, prohibiting further disclosure information.

COMMENT SHEET – WE WELCOME YOUR INPUT!We invite you to share with us your program ideas and comments about our services:_______________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

You can also send us an email at [email protected] Support WSSRA by following us on

27 WSSRA.NET

Special Events

REGISTRATIONNUMBER/AGE DATE DROP OFF &

PICK UP TIMES ACTIVITY DESTINATION FEE

490-01/3-22 12/20 9:00am-3:00pm

Ugly Holiday Sweater Bowling Bonanza Put on your ugliest holiday sweater and lace up your bowling shoes! We’ll kick off the Holiday Hullabaloos with an afternoon of bowling and holiday treats at Circle Lanes!

Circle Lanes, Forest Park

$21.00

490-02/3-22 12/21 9:00am-3:00pm

West Suburban Idol Are you the next West Suburban idol? We’re heading to 2BU Studios in Lincolnshire to sing in an recording studio. Everyone will come home with their own CD!

2BU Studios, Lincolnshire

$25.00

490-03/3-22 12/22 9:00am-3:00pm

Monkeying Around We’ll spend the day monkeying around Monkey Island in Melrose Park. A 40,000 square foot inflatable jungle is yours! (Must wear socks)

Monkey Island, Melrose Park

$21.00

490-04/6-22 12/27 9:00am-3:00pm

It’s Raining Nickels! Our stop for the day is Nickel City in Northbrook. There’s hundreds of games that only cost a nickel and 30 more that are free! Videos games, tickets and prizes! Oh yeah!

Nickel City, Northbrook

$25.00

490-05/6-22 12/28 10:00am-4:00pm

Splish Splash Spend the day with us splish splashing around The Water Works in Schaumburg!

The Water Works

$21.00

490-06/6-22 12/29 9:00am-3:00pm

Get Along Little Dogies Saddle up, pardners! We’re heading back to Equestrain Connection for a fun-filled day of equine adventures!

Equestrain Connection, Lake Forest

$28.00

RegistratiHOLIDAY HULLABALOOALL ABILITIES (SEE EACH EVENT FOR AGES)Enjoy fun-filled days of holiday festivities with WSSRA. Participants will be grouped according to age and ability levels. Your child will need to bring a sack lunch each day. WSSRA will provide a drink. Due to the great demand for these events, program availability is limited but not guaranteed to 3 events per individual. A LOTTERY WILL BE DRAWN AFTER FRIDAY, OCTOBER 21.To register for Holiday Hullabaloo programs:

STEP 1: Be sure to register for all events that you are interested in. If space is available, your child may be added to more than three events.

STEP 2: All completed registrations must be received by 4:30pm October 21 in order to be included in the lottery. STEP 3: WSSRA staff will contact you by November 5, after the lottery drawing, to confirm the actual events your child can attend.

Pick up/drop off point: Caroll Center, Kenilworth & Filmore, Oak Park Trans: $6.05/each event

SANTA’S POLAR EXPRESSJoin us for our third annual “Santa’s Polar Express” train ride. The train ride will follow the popular book “Polar Express” by Chris Van Allsburg. This delightful story will be read on our journey. WSSRA’s “Polar Express” will leave the Berwyn train station and travel to the North Pole (Aurora train station). Upon our arrival, Santa Claus will join us on our ride home. This event is co-sponsored by Thumbuddy Special.• all children must be accompanied by an adult • light refreshments will be served • seating for wheelchairs is available • limited tickets are available (5 per family) Age: all ages Date: Saturday, December 3 Time: 12:25-3:30 PMLocation: Berwyn Metra Train Station (Oak Park Ave. & Windsor)Train departs @ 12:55 PM Train returns @ 3:15 PMFee: $8.00 per child 11 & under; $15.00 per adult 12 & upRegistration Number: 491

West Suburban Special Recreation Association2915 Maple Street | Franklin Park, Il 60131P 847.455.2100 | F 847.455.2157www.wssra.net

PRSRT STDU.S. POSTAGE

PAIDCOMPLETE

MAILING SVC, IL

POSTMASTERDated MaterialPlease DO NOT HOLD

Trip to Disney

WE’LL DO:• We’ll attend various shows and parades

while visiting the parks• Dine with Disney Characters• Swimming at the hotel• Magic Kingdom• Epcot Center• Animal Kingdom

WHAT’S INCLUDED:

• room• airfare

• 3 meals per day• entrance to 3 Walt

Disney World Parks

DATE: JANUARY 15-19AGE: 18 & UP FEE: $1,320PROGRAM NUMBER: 182

ELIGIBLE PARTICIPANTS:• participants who are responsible for independent personal care including

feeding, dressing & toileting• participants who are independent in mobility either walking or wheeling• participants who are successful socially at a 5:1 participant staffing ratio• participants who are devoid of emotional outbursts that require 1:1 staffing• call Marianne Birko with questions concerning eligibility (WSSRA reserves the right

to determine if this trip appropriate for an individual)

REGISTRATION:• call the office• the program is limited to 10 participans• due to the popularity of this trip it will be offered as a lottery• all participants interested in attending this trip to Disney World must register no later than October 3rd at 10am• the lottery will be pulled on October 3rd and we will contact you by October 6th

• price EXCLUDES spending money

• price may vary by $100 based on group size and flight rates

• a $300 non-refundable deposit is due upon registration.

Refunds will be considered if a physicians note prohibiting

travel accompanies your request for refund or another

WSSRA participant is able to go on late notice

• no scholarships are available for this trip

program guide - wssra.net

Documents