Heart of IllinoisSpecial Recreation Association

REGISTRATION BEGINS 4/22/13!

No registrations will be processed until then.

SUMMER 2013 PROGRAMS

2 – Summer 2013

Welcome!Heart of Illinois Special Recreation Association (HISRA)

A cooperative extension of the Chillicothe, Morton, Peoria, and Washington Park Districts8727 N. Pioneer Rd. • Peoria, IL 61615 • 309-691-1929

hisra@peoriaparks.org

HISRA BOARD OF TRUSTEESThe Board meets at HISRA on the third Wednesday of the month at 5:15 p.m. Meetings are open to the public. Dick Howarth ...................................... ChillicotheKevin Yates ........................................... ChillicotheGary Watson ........................................ MortonTate Kaiser ............................................ MortonTim Cassidy .......................................... PeoriaJim Hancock ........................................ PeoriaDoug Damery ..................................... WashingtonLorelei Cox ........................................... Washington

HISRA VOLUNTEERSVolunteers are special people who share their time, knowledge, and spirit with HISRA participants. HISRA would like to thank those volunteers who have devoted their time and energy to the success of our programs. If you would like to join our volunteer staff, please contact us. We’ll put your skills to great use!

ATLANTO-AXIAL SUBLUXATIONIndividuals with Downs Syndrome are at risk of having a condition known as Atlanto-Axial Subluxation. HISRA must have a doctor’s written note on file stating a participant is free of the instability if he/she wishes to participate in programs that may cause undue stress upon the neck. Please take this into consideration when registering and inform staff if the condition is present.

HISRA FREQUENTLY USED PROGRAM LOCATIONS

• Freedom Hall (Morton) 349 W. Birchwood, 263-7429

• Landmark Lanes (Peoria) 3225 N. Dries Lane, 686-9168

• RiverPlex (Peoria) 600 NE Water St., 282-1700

• Golf Learning Center & Academy (Peoria) 7815 N. Radnor Road • 690-7162

• Kellogg Golf Course (Peoria) 7716 N. Radnor Road • 691-0293

• Shore Acres (Chillicothe) 100 Park Blvd., 274-3409

• Willow Knolls 14 Theatre (Peoria) 4100 W. Willow Knolls Dr, 689-8463

• Landmark Cinemas (Peoria) 3225 N. Dries Ln, 682-6356

• Morton Recreation Center (Morton) 324 Detroit Street, 263-7429

• Plaza Lanes (Washington) 1500 Washington Road, 444-3059

• EastSide Center (East Peoria) 1 EastSide Drive, 698-5437

• Christian Center (Peoria) 4100 N. Brandywine Drive, 685-4218

HISRA is the result of a desire on the part of your park district to provide quality recreation programs and services to individuals with disabilities and special needs. HISRA and its member districts enthusiastically support the spirit and intent of the Americans With Disabilities Act. HISRA is committed to providing opportunities for each individual to enjoy recreation activities in the least restrictive environment possible.

Your HISRA Staff:

Katie Hogan Van Cleve ............................................Executive Director

Sarah Payne ........................................................... Program Coordinator

Jennifer Wahl ......................................................... Program Coordinator

Corinne Wolffe ...................................................... Program Coordinator

Summer 2013 – 3

Summer 2013

IN THIS ISSUE:Inclusion Services ............................................3

Focus ....................................................................4

Outings................................................................5

Social Programs – Adults ..............................6

HISRA Center Based Events ..........................7

Parents Night Out ............................................7

Special Olympics .............................................8

All the Details ............................................. 9-10

Registration Form ...................................11-12

Code of Conduct ........................................... 13

Programs at a Glance .................................. 14

Participant Calendar .................................... 15

Attention residents of Peoria, Morton, Chillicothe, and Washington Park Districts: Have you seen any programs your park district offers that may be of interest to you or your child with special needs, but wondered if they could participate? Well, stop wondering and call HISRA at 691-1929!Upon reviewing the participant’s needs, HISRA’s professional staff will work to integrate participants, adapt activities, and provide additional support if appropriate so that it can be a successful inclusive setting. If you are an adult in Peoria, Morton, Chillicothe, or Washington with special needs, you are also welcome at all programs your local park district offers. HISRA provides all inclusion services at no cost to residents of its member districts. Please give three weeks notice for all inclusion needs.

Equal Fun ... for Everyone!

– INCLUSION SERVICES –

4 – Summer 2013

Focus ProgramDo you love hanging out with HISRA on the weekends and wish you didn’t have to wait all week? The FOCUS program is waiting for you! FOCUS is a program for dynamic adults looking for an engaging and enriching way to spend their weekdays. We are an active bunch that spends our time cooking, exploring the community, playing games, seeing friends, and having fun.

