SRSNLC - the Round Lake Area Park District!

COOPERATIVE Special Events4COOPERATIVEThese programs are offered at all agencies. Please register with your local Park District.Fall Getaway - Louisville, KentuckyYou may know that Louisville has a stunning waterfront skyline, but did youknow that it is the home of the nation’s largest urban forest? You may knowthat the official bats for major league baseball are made in Louisville, but didyou know that 90% of U.S. disco balls are made there too? Spend a beautifulautumn weekend with SRSNLC as we explore all that Louisville has to offer.From the Louisville Slugger Baseball Museum to the Muhammad Ali Center,there will not be a dull moment. Of course, no visit to Louisville would becomplete without touring classic Churchill Downs, home of the world’s mostfamous thoroughbred horserace –– the Kentucky Derby. Pack your suitcaseand get ready for the adventure of the year.Highlights from the2011 Fall Getaway to“Cranberry ‘Cranberry Country”Country’Location: Louisville, KentuckyAge: 16 & OlderMin/Max: 8/10Fee: $350 (Non-Refundable $100 Registration Deposit)Reg. Deadline: September 1, 2012CODE DAY DATE TRANSPORT TIMEL3401-D Th-Su 9/27-30 TBDRL14279 Th-Su 9/27-30 TBDW6819 Th-Su 9/27-30 TBDZ7106 Th-Su 9/27-30 TBDHomecoming DanceNEWWant to relive your high school days? Well, come to SRSNLC’s Homecoming Dance. Come dressed in yourfavorite high school attire and possibly get crowned Homecoming King or Queen.Location: RLAPD Sports CenterEvent Time: 7:00pm-9:00pmAge: 13 & OlderMin/Max: 25/125Fee: $12R / $18NRReg. Deadline: September 7, 2012CODE DAY DATE TRANSPORT TIMEL3401-B F 9/21 6:30pm-9:30pmRL14287 F 9/21 NONEW6817 F 9/21 6:15pm-10:30pmZ7089 F 9/21 6:30pm-10:30pmLINDENHURST • ROUND LAKE • WAUKEGAN • ZION

COOPERATIVE Special Events cont.These programs are offered at all agencies. Please register with your local Park District.Halloween BashGhouls and Goblins - come for a hauntingly spooktacular evening with SRSNLC! Minglewith the monsters as you enjoy barn dancing, refreshments anda hayride, weather permitting. Come dressed in your Halloweencostume to dance the night away - best costume wins a prize! Dressfor the weather -- part of this event is outdoors!Location: Renwood Golf CourseEvent Time: 7:00pm-9:00pmAge: 13 & OlderMin/Max: 25/125Fee: $12R / $18NRReg. Deadline: October 5, 2012CODE DAY DATE TRANSPORT TIMEL3401-C F 10/12 6:30pm-9:30pmRL14275 F 10/12 NONEW6818 F 10/12 6:15pm-10:30pmZ7144 F 10/12 6:00pm-10:30pm5Twist and shout . . . It’s Turkey Twist time for SRSNLC. Celebrate the season in style by joining your friendsfor an evening of dancing, snacks, raffles, and fun at the Lindenhurst Park District. It will be a night toremember; don’t miss out –– register early. NOTE: Gym shoes required.Location: Lindenhurst Park District GymEvent Time: 7:00pm-9:00pmAge: 13 & Older Min/Max: 50/150Fee: $13R / $20NRReg. Deadline: October 26, 2012Turkey TwistCODE DAY DATE TRANSPORT TIMEL3401-E F 11/9 NONERL14261 F 11/9 6:30pm-9:30pmW6820 F 11/9 6:15pm-10:30pmZ7166 F 11/9 6:15pm-10:00pmHoliday PartyTis’ the season to be jolly! Come celebrate the holidays with your pals from SRSNLC! Each participantwill receive a gift and visit from someone special! The night willinclude dancing and yummy snacks fit for the Big Guy himself!Location: Shepherd’s Crook Golf Course, ZionEvent Time: 6:30pm-8:30pmAge: AllMin/Max: 30/130Fee: $8R / $12NRReg. Deadline: November 1, 2012CODE DAY DATE TRANSPORT TIMEL3401-F Th 12/13 5:45pm-9:15pmRL14277 Th 12/13 6:00pm-9:00pmW6821 Th 12/13 5:45pm-9:45pmZ7023 Th 12/13 NONELINDENHURST • ROUND LAKE • WAUKEGAN • ZION

6LINDENHURST Seasonal ProgramsVolo Bog Tour & LunchLet’s take an adventure to the Volo Bog StateNatural Area in Ingleside, Illinois to explore theonly “quaking” bog in Illinois with an openwater center. After our journey, we will go toTammy’s in Spring Grove for lunch.*Please wear good walking shoes*Location: Ingleside, IllinoisAge: 13 & OlderMin/Max: 4/12Fee: $25R / $38NRReg. Deadline: One week prior.CODE DAY DATE TIMEL3403-A F 9/7 9:00am-3:00pmAll AboardHead to Roma’s Ristorante & Lounge in EastTroy for a fabulous pizza lunch before takinga ride back in time on the East Troy ElectricRailroad. Take in the gorgeous Wisconsinlandscape on the one hour relaxing roundtrip ride with a short excursion at The ElegantFarmer Depot.Location: East Troy, WisconsinAge: 13 & OlderMin/Max: 4/12Fee: $30R / $45NRReg. Deadline: September 3, 2012CODE DAY DATE TIMEL3403-D Sa 9/15 9:45am-4:45pmOktoberfest LuncheonCelebrate German heritage at SRSNLC’sOktoberfest Luncheon. Dine on traditionalGerman dishes including brats, sauerkraut,boiled red potatoes, brat rolls, apple pie andmore. Kick back and enjoy games, activities,and prize raffles.Location: Community CenterAge: 13 & OlderMin/Max: 4/12Fee: $18R / $27NRReg. Deadline: September 22, 2012CODE DAY DATE TIMEL3412-D Sa 10/6 11:00am-1:00pmJerry Smith’s Pumpkin FarmIf you love autumn, you will absolutely LOVE Jerry Smith’s PumpkinFarm. Enjoy a wide display of decorated pumpkins and scenery,kick back on a hayride, and select your own pumpkin to