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2121 W Indian Trail Rd Aurora, IL 60506 630.907.1114 Phone 630.907.1116 Fax www. FVSRA.org Enriching the Lives of People with Disabilities The Fox Valley Special Recreation Association exists to enrich the lives of people with disabilities. Working collaboratively with member agencies and comunity partners, we pledge to put PEOPLE FIRST. FVSRA provides a diverse range of year-round recreational activities to: • Enhance skill development. • Encourage self-awareness and community exploration. • Promote independence. • Provide a sense of enjoyment, satisfaction, and fulfillment. Inclusion Services for Park District Programs FVSRA services provide year-round opportunities for individuals with disabilities to participate with their non-disabled peers in recreational programs within communities. Inclusion opportunities are available to individuals of ALL ability levels, of ALL ages. If you, or a family member would like to enroll in a Park District program and need assistance, simply request additional services by marking the “special accommodations” section on the Park District registration form. The request will be forwarded to the FVSRA Inclusion Coordinator, Sophie Morgan, who will find the appropriate assistance and continue to monitor progress throughout the program by staying in direct contact with the individual or caregiver, as well as in contact with the Park District Staff. Please provide at least two weeks notice prior to the start of the program date for an inclusion request. For more information on FVSRA and Inclusion Services please contact Sophie Morgan at 630.907.1114 or SMorgan@Fvsra.org. There’s Something for Everyone of ALL ages! Community Outings Adventure Programs Computer Lessons Wheelchair Sports Dance Lessons Trips to Sporting Events Music/Piano Lessons Bowling Leagues Health and Fitness Special Events Overnight Outings Swim Lessons Parent and Child Programs Aquatic Programs Teen/Adult Social Clubs Special Olympics Sports What is the Importance of Community Therapeutic Recreation FVSRA services help increase the overall quality of life for individuals with disabilities through active involvement in community leisure activities. Participation benefits: • Physical conditioning. • Improvement in overall health. • Enhanced independent skills. • Community integration. • Elevated emotional well-being. • Increased life and leisure satisfaction. • Increased self-esteem. • The learning of acceptable behaviors.
Need another form Download one from our website: sgparks.org Last Name _________________________________________ First ____________________________ Home Phone (____)_____________________ (Parent/Legal Guardian) Street Address ___________________________________ Email_______________________________ Work Phone (____)_____________________ City ____________________________________ State _____________ Zip _______________ Cell Phone (____ )____________________ Last Name First Sex F/M Date of Birth Age Grade Program Name Session Program Fee Our athletic leagues depend on our volunteer coaches. If interested please complete the following information: Name:_____________________________________________________________________ (Circle One) Head Coach OR Assistant Coach Athletic League/Sport: _______________________________________________________ Age Group/Grade: _________________________ No refunds after registration deadline on programs, uniforms, or once teams are formed. Refunds requested before registration deadline are subject to a $10 minimum service charge. A 75% refund may be issued for athletic team participants (less costs) if replacement player is found. Activities will be cancelled if minimum registrations are not met by registration deadline. Full refunds are issued if the Park District cancels a program. Mail this form along with your payment to Sugar Grove Park District, 61 Main Street, Sugar Grove, IL 60554. Drop box available for your convenience 24 hours a day. Credit card payments may be faxed to 630-466-8675. Total Due: _______________ Cash ______ Check ______ ______ ______ Credit Card # _________________________________________ Exp. Date ____/____/____ 3 Digit Security Code from Back __________ Print Cardholder Name: ____________________________________ Signature: ________________________________________ The Sugar Grove Park District does its best to accommodate those individuals with special needs. If you need any special assistance with a program, please call the office at 630-466-7436 and we will do our best to assist you. WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK Please read this form carefully and be aware that in signing up and participating in the programs listed above you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with these programs (including transportation services and vehicle operations, when provided). I recognize and acknowledge that there are certain risks of physical injury to participants in these programs, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity, that my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in these programs against the Sugar Grove Park District, including its officials, agents, volunteers and employees. I have read and fully understand the enclosed important information, warning of risk, assumption of risk and waiver and release of all claims. Participation will be denied if the signature of adult participant OR Parent/Guardian and date are not on this waiver Print Participant’s Name Participant’s Signature (18 years or older OR Parent/Guardian) Date
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Page 3 and 4: Table of Contents SUGAR GROVE PARK
Page 5 and 6: Adult SUGAR GROVE PARK DISTRICT FAL
Page 7 and 8: Preschoolers SUGAR GROVE PARK DISTR
Page 9 and 10: Seniors SUGAR GROVE PARK DISTRICT F
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