This season, the FOCUS program will run Monday through Thursday, May, June, July, and August. You can register for one day per week up to all four days. Chosen days must remain consistent for the entire season. This season there will be no Focus on Monday, May 27th, Monday, June 3rd, Tuesday, June 4th, Wednesday, June 5th, Thursday, June 6th, or Thursday, July 4th. The Summer FOCUS program begins May 6, 2013 and ends August 29, 2013. Participants will need to make a 10% down payment and then make equal monthly payments on May 1st, June 1st, July 1st, and August 1st.Age: 18+

Code Day-Date Time Fee-R/NRMondays56600 M:5/6 9:00am-3:00pm $480/$630Tuesdays56601 Tu:5/7 9:00am-3:00pm $512/$672Wednesdays56602 W:5/8 9:00am-3:00pm $512/$672Thursdays56603 Th:5/9 9:00am-3:00pm $480/$630

FOCUS

PARENTS NIGHT OUT

If you need a night out, this is for you! Drop your kids off at HISRA and enjoy an evening out! All children in the family are welcome to attend. Each additional child is only $7 each!

During Parents Night Out, participants will enjoy dinner, play games, make crafts, and more! SPACE IS LIMITED! PLEASE REGISTER AT LEAST 2 WEEKS IN ADVANCE FOR STAFFING PURPOSES. Fee is per program. Choose as many as you like!

Age: 2+Fee-R/NR: $27/$37, additional child: $7 each

Code Day-Date Time Fee-R/NR/Sib.56580 Sa:5/18 6:00pm-11:00pm $27/$37/$756581 Sa:6/22 6:00pm-11:00pm $27/$37/$756582 Sa:7/20 6:00pm-11:00pm $27/$37/$756583 Sa:8/3 6:00pm-11:00pm $27/$37/$7

Summer 2013 – 5

The symbol next to a program indicates that transportation is provided for residents of our member districts for this program to and from Chillicothe (Shore Acres Park), Morton (Morton Freedom Hall) and Washington (St. Claire’s Crossing).

OUTINGS

Washington Cherry Festival The Washington Cherry Festival! Carnival games and rides, food, music, fun and more! Join your HISRA friends on this adventure!Age: 19+Code Day-Date Time Fee-R/NR56616 Sa:6/1 5:00pm-9:30pm $30/$40

Corn Stock Theatre Join us as we head to Bradley Park to enjoy a show at Corn Stock Theatre! Don’t forget to eat dinner before the program and bring money for concessions during intermission if you wish. An end time of this program will be determined when the show ends. Staff will call parents/guardians with specific pickup times.Age: 19+Code Day-Date Time Fee-R/NRCorn Stock Theatre – “The Music Man”56609 Sa:6/8 6:30pm $30/$40Corn Stock Theatre – “The Wiz”56610 F:8/2 6:30pm $30/$40

Fireworks Spectacular Tonight we will enjoy a picnic, live music and fireworks – everything needed for an Independence Day celebration! Join us for this annual event at Glen Oak Park! An end time of this program will be determined when the show ends. Staff will call parents/guardians with specific pickup times.Age: 19+Code Day-Date Time Fee-R/NR56608 W:7/3 5:30pm $20/$25

HISRA Peoria Chiefs Game Join your friends at HISRA for a baseball game on a warm summer night! Don’t forget to eat dinner before you come and feel free to bring money for concessions and souvenirs. An end time of this program will be determined as the game comes to a close. Staff will call parents/guardians with specific pickup times.Age: 19+

Code Day-Date Time Fee-R/NRHISRA Peoria Chiefs Game #1 and Fireworks56611 F:6/28 5:30pm $22/$27HISRA Peoria Chiefs Game #256612 F:7/19 6:00pm $22/$27

Cubs vs Cardinals Game at Wrigley FieldTake me out to the ballgame, take me out to the crowd, buy me some peanuts and cracker jacks, I don’t care if I ever get back ... That’s right! We are heading up to the majors to watch the Chicago Cubs take on their biggest rival – the St. Louis Cardinals at Wrigley Field in Chicago! HISRA will provide your lunch and dinner, please bring extra money for concessions and souvenirs. There will be a pick up and drop off at the RiverPlex and at HISRA on the day of the event. An end time of this program will be determined as the game comes to a close. Staff will call parents/guardians with specific pickup times.Age: 19+Code Day-Date Time Fee-R/NR56607 Sa:8/17 8:00am $150/$200

6 – Summer 2013

Code for 1:3 Ratio Program Code for 1:5 RatioPizza and Bowling 1:3 #1 56595F:7/125:30pm-9:30pm

Pizza and Bowling 1:3 #2 56596Sa:8/105:30pm-9:30pm

Pizza and Bowling Let’s strike up some fun and go bowling! We’ll have some pizza and enjoy some bowling with friends!