bringhome for carving. Pack a sack lunch and beverage.Location: Kenosha, WisconsinAge: 13 & OlderMin/Max: 4/12Fee: $15R / $22NRReg. Deadline: Two weeks prior.CODE DAY DATE TIMEL3403-E Sa 10/20 10:15am-3:00pmMilwaukee Domes &Water Street BreweryCheck out Milwaukee’s living landmark—theMitchell Park Horticultural Conservatorycommonly referred to as “the domes”.Experience a desert oasis, a tropical jungle,and special floral gardens all in one morning.Complete your day with a relaxing lunch atthe Water Street Brewery.Location: Milwaukee, WisconsinAge: 15 & OlderMin/Max: 4/12Fee: $35R / $53NRReg. Deadline: October 1, 2012CODE DAY DATE TIMEL3403-B W 10/10 9:00am-4:00pmSRACLCWinter WonderlandWinter is upon us and there is no better wayto stay warm than to dance the night awayat SRACLC’s Winter Wonderland Dance at theSullivan Center in Vernon Hills.Location: Vernon Hills, IllinoisAge: 13 & OlderMin/Max: 4/12Fee: $18R / $27NRReg. Deadline: November 16, 2012CODE DAY DATE TIMEL3408-B F 12/14 6:15pm-9:45pmShedd AquariumYou’ll find something wet, wild and wonderful wherever you walkat the Shedd. The galleries are home to creatures from the Watersof the World – rivers and reefs, Great Lakes and small ones, and theglobal ocean. Immerse yourself in the Caribbean Reef, AmazonRising’s flooded forest, the Oceanarium’s Pacific Northwest coastand Wild Reef’s Indo-Pacific reef. Go totally polar in Polar Play Zoneand check out Shedd’s aquatic show. Lunch included.Wii PartyKick off your weekend with a Wii Party. Testyour skills at Wii bowling, Just Dance, and otherpopular games. While waiting for your turn,amaze your friends with your karaoke skills. Apizza dinner is provided.Location: Community CenterAge: 13 & OlderMin/Max: 4/12Fee: $15R / $23NRReg. Deadline: September 5, 2012CODE DAY DATE TIMEL3403-H F 9/14 6:00pm-8:15pmSRSNLC Slumber PartyGrab your best P.J.’s and your sleeping bag forthe SRSNLC Slumber Party! It will be a funnight of games, movies, friends & pizza. Aletter will be mailed 2 weeks prior to event withmore information about the slumber party.OPTIONAL -small air mattress or sleeping pad.Location: Leisure Center, ZionAge: 16 & OlderMin/Max: 4/8Fee: $25R / $38NRReg. Deadline: October 26, 2012CODE DAY DATE TIMEL3401-A F-Sa 11/16-17 5:30pm-11:30amLocation: John H. Shedd Aquarium, ChicagoAge: 13 & OlderMin/Max: 6/12Fee: $62R / $93NRReg. Deadline: November 16, 2012CODE DAY DATE TIMEL3403-G Tu 12/4 10:00am-5:00pmROUND LAKE • 847-546-8558 • www.rlapd.orgLINDENHURST • 847-356-6011 • www.lindenhurstparks.org

LINDENHURST Seasonal ProgramsZion SocialClub DancesFor those who love music, dancing, andsocializing, SRSNLC—Zion hosts regular themedances. Fee includes door prize, refreshments,and a whole lot of dancing.September—Fall FlingOctober—Monster MashNovember—Gobble & ShoutDecember—Jingle Bell RockLocation: Leisure Center, ZionAge: 13 & OlderMin/Max: 4/12Fee: $12R ($18 door-to-door) / $18NRReg. Deadline: One week prior.CODE DAY DATE TIMEL3404-A F 9/7 6:30pm-9:30pmL3404-B F 10/5 6:30pm-9:30pmL3404-C F 11/2 6:30pm-9:30pmL3404-D F 12/7 6:30pm-9:30pmDinner GroupSocialize with friends over dinner whilepracticing important skills such as ordering,meal etiquette, and determining gratuity. Allexpenses included.September—Golden Panda, AntiochOctober—Savanna House, WadsworthNovember—Tacos El Norte, GurneeLocation: Varies - Meet at the LindenhurstPark DistrictAge: 16 & OlderMin/Max: 5/12Fee: $25R ($31 door-to-door) / $38NRReg. Deadline: Two weeks prior.CODE DAY DATE TIMEL3412-A W 9/19 5:15pm-8:45pmL3412-B Tu 10/16 5:15pm-8:45pmL3412-C M 11/12 5:15pm-8:45pmMonday Movie ClubSee it on the big screen. Monday Movie Clubparticipants enjoy a movie at Marcus GurneeCinema once a month. Price includes movieticket. Times and theatre subject to changebased on movie selection.Location: Gurnee Cinema, GurneeAge: 13 & OlderMin/Max: 4/12Fee: $15R / $23NRReg. Deadline: Two weeks prior.CODE DAY DATE TIMEL3405-A M 9/10 6:15pm-9:15pmL3405-B M 10/8 6:15pm-9:15pmL3405-C M 11/19 6:15pm-9:15pmL3405-D M 12/10 6:15pm-9:15pmHelping HeartsHelping Hearts is a participant-led serviceorganization. Participants take an active rolein choosing, planning, and implementingservice projects that benefit Lindenhurst andsurrounding communities under the guidanceof SRSNLC staff and volunteers.Location: Community CenterAge: 13 & OlderMin/Max: 4/12Fee: $15R / $23NRReg. Deadline: October 4, 2012CODE DAY DATE TIMEL3410-A Th 10/18-11/1 10:00am-11:30am7Denny’s and a MatineeFriends from SRSNLC Lindenhurst and Zionmeet once a month for brunch at Denny’sfollowed by a movie at Gurnee Cinema.Brunch and movie ticket included.Location: Gurnee, IllinoisAge: 16 & OlderMin/Max: 2/10Fee: $27R / $41NRReg. Deadline: One week prior.CODE DAY DATE TIMEL3406-A F 9/14 10:00am-3:00pmL3406-B F 10/19 10:00am-3:00pmL3406-C F 11/16 10:00am-3:00pmL3406-D F 12/21 10:00am-3:00pmPizza and a MovieIt is Friday night and that can only mean onething… Pizza and a Movie. Join your friendsfor delicious pizza and the latest DVD. Registerfor one or all—new movies each date.Location: Community CenterAge: 13 & OlderMin/Max: 4/16Fee: $12R / $18NRReg. Deadline: Two weeks prior.CODE DAY DATE TIMEL3402-A F 11/30 5:45pm-8:00pmL3402-B F 12/28 5:45pm-8:00pmFancy Night OutGet gussied up for a fabulous seafood dinnerat Joe’s Crab Shack in Gurnee, Illinois. Thisprogram is offered in collaboration withSRSNLC Zion.Location: Joe’s Crab Schack, GurneeAge: 13 & OlderMin/Max: 4/12Fee: $40R / $60NRReg. Deadline: November 15, 2012CODE DAY DATE TIMEL3412-E Th 12/6 5:15pm-8:45pmDave and Buster’sEnjoy lunch and an afternoon playing games at Dave and Buster’s in Wauwatosa,Wisconsin. Lunch and a $20 Power Card is included—participants may bring extramoney to reload their Power Card.Location: Wauwatosa, WisconsinAge: 18 & OlderMin/Max: 4/12Fee: $42R / $63NRReg. Deadline: October 10, 2012CODE DAY DATE TIMEL3403-H W 10/24 10:00am-4:00pmLINDENHURST • 847-356-6011 • www.lindenhurstparks.org

Saturday SocialitesDon’t be a wall flower—spend your Saturdaysout and about with Saturday Socialites.Practice your social skills, explore new andexciting activities, and acquaint yourself withyour community.October –– Jerry Smith’s Pumpkin FarmFee: $15R / $22NR (Pack a sack lunch)November –– Swimming at The WaterWorks in SchaumburgFee: $32R / $48NR (Pack a sack lunch)Location: Varies –– Meet at the LindenhurstPark DistrictAge: 5-12 Years Min/Max: 4/8Reg. Deadline: Two weeks prior.CODE DAY DATE TIMEL3413-A Sa 10/13 10:00am-2:45pmL3413-B Sa 11/3 11:00am-4:30pmThe Benefits of Art for Special Populations . . .Contrary to popular belief, art is not purely aesthetic. Art motivates and engages childrenand adults in learning, stimulates memory, enhances symbolic communication, promotesrelationships, assists motor skill development, and provides an avenue for building selfconfidenceand competence.SRSNLC—Lindenhurst offers a variety of youth and adult art programs to provide numerousopportunities for art exploration, self-expression, and creativity. Discover the benefits of art!Intro to ClayLINDENHURST Arts & CraftsSmash, pound, press, roll, and create. Basicceramic skills will be taught in this introductoryclay class including the score and slip techniqueand hand building using coils, slabs, and thepinch method. Note: This class uses air dryand oven fired clay; no kiln will be used.Location: Community CenterAge: 6-12 YearsMin/Max: 4/8Fee: $30R / $45NRReg. Deadline: September 25, 2012CODE DAY DATE TIMEL3409-B Tu 10/9-10/30 3:45pm-4:30pmLINDENHURST Youth & TeenTeen SceneSensory ArtDaily life can be filled with numerous nontactilestimuli such as television, video games,ipods, and computers. In Sensory Art, yourchild participates in a variety of art activitiesdesigned to promote tactile stimulation.Dabble in shaving cream, sprinkle colored rice,squeeze moist clay, and finger paint—yoursenses will thank you. Emphasis is placedon the art process rather than the finishedproduct.Location: Community CenterAge: 3-7 YearsMin/Max: 4/8Fee: $24R / $36NRReg. Deadline: September 25, 2012CODE DAY DATE TIMEL3409-E Tu 10/9-10/30 2:15pm-3:00pmRegister online . . .it’s fast, easy and convenient!For online registration, please visit the Lindenhurst Park Districtwebsite at www.lindenhurstparks.org or contact Julie Rushmeyer at847.356.6011 ext. 108 for more information.Teen Scene programs are designed specifically for youth ages thirteen through nineteenyears old. Each program assists teens in building relationships, developing new skills, andexploring Lake County and the greater Chicago area.October –– Halloween Barn Bash DanceFee: $12R / $18NRNovember –– Turkey Twist DanceFee: $13R / $20NRDecember –– SRSNLC Holiday PartyFee: $8R / $12NRLocation: Varies –– Meet at the LindenhurstPark DistrictAge: 13-19 Years Min/Max: 4/8Reg. Deadline: Two weeks prior.CODE DAY DATE TIMEL3407-A F 10/12 6:30pm-9:30pmL3407-B F 11/9 7:00pm-9:00pmL3407-C Th 12/13 5:45pm-9:15pmCrafty CreationsROUND LAKE • 847-546-8558 • www.rlapd.orgLINDENHURST • 847-356-6011 • www.lindenhurstparks.org9Crafty Creations is ideal for those who love artand creativity. Each participant will create acustom project perfect for display. Each craftis selected to promote creativity and developfine motor skills.Location: Community CenterAge: 13 & OlderMin/Max: 3/8Fee: $15R / $23NRReg. Deadline: Two weeks prior.CODE DAY DATE TIMEL3409-C W 10/17 9:30am-11:00amIntro to CeramicsBasic ceramic skills are taught in thisintroductory clay class including the score andslip technique and hand building using coils,slabs, and the pinch method. Participantswill create a unique clay piece at the firstclass and complete the piece with paint andembellishments at the second class. Note:This class uses air dry and oven fired clay;no kiln will be used.Location: Community CenterAge: 13 & OlderMin/Max: 3/8Fee: $15R / $23NRReg. Deadline: Two weeks prior.CODE DAY DATE TIMEL3409-A Th 9/13-9/20 2:00pm-3:15pm