In an effort to assure that all participants have the opportunity to participate in HISRA Programming, please only choose 1 of the Pizza and Bowling program dates offered.

Age: 19+Fee-R/NR: $27/$34

Pizza and Bowling 1:5 #156597F:5/175:30pm-9:30pm

Pizza and Bowling 1:5 #256598Sa:7/135:30pm-9:30pm

Pizza and Bowling 1:5 #356599F:8/95:30pm-9:30pm

Dinner and a Movie 1:356592Sa:7/275:00pm

Dinner and a Movie Join your friends at HISRA for dinner at a local restaurant and a movie! We will either choose a movie at one of our local theatres, or we will rent a movie and enjoy it at HISRA! Don’t forget your popcorn money! The end time of this program will be determined closer to the date of the event - based on movie times.Age: 19+ Fee-R/NR: $30/$40

Dinner and a Movie 1:556593F:7/265:00pm

Mini Golf and Ice Cream 1:356613F:8/166:00pm-9:00pm

Mini Golf and Ice Cream Let’s play some Mini Golf and enjoy some Ice Cream at Roc Ice Cream and Golf in East Peoria!Age: 19+ Fee-R/NR: $20/$25

Mini Golf and Ice Cream 1:556614F:7/ 56:00pm-9:00pm

SOCIAL PROGRAMS – ADULTSHISRA Adult Programming is a series of programs designed to offer an exciting opportunity to hang out with friends! Fee is per program. Please note-participants will only be allowed to register for 1 Pizza and Bowling Program per season. Age: 19+IMPORTANT INFORMATIONThe activities listed under 1:3 are for individuals who need more assistance to enjoy the activities. An approximate 1:3 staff-to-participant ratio will be assigned.

Another group of activities is for individuals who need minimal assistance to have fun with the group. An approximate 1:5 staff-to-participant ratio will be assigned.

Not sure which ratio is appropriate? Call HISRA – we can help!

The symbol next to a program indicates that transportation is provided for residents of our member districts for this program to and from Chillicothe (Shore Acres Park), Morton (Morton Freedom Hall) and Washington (St. Claire’s Crossing).

Summer 2013 – 7

HISRA CENTER BASED EVENTS

The symbol next to a program indicates that transportation is provided for residents of our member districts for this program to and from Chillicothe (Shore Acres Park), Morton (Morton Freedom Hall) and Washington (St. Claire’s Crossing).

Wii Mania @ HISRA Get ready for an evening of fun! Wii will spend the night playing Wii and enjoying some snacks here at HISRA!Age: 15+Code Day-Date Time Fee-R/NR56589 F:5/3 7:00pm-9:00pm $15/$20

Cinco de Mayo Party Let’s celebrate Cinco de Mayo with our friends at HISRA! We will enjoy music, food and fun! Join us!Age: 15+

Code Day-Date Time Fee-R/NR56615 Sa:5/4 7:00pm-9:00pm $15/$20

BINGOSnacks and great prizes are a couple of good reasons to get registered for this program B-4 it fills up! We will meet at HISRA and play a variety of Bingo games with the opportunity to win some great prizes!Age: 15+Code Day-Date Time Fee-R/NR56584 Su:5/19 2:00pm-4:00pm $10/$1556585 Su:7/21 2:00pm-4:00pm $10/$1556586 Su:8/4 2:00pm-4:00pm $10/$15

Dinner & Games @ HISRA Come spend an evening at HISRA as we enjoy dinner and then spend the rest of the evening playing games at HISRA!Age: 15+Code Day-Date Time Fee-R/NR56587 F:5/31 6:00pm-10:00pm $20/$25

Summer Solstice BBQ HISRA is hosting a BBQ to celebrate the Summer Solstice and you’re invited! We will have fun lawn games and great tasting food!Age: 15+Code Day-Date Time Fee-R/NR56588 F:6/21 5:30pm-8:30pm $20/$25

Ice Cream Social @ HISRAIt’s time to cool off with a cool treat! HISRA is hosting an Ice Cream Social, we will have ice cream and lots of toppings - come build an ice cream treat with your friends!Age: 15+Code Day-Date Time Fee-R/NR56591 Su:6/23 2:00pm-4:00pm $10/$15

Luau Dance Grab your grass skirts – HISRA is hosting a Luau! Join us for music, food and FUN!Age: 15+Code Day-Date Time Fee-R/NR56617 Sa:6/29 7:00pm-9:00pm $15/$20

Backyard BBQ HISRA is hosting a Backyard BBQ and you’re invited! We will have fun lawn games and great tasting food. Come on y’all! Let’s BBQ it up HISRA style!Age: 15+Code Day-Date Time Fee-R/NR56590 Sa:7/6 5:30pm-8:30pm $20/$25