10Northwestern WildcatsFootballCome see Chicago’s Big Ten team play at RyanField. Cost includes ticket and food for ourtailgate; please remember to bring money forsouvenirs. GO CATS!!!!Meet Location: RLAPD Teen CenterLocation: Ryan Field, EvanstonAge: 13 & OlderMin/Max: 4/12Fee: $50R / $75NRReg. Deadline: August 25, 2012CODE DAY DATE TIMERL14269 Sa 9/22 TBDWhat’s CookingLake CountyYou have just been designated SRSNLC’snewest food critic; let’s see how our LakeCounty area restaurants measure up. Try outspecialty dishes and rate the restaurant andfood based on your experience. Door todoor transportation provided for Round Lake,Fox Lake and Lake Villa residents only. Pleaseremember to bring money for dinner.Age: 13 & OlderMin/Max: 4/12Fee: $10R ($6 door-to-door) / $15NRReg. Deadline: One week before each outingREFLECTION’S, Lake VillaCODE DAY DATE TIMERL14256 W 9/19 6:00pm-8:30pmPIZZA ITALIA, MundeleinCODE DAY DATE TIMERL14253 W 10/17 6:00pm-8:30pmHENNY PENNY, McHenryCODE DAY DATE TIMERL14254 W 11/14 6:00pm-8:30pmCHANG JIANG BUFFET, Round Lake BeachCODE DAY DATE TIMERL14255 W 12/19 6:00pm-8:30pmROUND LAKE On The TownAll AboardIt will be a wonderful sight we’ll be happy tonight aswe dance in a winter wonderland. Party with friends aswe celebrate the season with other SRAs. Snacks andmerriment will be plentiful as we deck the halls at this party.Meet Location: RLAPD Teen CenterLocation: Sullivan Center, Vernon HillsAge: 13 & OlderMin/Max: 4/12Fee: $18R / $27NRReg. Deadline: November 30, 2012CODE DAY DATE TIMERL14278 F 12/14 6:00pm-9:45pmHead to Roma’sRistorante & Lounge inEast Troy for a fabulouspizza lunch beforetaking a ride back intime on the East TroyElectric Railroad. Takein the gorgeous Wisconsin landscape on theone hour relaxing round trip ride with a shortexcursion at The Elegant Farmer Depot.Meet Location: RLAPD Teen CenterLocation: East Troy, WIAge: 13 & OlderMin/Max: 4/12Fee: $30R / $45NRReg. Deadline: September 3, 2012CODE DAY DATE TIMERL14268 Sa 9/15 9:30am-5:00pmFive Guys and a FlickCome try the new Five Guys Burgers in Gurneethen catch the latest flick at the nearby theatre.Lunch and movie are included in the fee.Meet Location: RLAPD Teen CenterLocation: Gurnee, ILAge: 13 & OlderMin/Max: 4/12Fee: $27Reg. Deadline: November 9, 2012CODE DAY DATE TIMERL14276 Sa 11/17 11:00am-3:00pmROUND LAKE • 847-740-9828 • www.rlapd.orgOktoberfest LuncheonCelebrate German heritage at SRSNLC’sOktoberfest Luncheon. Dine on traditionalGerman dishes including brats, sauerkraut,boiled red potatoes, brat rolls, apple pie andmore. Kick back and enjoy games, activities,and prize raffles.Meet Location: RLAPD Teen CenterLocation: Lindenhurst Park DistrictAge: 13 & OlderMin/Max: 4/8Fee: $18R / $27NRReg. Deadline: Sesptember 22, 2012CODE DAY DATE TIMERL14274 Sa 10/6 10:30am-1:30pmMNASR Halloween DanceGet ready for a night of scares at MNASR’Sannual dance. Come dressed in your costumefor the contest, walk through the scary mazeand monster mash the night away.Meet Location: RLAPD Teen CenterLocation: Niles, ILAge: 13 & OlderMin/Max: 4/12Fee: $18R / $23NRReg. Deadline: September 28, 2012CODE DAY DATE TIMERL14275 F 10/26 5:00pm-10:00pmSRACLC Winter Wonderland Dance

Special OlympicsBowlingROUND LAKE Sports and FitnessBowling is perhaps the most popular SpecialOlympics sport in Illinois. Join us for our fallsessions of bowling and start training for theArea 13 bowling tournament in June. Bowlersof all abilities are welcome. The fee includestwo games of bowling and shoe rental. Gamesbegin promptly at 6:30pm so please arriveearly.Location: Kristof’s Entertainment Center,Round LakeAge: 8 & OlderMin/Max: 4/34Fee: $52R / $78NRFall 1 Reg. Deadline: September 20, 2012Fall 2 Reg. Deadline: November 15, 2012FALL 1CODE DAY DATE TIMERL14257 Th 9/27-11/15 6:30pm-8:30pmFALL 2 (No Bowling 12/27)CODE DAY DATE TIMERL14259 Th 11/29-1/24 6:30pm-8:30pmNSSRA BowlingTournamentCalling all bowlers! We are heading toDeerfield to compete against area bowlersin NSSRA’s annual bowling tournament. Feeincludes two games of bowling, lunch, andawards. Registration in the fall 1 session ofbowling is required.Meet Location: Round Lake Area Park DistrictTeen CenterLocation: Brunswick Zone, DeerfieldAge: 13 & OlderMin/Max: 4/12Fee: $22R / $33NRReg. Deadline: October 31, 2012CODE DAY DATE TIMERL14231 Sa 12/1 8:30am-2:00pmUpcoming SpecialOlympics DatesSeptember 8th & 9thOUTDOOR SPORTS FESTNovember 3rdSECTIONAL BOWLINGDecember 1stSTATE BOWLINGSpecial Olympics BasketballBeginner Individual Skills (Ages 8 & up)In this program you will learn thefundamentals of the game of basketball.This will include passing, dribbling, andshooting. This program is perfect for anathlete who is new to basketball.*No practice 11/19, 12/24, and 12/31*Location: Indian Hill Elementary SchoolMin/Max: 3/6Fee: $45Reg. Deadline: October 29, 2012CODE DAY DATE TIMERL14248 M 11/5-1/14 5:30pm-6:00pmAdvanced Individual Skills (Ages 8 & up)In this program you will build on yourpassing, dribbling, and shooting byadding in different elements like passing todifferent targets, dribbling around cones,and shooting from farther locations. It isrecommended that you complete a seasonof Beginner Individual Skills before joining.*No practice 11/19, 12/24, and 12/31*Location: Indian Hill Elementary SchoolMin/Max: 3/6Fee: $45Reg. Deadline: October 29, 2012CODE DAY DATE TIMERL14249 M 11/5-1/14 6:00pm-6:30pmROUND LAKE • 847-740-9828 • www.rlapd.org11Basketball is one of the most popular Special Olympics sports in Illinois. This fall SRSNLCRound Lake will be offering Beginner Individual Skills, Advanced Individual Skills, a JuniorLevel Team, and a Senior Level Team. All options have the opportunity to compete at SpecialOlympics Tournaments.Jr. Superstars Team (Ages 8 to 14)In this program you join the Jr. SuperstarsBasketball Team and play different SRA’s inthe community. Games will take place onSaturday afternoons. It is recommendedthat you complete a season of IndividualSkills before joining.*No practice 11/19, 12/24, and 12/31*Location: Indian Hill Elementary SchoolMin/Max: 8/12Fee: $55Reg. Deadline: October 29, 2012CODE DAY DATE TIMERL14247 M 11/5-2/11 6:30pm-7:30pmSuperstars Team (Ages 15 and up)In this program you join the SuperstarsBasketball Team and play different SRA’s inthe community. Games will take place onTuesday evenings. It is recommended that allplayers have a prior knowledge of the game ofbasketball, including playing as a team.*NO practice 11/20, 12/25 and 1/1*Location: Robert W. Rolek Comm. CenterMin/Max: 8/15Fee: $55Reg. Deadline: October 2, 2012CODE DAY DATE TIMERL14246 Tu 10/9-2/19 6:30pm-8:00pmPLEASE NOTE -THE POLICY ON REGISTERINGFOR SPECIAL OLYMPICS SPORTS!To compete at Special Olympics tournaments a Special OlympicsMedical Application is needed. If you or your athlete does not havea Special Olympics Medical Application on file your registration willbe held until approval is made by the SRSNLC Program Supervisorand a completed Special Olympics Medical Application is submitted.Athletes who wish not to compete at Special Olympics Tournamentsmay still participate in our eight week programs without a SpecialOlympics Medical Application.

12YOUTH -Saturday SocialitesDon’t be a wall flower, spend your Saturdaysout and about with Saturday Socialites.Practice your social skills, explore new andexciting activities, and acquaint yourself withyour community. Pack a sack lunch.Meet Location: RLAPD Teen CenterLocation: Jerry Smith’s Apple FarmAge: AllMin/Max: 2/4 FamiliesFee: $30 per familyReg. Deadline: October 5, 2012CODE DAY DATE TIMERL14289 Sa 10/13 10:00am-2:00pmYOUTH -Sensory StationAt Sensory Station, you and your child willparticipate in a variety of activities designedto promote tactile stimulation. Dabble inshaving cream, sprinkle colored rice, squeezemoist clay or relax on our bean bag chairs.Emphasis is placed on having fun in a calmenvironment. Each week we will offer differentactivities for you and your child to choose fromwhile socializing with other families. Pleasecome dressed to get messy.Location: RLAPD Teen CenterAge: 2-6 YearsMin/Max: 4/12Fee: $5 for 1st Child / $3 for add’l childrenReg. Deadline: One week priorTUESDAYSCODE DATE TIMERL14292 9/18 10:00am-10:45amRL14293 10/9 10:00am-10:45amRL14294 10/23 10:00am-10:45amRL14295 11/6 10:00am-10:45amRL14296 11/27 10:00am-10:45amRL14297 12/4 10:00am-10:45amRL14305 12/18 10:00am-10:45amTHURSDAYSCODE DATE TIMERL14298 9/20 5:00pm-5:45pmRL14299 10/11 5:00pm-5:45pmRL14300 10/25 5:00pm-5:45pmRL14301 11/8 5:00pm-5:45pmRL14302 11/29 5:00pm-5:45pmRL14303 12/6 5:00pm-5:45pmRL14304 12/20 5:00pm-5:45pmROUND LAKE Youth & TeenNEWTEEN SCENE -Friday Nights @The Teen CenterFriday Night @ the Teen Center is going tobe a whole bunch of fun. We will either bewatching a movie, checking out some sports,or maybe play some games.Location: RLAPD Teen CenterAge: 13 & OlderMin/Max: 4/12Fee: $6Reg. Deadline: One week priorCODE DAY DATE TIMERL14270 F 9/28 6:00pm-9:00pmRL14271 F 10/19 6:00pm-9:00pmRL14272 F 11/16 6:00pm-9:00pmTEEN SCENE-Monday Night RAWNEWWOOOO!! Come to the Teen Center, eatsome pizza and watch C.M. Punk, John Cena,and other WWE Superstars in action duringMonday Night Raw. The only question youhave to ask yourself is, ‘Whatcha gonna dowhen SRSNLC runs wild over you?’Location: RLAPD Teen CenterAge: 13-19 YearsMin/Max: 4/12Fee: $10Reg. Deadline: One week priorCODE DAY DATE TIMERL14250 M 9/17 6:30pm-9:00pmRL14251 M 10/15 6:30pm-9:00pmRL14252 M 11/19 6:30pm-9:00pmTheROUND LAKE • 847-740-9828 • www.rlapd.orgClubT.O.D.A.Y. Club - Together Opening DoorsAround You, is a program designed for adults,ages 18 and older, looking to enrich their livesin a safe and nurturing environment. As analternative to the work place, the T.O.D.A.Y.Club will provide a safe environment for lifeskill education and social development throughinnovative activities, hands on learning andpeer interaction. We will celebrate each dayby exploring the participant’s community,resources, and personal potential. The programruns from 10:00am-3:00pm.Location: RLAPD Teen CenterReg. Deadline: One week priorSEPTEMBER (No Club 9/3)DAYS CODE PRICEM/W/F RL14286 $330/$345OCTOBERDAYS CODE PRICEM/W/F RL14280 $420/$435NOVEMBER (No Club 11/23)DAYS CODE PRICEM/W/F RL14282 $360/$375DECEMBER (No Club 12/24, 12/26 & 12/31)DAYS CODE PRICEM/W/F RL14284 $300/$315Power Play!T.O.D.A.Y. Club Jr.NEWNot old enough for T.O.D.A.Y. Club? That’salright, come join us on Saturdays whilewe provide a safe environment for life skilleducation and social development throughinnovative activities, hands on learning andpeer interaction. Each month will have adifferent theme but our focus will be onencouraging a healthy active lifestyle. Pleasesend a lunch with your child. Program meetstwice a month.Location: RLAPD Teen CenterAge: 12-17 YearsProgram Time: 11:00am-2:00pmMin/Max: 4/24Fee: $20Reg. Deadline: One week priorCODE MONTH DATE TIMERL14306 Sept. 9/8 & 9/22 11:00am-2:00pmRL14307 Oct. 10/6 & 10/20 11:00am-2:00pmRL14308 Nov. 11/3 & 11/17 11:00am-2:00pmRL14309 Dec. 12/1 & 12/15 11:00am-2:00pm