BINGO

8 – Summer 2013

SPECIAL OLYMPICS

Special Olympics competition will be available if you are eligible and wish to participate. All Special Olympics athletes must have a valid

medical application on file for the entire length of the season. Age: 8+

Special Olympics GolfAre you interested in hitting the links but not sure what the first step is? Are you a seasoned golfer just itching for the course to open? Our Special Olympics Golf program is perfect for golfers of all levels. PGA professionals and coaches will provide opportunities to learn the fundamentals of golf, including driving, putting, chipping, scoring, and etiquette. Competition will be available if you are eligible and wish to participate. Athletes may participate in skills, 5 hole course play, 9 hole course play, or 9 hole unified course play. Unified means that a sibling, parent, or friend plays alongside the Special Olympics golfer as a teammate. Unified Partners must register. There is no fee for Unified Partners. This program is held at the Golf Learning Center and Kellogg Golf Course. Drop off and pick up at practice location.Code Day-Date Time Fee-R/NR56765 Begins 5/15 5:00pm-8:00pm $80/$10056766 -Unified Partner

Special Olympics SoftballGrab your glove and hit the field! Our T-ball/Softball program will begin May 21st. This year, we will try our hand at fielding both a slow pitch team as well as a T-ball team. Assessments will be completed at the first practice for team placement and practice time assignments will be made at that time. Special Olympics competition will also be available at area and possibly state tournaments if you are eligible and wish to participate. Practice location will be at Glen Oak Park. Game days will occur at various times and locations. A season calendar will be made available at the start of the season. Register early as this program fills up quickly. Drop off and pick up for this program will be at the practice location.Code Day-Date Time Fee-R/NR56767 Begins 5/21 5:00pm-8:00pm $40/$50

Special Olympics BowlingStrike up some fun and stay out of the sun at Landmark this summer! During this program, athletes bowl weekly in preparation for the district competition held at Landmark Lanes on August 24, 2013. New this year, bowlers must choose whether they will compete as a single, double, or team. Pick up and drop off at Landmark Lanes. Code Day-Date Time Fee-R/NR56768 Begins 6/17 5:30pm-7:00pm $50/$65

Important Special Olympics Dates

5/1: Golf Registration deadline

5/7: Softball Registration deadline

6/3: Bowling Registration deadline

6/10: Softball and Golf Med Apps due

6/14-16: Summer games, Illinois state University

7/1: Bowling Med Apps due

7/26: District Golf, Forsyth, IL

7/27: District Softball, Springfield, IL

8/24: District Bowling, Peoria, IL

Athletes must register for Special Olympics sports at least two weeks prior to the start of the program.

Summer 2013 – 9

REGISTRATION INFORMATION • Registration forms (with payment) can be mailed to the

HISRA Office at 8727 N. Pioneer Road, Peoria, IL 61615.• Walk-in registrations (with payment) will be accepted at

HISRA during regular business hours (8:00 am - 4:30 pm). After hours registrations and payments can be deposited in the drop box at the front of the HISRA building.

• Faxed registrations will ONLY be accepted for credit card payments.

• Staff WILL NOT accept payments or registration forms at programs.

• Registration forms must be filled out COMPLETELY and the waiver at the bottom of each registration form MUST be signed each time a participant registers.

• Payment must accompany all registration forms. Registrations will not be entered into the system until payment is received.

• Persons living outside the Chillicothe Park District, Morton Park District, Peoria Park District, and Washington Park District must pay the second fee listed (NR = Non-Resident).

• There are no pro-rated fees for camps, programs or activities.• Due to limited space, registrations are taken on a first-come,

first-served basis, when received with payment. No phone registrations will be accepted.

• If a program is full, you will be placed on the waiting list. If space becomes available, you will be called and payment will be needed immediately.

• An Annual Information Form must be completed once per year. All questions must be answered or marked N/A, if not applicable. For safety reasons, an individual without a completed Annual Information Form on file for the current year will not be permitted to participate in any HISRA program.

• Participants must register for all programs, camps and

Special Olympics sports at least two weeks prior to the start date.

• YOU MAY NOT REGISTER FOR ANY PROGRAM IF YOU HAVE A REMAINING BALANCE FROM ANY PAST SEASON. THERE ARE NO EXCEPTIONS TO THIS POLICY!

PROGRAM POLICIES• Participants should arrive no more than 5 minutes before

the program start time unless instructed otherwise.• The HISRA van will wait only 5 minutes for late arrivals.• To eliminate additional staff costs, participants need to be

dropped off and picked up as close to the program start and end times as possible. If participants are dropped off excessively early or picked up excessively late, a fee of $10 for every 15 minutes will be charged for this time. At any time we reserve the right to refuse an excessively early participant due to lack of available staff until the start time of the program.