WAUKEGAN General ProgramsPROGRAM GUIDE KEYBUS – Door to DoorPrograms with this symbol offerdoor to door transporation withadditional fee.HOUSE – TransportationHome OnlyPrograms with this symbol offertransportation home only.DOLLAR SIGN – BringSpending MoneyPrograms with this symbolrequire additional money bebrought for the purchase of ameal or souvenirs.Transportation appliesto Waukegan In-districtresidents only.Time to SpareBowlingBowling can help improve hand-eyecoordination, strength, flexibility, and grossmotor skills. Socialize while you wait for yourturn. Fee will include two games of bowlingand rental shoes for 8 weeks. Bowlers willreceive refreshments, snacks, and a prize onthe last day of program.Location: Sunset LanesAge: 13 & OlderMin/Max: 6/24Fee: $75R ($87 w/transportation) / $112NRReg. Deadline: September 4, 2012CODE DAY DATE TIMEW6103 M 9/10-10/29 4:45pm-6:00pmFamily ZumbaNo TransportationMake a commitment to get healthy with yourfamily! Zumba combines Latin Americanmusic and dance to create one great class thatfeels more like a party than a work-out. We’llbegin with the basics, so everyone can joinwith or without previous dance experience.The fee is a family rate for up to four people;each additional member will be charged $5.At least one member of the family must havea disability. One member of the familymust also be over 18 and not a regularSRSNLC participant.* NO class on 10/31 *Location: Jane Addams CenterAge: 10 & OlderMin/Max: 12/30Fee: $20R / $30NRReg. Deadline: September 5, 2012CODE DAY DATE TIMEW6206 W 9/12-11/7 5:00pm-6:00pmLive It UpDo you want to increase independence insome important activities of daily living? Live ItUp will be an on-going program that will focuson helping you learn a new skill each week.This 5 week session will focus on settinggoals and determining how to meet yourneeds for today and your future. LetSRSNLC staff help you learn or improve yourknowledge of community resources, nutrition,first aid/safety, health and fitness in sessionsto come.*SRSNLC reserves the right to evaluate aparticipant’s functioning level to determineappropriateness for the program. To discussplacement for this program contact Kari Robinsonprior to registration at 847-360-4763.Location: Douglas HouseAge: 13 & OlderMin/Max: 3/6Fee: FREE R / $5NRReg. Deadline: October 12, 2012*This program will take place every other Fridayduring the time specified. We will only meetfive times.CODE DAY DATE TIMEW6503 F 10/19-12/7 6:00pm-7:00pmShake It UpWAUKEGAN • 847-360-4760 • www.waukeganparks.org13Shake It Up is your opportunity for a total bodywork-out! At the Field House at Hinkston Park,there’s plenty of ways to exercise. Come learnabout the fitness equipment, use the walkingtrack or get an aerobic work-out. We’ll alsoprovide you with a healthy snack.Location: The Field HouseAge: 13 & OlderMin/Max: 4/10Fee: $30R ($42 w/transportation) / $45NRReg. Deadline: November 7, 2012CODE DAY DATE TIMEW6204 W 11/14-12/19 5:15pm-6:15pmCraft Connoisseurs“Art activates the creative part of our brain– the part that works without words and canonly be expressed nonverbally.”- Grant Eckert.Activate your brain in this three-week session.Art materials will be provided. Experience thebenefits of arts each week!Location: Douglas HouseAge: 13 & OlderMin/Max: 4/10Fee: $25R ($37 w/transportation) / $38NRReg. Deadline: October 29, 2012CODE DAY DATE TIMEW6017 M 11/5-11/19 6:00pm-7:00pmChef MastersWhatcha Got Cookin’? In a 3 week session youwill prepare your own dinner that includes allfive food groups as well as learn about safety,hygiene and etiquette.Location: Douglas HouseAge: 13 & OlderMin/Max: 4/8Fee: $25R ($37 w/transportation) / $38NRReg. Deadline: November 19, 2012CODE DAY DATE TIMEW6018 M 11/26-12/10 5:00pm-6:30pm

14WAUKEGAN Social PageRestauranteersDevelop your sense of taste as we sample local eateries in the Waukegan area. Enjoy thecompany of other diners in a relaxed atmosphere as we dine on the local cuisine. Feeincludes your meal and transportation to and from the establishment.Age: 13 & Older Min/Max: 5/10 Fee: $26R per outing / $39NR per outingMovie Review CrewWatch the latest flick on the big screen! We willtravel to Gurnee Cinemas for an evening out atthe movies. Admission and drink are includedin the price. Moviegoers will be called the dayof the program with pick-up time.DATE LOCATION REG. DEADLINE9/20 TACOS EL NORTE September 5, 201210/4 CHILI’S September 19, 201211/29 AVALON November 14, 201212/20 RED ROBIN December 12, 2012CODE DAY DATE TIMEW6753 Th 9/20 5:30pm-7:00pmW6754 Th 10/4 5:30pm-7:00pmW6755 Th 11/29 5:30pm-7:00pmW6756 Th 12/20 5:30pm-7:00pmLocation: Gurnee CinemasAge: 13 & OlderMin/Max: 6/10Fee: $20R / $30NRReg. Deadline: One week priorCODE DAY DATE TIMEW6759 Th 9/27 approx. 7:00pm-9:00pmW6760 Th 11/1 approx. 7:00pm-9:00pmDinner and a MovieSpend your evening with friends at theDouglas House as we watch and critique thehottest and most up to date releases or anolder classic. Movies are rated G throughPG-13 and are age appropriate.Location: Douglas HouseAge: 13 & OlderMin/Max: 4/10Fee: $15R / $23NRReg. Deadline: One week priorCODE DAY DATE TIMEW6757 Th 10/18 approx. 6:00pm-8:00pmW6758 Th 11/15 approx. 6:00pm-8:00pmOut & AboutThe average American watches 4½ hours of television everyday. That is way toomuch! Get out and about to enjoy the community. Every program offers thechance to increase your social skills.Location: Varies: Meet at the Douglas HouseAge: 13 & Older Min/Max: 4/10Reg. Deadline: One month before programDATE LOCATION FEE10/5 ZION SOCIAL DANCE $9R / $14NR12/1 BOWLING TOURNEY $22R / $33NR12/14 WINTER DANCE (SRACLC) $18R / $27NRCODE DAY DATE TIMEW6701 Th 10/5 6:15pm-10:00pmW6122 Th 12/1 8:30am-1:00pmW6702 Th 12/14 6:00pm-10:00pmHeART for ArtsLet your creativity reign supreme as we dive into the art world. Find your creativity whilecrafting your own piece of artwork, express yourself through dramatic activities, or danceoff a few calories. The benefits of arts are endless. Each month is a new activity.Location: Douglas HouseAge: 13 & Older Min/Max: 4/10 Reg. Deadline: One week before programDATE ACTIVITY FEE10/11 ART ACTIVITY $15R / $23NR11/8 DRAMA ACTIVITY $15R / $23NR12/6 DANCE LESSONS $10R / $15NRCODE DAY DATE TIMEW6019 Th 10/11 6:00pm-7:00pmW6020 Th 11/8 6:00pm-7:00pmW6021 Th 12/6 6:00pm-7:00pmWAUKEGAN • 847-360-4760 • www.waukeganparks.org

WAUKEGAN Just for Kids & TeensSnowflake CampWinter blahs put youin a freeze? SRSNLCwill help you thaw.Join in the winterfun at our camp.Children go on fieldtrips, have fun inthe snow, and meetnew friends. Don’twaste your winterbreak. Spend it withSRSNLC for a chillinggood time. Send abag lunch each day. A medication releasemust be on file before the start of camp.Location: Douglas HouseAge: 5-12 YearsMin/Max: 4/10Fee: $65R / $98NRReg. Deadline: December 5, 2012CODE DAY DATE TIMEW6404 W-F 12/26-12/28 9:30am-4:00pmW6405 W-F 1/2-1/4 9:30am-4:00pmBlizzard CampTired of being stuckinside all winter?Break through thebarriers of ice thatkeep you fromhaving fun! JoinSRSNLC as theyoffer winter breakcamp for teenswith developmentaldisabilities. Go ongreat field trips, playgames, and keepyour social life from freezing over duringthe winter break! Send a bag lunch eachday. A medication release must be on filebefore the start of camp.Location: Douglas HouseAge: 13-22 YearsMin/Max: 4/10Fee: $65R / $98NRReg. Deadline: December 5, 2012CODE DAY DATE TIMEW6406 W-F 12/26-12/28 9:30am-4:00pmW6407 W-F 1/2-1/4 9:30am-4:00pmSaturdaySocialites15Have some fun this fall. Spend your Saturdayswith some friends from SRSNLC. We’ll help youmeet new friends and socialize with other kids.Location: Vaires: Meet at the Douglas HouseAge: 5-12 YearsMin/Max: 4/10Reg. Deadline: Two weeks before programDATE ACTIVITY FEE9/22 MOVIE MATINEE $15R / $22NR*Program time and movie will be chosencloser to actual program date.10/13 JERRY SMITH’S $15R / $22NR11/3 ART ACTIVITY $10R / $15NRCODE DAY DATE TIMEW6557 Sa 9/22 approx. 12:30-3:00pmW6558 Sa 10/13 10:00am-12:30pmW6559 Sa 11/3 10:00am-11:00amStop hanging out in your house this fall! Get out and enjoy what the community has to offer.Teen Scene is your chance to makenew friends and develop new skills.The first night is the HomecomingDance, then a Halloween CostumeParty. In November we’ll go to theTurkey Twist Dance. End the yearoff with a holiday party! Sign upfor one session or all four!Location: VairesAge: 13-22 YearsMin/Max: 4/10Reg. Deadline: Two weeksbefore the eventTeen SceneDATE ACTIVITY FEE9/21 HOMECOMING DANCE $12R / $18NR10/31 COSTUME PARTY $10R / $20NR11/9 TURKEY TWIST $13R / $20NR12/13 HOLIDAY PARTY $8R / $12NRCODE DAY DATE TIMEW6817 F 9/21 6:15pm-10:30pmW6561 W 10/31 6:00pm-8:00pmW6820 F 11/9 6:15pm-10:30pmW6821 Th 12/13 5:45pm-9:45pmP2K2Come join P2K2 and get active and healthy!Power Playing Kallisthenics Kids is a freeprogram for children ages 5-13 years old witha disability. This program focuses on makingwise choices regarding health, wellness, andnutrition. Topics to be covered are EnergyBalance, the Food Pyramid, Calories, FoodLabels, the Heart and Body, healthy activities,and Balance in Action.*NO program on 10/31 or 11/21*Location: Douglas HouseAge: 5-12 YearsMin/Max: 4/10Fee: FREEReg. Deadline: August 22, 2012CODE DAY DATE TIMEW6560 W 8/29-12/19 4:00pm-6:00pmWAUKEGAN • 847-360-4760 • www.waukeganparks.org