• When arriving at and departing from a program, parent/guardians are asked to check in and out with the staff person in charge of the program. If a participant is to be picked up by someone unfamiliar to HISRA staff the parent/guardian is asked to notify HISRA staff in writing.

• If you request HISRA staff to dispense medication during programs or trips, the medicine MUST be in the original prescription packaging that shows the dosage and administration instructions. All medication administration forms must be filled out.

• Siblings or friends may participate in programs if space is available. A completed registration form, with the waiver signed, accompanied by payment must be received prior to attendance.

• Participants are encouraged not to bring unnecessary valuable personal items to programs. HISRA is not responsible for theft or loss during activities or events.

• If attending a movie, HISRA will choose the film according to age appropriateness whenever possible (Camps and Kids Korner: PG; Adult Programs: PG or PG-13). The theaters do not guarantee weekend movie times until Friday. HISRA will call with applicable times on the Friday prior to the activity or event.

• Any alcohol consumed at any HISRA event or program must be paid for by the individual participant. No HISRA funds will be used to purchase alcohol.

• Minimum and Maximum requirements have been established for each camp and program. If minimum registration requirements are not met, HISRA may be forced to cancel a program. HISRA reserves the right to adjust minimum and maximum registration requirements to accommodate the staffing needs of individual registrants.

• HISRA is not open to the public, therefore only registered participants will be allowed in the HISRA building during programming.

ALL THE DETAILSProgram Registration

On 4/22/13 HISRA will begin taking registrations for Summer 2013 programs.

Please note: any registrations for Summer 2013 programs received prior to 4/22/13 will be placed,

unopened, into a container at the front desk. On 4/22/13, HISRA staff will begin to randomly

enter registrations from the container.Beginning 4/22/13, walk-in registrations

will be processed as they come in.THE FOLLOWING PAPERWORK MUST BE

COMPLETED IN ORDER FOR A REGISTRATION TO BE ACCEPTED AND PROCESSED:

1. Registration Form2. 2013 Annual Information Form

3. Payment Arrangements

10 – Summer 2013

MEMBER DISTRICT TRANSPORTATIONHISRA makes every effort to make your participation in programs possible. HISRA may cancel member district transportation if enrollment is low or no member district residents are using transportation. Fees will be assessed for non-resident use of member district transportation.

MORTON RESIDENTSMorton Residents may register and pay for any programs at the Morton Park District office; however, to guarantee space is available, your best bet is to register directly through the HISRA office (691-1929).

PAYMENT OPTIONSPayment is required at the time of registration. HISRA accepts Cash, Checks, Credit Cards and Money Orders. If payment plan options are needed – please contact the HISRA office. HISRA is willing to work with participants on extenuating circumstances for payment. Please notify HISRA of your need as soon as possible when registering. One responsible party for payment.

ELECTRONIC CHECK CONVERSION When you provide a check as payment, you authorize HISRA and the Peoria Park District to use information from the check to make a one-time electronic fund transfer from your account. Funds may be withdrawn from your account as soon as the same day we receive your payment, and you will not receive your check back from your financial institution.In the event your check is not honored due to insufficient funds/account closure, you shall be liable for the amount of the check plus $30 (per check) for costs incurred by HISRA. In the event HISRA commences a collection action in the court, you shall be liable for all costs and expenses incurred by HISRA in connection with the collection of the check and any other damages permitted under Illinois law.

SCHOLARSHIP FUNDSLimited funds are available for residents of our member districts to those demonstrating financial need–please contact the HISRA office for details.

REFUND POLICYA full or partial refund will be considered if:• HISRA must cancel a program.• An ongoing program is deemed inappropriate for a

participant.• We receive a WRITTEN NOTICE of cancellation from you within

four (4) working days prior to program start date, unless otherwise noted (camps require a 2 week written notice of cancellation).

• If HISRA was required to purchase advance tickets, entry fees or supplies, only a partial refund will be made.

• Excessive cancellations may result in reduced refunds due

to processing fees.• Refunds will not be given to participants who do not show

up for programs for which they have registered.

ALTERNATE FORMAT OF BROCHUREIf you need an audio version of this brochure, please contact the HISRA Office.

AMERICANS WITH DISABILITIESIn keeping with the Americans with Disabilities Act, recreation programs offered by HISRA are available in the most integrated setting possible to facilitate program participation. HISRA will make reasonable accommodation to individuals with disabilities who meet essential eligibility requirements for the desired program.

EQUAL OPPORTUNITYHISRA will not exclude anyone from participation in, deny anyone the benefits of, or otherwise subject anyone to discrimination because of the person’s race, sex, color, national origin or disability (except where sex is a bona fide requirement for participation). For details, contact the Affirmative Action Officer at 682-1200.

PROGRAM CHANGES/CANCELLATIONS• Programs have minimums and maximums, and are filled on

a first come, first served basis. HISRA reserves the right to add, omit and otherwise change any or all of the program provisions (including advertised fees and charges) outlined in this brochure when deemed in the best interest of the participants. Such changes may also be instituted due to situations which develop that are beyond our control.

• HISRA reserves the right to modify or postpone programs, or change instructors.

• In the event of severe weather, HISRA may be forced to cancel programs. HISRA staff attempt to make these decisions as early as possible in order to notify participants in a timely manner by phone. Please call the HISRA office to verify if a program has been cancelled. If a program has insufficient registration, HISRA staff will attempt to notify the participant or adult contact by phone at least four days in advance.

GIFT CARDSGift Cards are available for purchase at the HISRA office during regular business hours.

WE’RE ONLY HUMAN!Occasionally there may be an error in the information included in this booklet. If so, HISRA will do everything possible to correct the situation promptly. Thank you for your patience and understanding should this occur.

ALL THE DETAILSAll forms are available online at http://www.peoriaparks.org/heart-of-illinois-special-recreation

Summer 2013 – 11

FOCUS CODE DATES CIRCLE: FEE: R/NR X CIRCLE:

Transp?Focus Mondays 56600 M:5/ 6 $480/$630 N/A

Focus Tuesdays 56601 Tu:5/ 7 $512/$672 N/A

Focus Wednesdays 56602 W:5/ 8 $512/$672 N/A

Focus Thursdays 56603 Th:5/ 9 $480/$630 N/A

OUTINGS CODE DATES CIRCLE: FEE: R/NR X CIRCLE:

Transp?Washington Cherry Festival 56616 Sa:6/1 $30/$40 M C W

Corn Stock Theatre “The Music Man”

56609 Sa:6/8 $30/$40 M C W

Chiefs Game #1 & Fireworks 56611 F:6/28 $22/$27 M C W

Chiefs Game #2 56612 F:7/19 $22/$27 M C W

Fireworks Spectacular 56608 W:7/3 $20/$25 M C W

Corn Stock Theatre “The Wiz”

56610 F:8/2 $30/$40 M C W

Cubs Game 56607 Sa:8/17 $150/$200

PARENTS NIGHT OUT CODE DATES CIRCLE: FEE: R/NR X CIRCLE:

Transp?Parents Night Out 56580 Sa:5/18 $27/$37/$7 N/A

Parents Night Out 56581 Sa:6/22 $27/$37/$7 N/A

Parents Night Out 56582 Sa:7/20 $27/$37/$7 N/A

Parents Night Out 56583 Sa:8/3 $27/$37/$7 N/A

SPECIAL OLYMPICS CODE DATES CIRCLE: FEE: R/NR X CIRCLE:

Transp?SO Golf 56765 Begins W:5/15 $80/$100 N/A

SO Golf, Unified PartnerName ________________

56766 Begins W:5/15 $0 N/A

SO Softball 56767 Begins Tu:5/21 $40/$50 N/A

SO Bowling 56768 Begins M:6/17 $50/$65 N/A

ADULT SOCIAL – 1:3 RATIO* CODE DATES CIRCLE: FEE: R/NR X CIRCLE:

Transp?please choose only one Pizza and Bowling program

Pizza and Bowling 1:3 #1 56595 F:7/12 $27/$34 M C W

Dinner and a Movie 1:3 56592 Sa:7/27 $30/$40 M C W

Pizza and Bowling 1:3 #2 56596 Sa:8/10 $27/$34 M C W

Mini Golf and Ice Cream 1:3 56613 F:8/16 $20/$25 M C W

ADULT SOCIAL – 1:5 RATIO CODE DATES CIRCLE: FEE: R/NR X CIRCLE:

Transp?Pizza and Bowling 1:5 #1 56597 F:5/17 $27/$34 M C W

Mini Golf and Ice Cream 1:5 56614 F:7/5 $20/$25 M C W

Pizza and Bowling 1:5 #2 56598 Sa:7/13 $27/$34 M C W

Dinner and a Movie 1:5 56593 F:7/26 $30/$40 M C W

Pizza and Bowling 1:5 #3 56599 F:8/9 $27/$34 M C W

HISRA CENTER BASED EVENTS CODE DATES CIRCLE: FEE: R/NR X CIRCLE:

Transp?Wii Mania @ HISRA 56589 F:5/3 $51/$20 M C W

Cinco de Mayo Party 56615 Sa:5/4 $15/$20 M C W

BINGO 56584 Su:5/19 $10/$15 N/A

Dinner & Games @ HISRA 56587 F:5/31 $20/$25 M C W

Summer Solstice BBQ 56588 F:6/21 $20/$25 M C W

Ice Cream Social @ HISRA 56591 Su:6/23 $10/$15 N/A

Luau Dance 56617 F:6/29 $15/$20 M C W

Backyard BBQ 56590 Sa:7/ 6 $20/$25 M C W

BINGO 56585 Su:7/21 $10/$15 N/A

BINGO 56586 Su:8/4 $10/$15 N/A

Inclusion Services 56778 N/A

Fees Add the program fees:SUBTOTAL $

Must complete the registration form on back

PROGRAMS

TRANSPORTATION: M= Morton Freedom Hall C= Shore Acres in Chillicothe W= St. Claire’s Crossing in Washington

H I S R A R E G I S T R A T I O N FORM Name of Participant:

Heart of IllinoisSpecial Recreation Association

12 – Summer 2013

Heart of Illinois Special Recreation Association8727 N. Pioneer Rd.Peoria, IL 61615

As a participant, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, including death, damages, or loss which I may sustain as a result of participating in any and all activities connected with or associated with such program. I agree to waive and relinquish all claims I may have as a result of par-ticipating in the program against the Heart of Illinois Special Recreation Association and its officers, agents, servants, and employees. I do hereby fully release and discharge the Heart of Illinois Special Recreation Association and its officers, agents, servants, and employees from any and all claims from injuries, including death, damage, or loss which I may have or which may accrue to me on account of my participation in the program. I further understand and agree that the terms such as “participating,” “programs,” and “activities,” referred to in the 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 any events. I authorize HISRA staff to dispense prescribed medications in their original container or accompanied by a copy of a signed prescription to me/my child.

I understand the nature of these programs for which I am registering, and fully understand this Waiver, Release, and Hold Harmless Agreement. I further understand that any advisements 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. Additionally, in order that the Heart of Illinois Special Recreation Association may better serve the interests of myself/my child, I hereby grant permission for Special Recreation staff to access relevant education and/or medical records. I hereby consent to the use of my/my child’s photograph in the Heart of Illinois SRA brochures, publications, or promotional materials.

Signature of Participant or Parent/Guardian Date

RETURN WITH HISRA, 8727 N. Pioneer Rd., Peoria, IL 61615PAYMENT TO: Fax: 309-691-4383 (credit card payments only)

WAIVER (MUST be signed for participation)

PAYMENT

DON’T FORGET!

� Check � Cash � Master Card � Visa � Discover

Credit Card Number

ALL registrations MUST be signed and accompanied by payment in order to be processed.

� Requesting Scholarship � Third-Party Payor � Payment Plan

Please contact HISRA if payment plan options are needed.

H I S R A R E G I S T R A T I O N FORM – continued from front

SUBTOTAL from front $Donations $TOTAL $

Full Name of Participant:

Birthdate: / / Age: Male/Female (CIRCLE)

Parent/Guardian Full Name:

Address:

City, State, ZIP:

Phone:

Disability:

E-mail:

Expiration Date: / Amount: $

Authorized Signature:

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for credit card use only

Summer 2013 – 13

HEART OF ILLINOIS SPECIAL RECREATION ASSOCIATION

CODE OF CONDUCT• The following guidelines have been developed to help

make the Heart of Illinois Special Recreation Association (HISRA) programs and services safe and enjoyable for all participants. Additional rules may be developed for partic-ular programs as deemed necessary by staff. The team at HISRA is committed to providing a safe, needs-satisfying, growth-oriented experience for every participant. We believe discipline is not merely a list of expectations, but rather an approach to teaching skills in self-control, responsible choice making, and appropriate community participation.

• A positive approach will be used regarding discipline. Staff will periodically review rules with participants during the program session. Prompt resolution will be sought specific to each individual situation. HISRA reserves the right to dismiss a participant whose behavior endangers the safety of himself or others assuming the procedures listed below are implemented and followed accordingly.

• Individual needs are taken into consideration. Disability information should be identified in advance to the pro-gram supervisor/staff so appropriate supports may be put in place. Please be sure your Annual Information Form is current and update staff with any changes.

• The following are guidelines that may be imposed in the disciplinary action process. These guidelines in no way guarantee that a participant will necessarily receive each level before dismissal based on the severity of the ac-tion. Also, please note that when programs are held at non-HISRA/Park District facilities, private facility rules take precedence over program code of conduct.

LEVEL 1The resolution of Level 1 behaviors is primarily the responsibility of program leaders and staff members. Level 1 behaviors include, but are not limited to the following:• Purposely distracting others• Inappropriate remarks• Inappropriate contact• Littering• Inappropriate dress• Pushing and/or shoving• Profanity and/or obscenity• Excessive/loud talking• Throwing objects• Refusal to follow instruction

LEVEL 2These interventions are the responsibility of Program Coordinator (or designee) with assistance from leaders/staff. Level 2 behaviors include, but are not limited to the following:• Possession of harmful objects• Discriminatory conduct• Intimidation/threats• Possession of stolen property• Unauthorized gambling• Theft• Damage to property• Persistent Level 1 behaviors• Disregard for others’ safety• Fighting, kicking, biting, spitting, pinching• Leaving grounds without permission

LEVEL 3These interventions are the responsibility of the Program Coordinator with consultation from Executive Director. Level 3 behaviors include, but are not limited to the following:• Persistent Level 2 behaviors• Arson/attempted arson• Sexual Misconduct • Possession of explosives• Burglary/robbery• Group violence• Use/possession of a weapon• Bomb threats• Use of a tool as a weapon• Endangerment• Vandalism• Fire alarms• Possession of stolen property• Interference with staff authority• Severe or repeated physical aggression• Abuse and/or harassment: verbal, physical, sexual, and

emotional

EACH INDIVIDUAL BEHAVIOR WILL BE ADDRESSED ON A CASE-BY-CASE BASIS WITH CONSIDERATION OF INDIVIDUAL DISABILITIES, MEDICAL ISSUES AND BEHAVIOR PLANS.

CODE OF CONDUCT

14 – Summer 2013

MAY 20135/1 Special Olympics Golf registration deadline5/3 Wii Mania5/4 Cinco de Mayo Party5/6 FOCUS - Mondays Begins5/7 Special Olympics Softball registration deadline5/7 FOCUS - Tuesdays Begins5/8 FOCUS - Wednesdays Begins5/9 FOCUS - Thursdays Begins5/15 Special Olympics Golf begins5/17 Pizza & Bowling 1:5 #15/18 Parents Night Out #15/19 Bingo #15/21 Special Olympics Softball begins5/27 HISRA CLOSED5/31 Dinner & Games @ HISRA

JUNE 20136/1 Washington Cherry Festival6/3 Special Olympics Bowling registration deadline6/8 Cornstock Theatre-The Music Man6/10 Special Olympics Softball and Golf med apps due6/14-16 Special Olympics Summer Games6/17 Special Olympics Bowling begins6/21 Summer Solstice BBQ6/22 Parents Night Out #26/23 Ice Cream Social6/28 Peoria Chiefs Game #1 (with fireworks)6/29 Luau Dance

JULY 20137/1 Special Olympics Bowling med apps due7/3 Fireworks Spectacular7/4 HISRA CLOSED7/5 Mini Golf and Ice Cream 1:57/6 Backyard BBQ7/12 Pizza & Bowling 1:3 #17/13 Pizza & Bowling 1:5 #27/19 Peoria Chiefs Game #27/20 Parents Night Out #37/21 Bingo #27/26 Dinner & a Movie 1:57/27 Dinner & a Movie 1:37/26 Special Olympics Golf District Qualifier7/27 Special Olympics Softball District Tournament

AUGUST 20138/2 Cornstock Theatre-The Wiz8/3 Parents Night Out #48/4 Bingo #38/9 Pizza & Bowling 1:5 #38/10 Pizza & Bowling 1:3 #28/16 Mini Golf and Ice Cream 1:38/17 Cubs vs. Cardinals Game8/24 Special Olympics Bowling District Tournament

PROGRAMS AT A GLANCE

*please remember that registration closes two weeks prior to each program.

Summer 2013 – 15

PROGRAM CALENDAR Name of Participant:

Fill in this calendar to help keep track of the dates/times of programs or special events for you or your child.

Office

Closed

Office

Closed

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REGISTRATION BEGINS APRIL 22, 2013!Call 691-1929 or Fax 691-4383www.peoriaparks.org/heart-of-illinois-special-recreation

OFFICE HOURSMon - Fri, 8:30 am - 12:00 pm & 1:00 pm - 4:30 pmClosed 5/27 and 7/4

Heart of Illinois Special Recreation Association8727 N. Pioneer Rd.Peoria, IL 61615

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Peoria, IL

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Heart of Illinois Special Recreation Association (HISRA)A cooperative extension of the Chillicothe, Morton, Peoria, and Washington Park Districts

8727 N. Pioneer Road, Peoria, IL 61615Phone: (309) 691-1929

http://peoriaparks.org/heart-of-illinois-special-recreation

HISRA provides quality recreation programs and services to individuals with disabilities and special needs. We support the spirit and intent of the Americans With Disabilities Act. HISRA is committed to providing opportunities for each individual to enjoy recreation activities in the least restrictive environment possible.

• After School Programs

• Parents Night Out

• Spring Break & Holiday Camps

• Summer Camps

• Special Olympics

• Adapted Sports

• Kids Korner

• And More!