16All AboardLet’s head to Romas’ Ristorante & Lounge inEast Troy for a fabulous pizza lunch beforetaking a ride back in time on the East TroyElectric Railroad. Take in the gorgeousWisconsin landscape on the one hour relaxinground trip ride with a short excursion to theElegant Farmer Depot.Location: East Troy, WisconsinAge: 13 & OlderMin/Max: 4/10Fee: $30R / $45NRReg. Deadline: September 3, 2012CODE DAY DATE TIMEW6704 Sa 9/15 9:45am-4:45pmOktoberfest LuncheonWAUKEGAN Special EventsCelebrate German heritage at SRSNLC’sOktoberfest Luncheon. Dine on traditionalGerman dishes including brats, sauerkraut,boiled red potatoes, brat rolls, apple pie andmore. Kick back and enjoy games, activities,and prize raffles.Location: Lindenhurst Community CenterAge: 13 & OlderMin/Max: 4/10Fee: $18R / $27NRReg. Deadline: September 22, 2012CODE DAY DATE TIMEW6707 Sa 10/6 10:00am-2:30pmCookie CreationsLet the aroma of sweetsand cookies fill yoursenses in this bakingclass. Make sweet treatsfor your friends andfamily. All participantswill take home one dozenof our homemade treats!Location: Douglas HouseAge: 13 & OlderMin/Max: 4/8Fee: $10R / $15NRReg. Deadline: December 10, 2012CODE DAY DATE TIMEW6706 M 12/17 approx. 6:00pm-7:30pmWAUKEGAN SportsAll-Star Basketball(No Transportation)Gather the skills taught and compete againstother Special Recreation Associations in theSpecial Olympics and ITRS/PSD Tournaments.Basketball will help improve motor skills,hand-eye coordination, balance, strength,speed, flexibility conditioning and endurance.Athletes will receive skill training on ballhandling, shooting, rebounding, defensiveand offensive teamwork, as well as goodsportsmanship. The team will be competingin the Special Olympics District Tournament inJanuary and the ITRS Tournament in February.Location: The Field HouseAge: 13 & OlderMin/Max: 5/12Skills Fee: $40R / $60NRTeam Fee: $55R / $83NRFamily FramesWAUKEGAN • 847-360-4760 • www.waukeganparks.orgSRSNLC has some time to spare for your family!Enjoy an afternoon of bowling with otherSRSNLC families at Sunset Lanes. Help yourkids work on their coordination as they bowltwo games and meet new friends.Please register each family member separately.At least one member of the family must be over18. No transportation is provided.*Includes two games,shoe rental and snacks*Location: Sunset Lanes, WaukeganAge: AllMin/Max: 6/24Fee: $7R per person / $11NR per personReg. Deadline: November 23, 2012CODE DAY DATE TIMEW6741 Sa 11/17 1:00pm-2:30pmReg. Deadline: October 9, 2012* NO practice on 12/25 or 1/1/13 *Basketball: SKILLSCODE DAY DATE TIMEW6150 Tu 10/30-1/22/13 6:00pm-7:00pmBasketball: TEAMCODE DAY DATE TIMEW6151 Tu 10/30-2/12/13 7:00pm-8:30pm

WAUKEGAN Inclusive OpportunitiesTo learn more about programs SRSNLC is offering in cooperation withthe Waukegan Park District CALL THE SRSNLC OFFICE at 847•360•476017WaukeganPark DistrictSpecialEvents . . .HalloweenfestThe Waukegan Park District will be hosting itsAnnual Halloweenfest at Bowen Park. Therewill be a haunted trail, haunted house anenchanted walk for your children, bonfi refilled with spooky stories and lots of games.Concession stands will be available. Parentsmust provide supervision.Location: Bowen ParkAge: AllFee: FREECODE DAY DATE TIMEFREE Sa 10/27 3:00pm-8:00pmThis program is hosted by the Waukegan ParkDistrict. Help provide money and food for theless fortunate. Residents that win the raceswin a turkey! All registered participants willbe entered in a drawing for some great prizes.Parents must provide supervision at this event.Fee is 2 cans of non-perishable food.Turkey TrotLocation: Belvidere ParkAge: AllFee: 2 cans of non-perishable food***Registration is from 9:00am-9:45am***CODE DAY DATE TIMEFREE Sa 11/10 10am Races BeginWorldwide Day of PlayKids and families join us as the WaukeganPark District celebrates “Go Healthy Month”by getting active. This is a free event for thewhole family. Don’t miss out! Call 847-782-3300 for more information or visit www.waukeganparks.org.Activities include: Dodgeball, Volleyball,Basketball, Jump Rope, Cup Stacking, FreeThrow Contests, Open Gym, & Climbing Wall.Location: The Field HouseAge: AllFee: FREECODE DAY DATE TIMEFREE Sa 9/22 11:00am-2:00pm14th AnnualPolar Bear PlungeThis winter you’ll be “Freezin’ for a Reason!”Waukegan Park District will hold its 14thAnnual Polar Bear Plunge at the WaukeganMunicipal Beach. Start 2013 off wet or watchthe action from the sidelines. Proceeds willbenefit Waukegan Athletic and Scholarshipprograms for Special Recreation Services ofNorthern Lake County. The first five hundredparticipants will receive an event shirt. Bebrave take the Plunge!Location: Waukegan Municipal BeachFee: $10 pre-register / $15 day of eventCODE DAY DATE TIMEW0410 Tu 1/1/2013 10:00am-11:00amWAUKEGAN • 847-360-4760 • www.waukeganparks.org

18Social ClubDo you love music, dancing, and socializingwith friends? This is a great Friday night getaway once a month! Each month is a differentthemed dance. Fee includes door prize,refreshments, and a whole lot of dancing.9/7 – Fall Fling10/5 – Monster Mash11/2 – Gobble & Shout12/7 – Jingle Bell RockLocation: Leisure Center GymAge: 10 & OlderMin/Max: 25/100Fee: $6R per dance / $9NR per danceCODE DAY DATE TIMEZ7060-1 F 9/7 7:00pm-9:00pmRegistration Deadline: August 31, 2012Z7060-2 F 10/5 7:00pm-9:00pmRegistration Deadline: September 28, 2012Z7060-3 F 11/2 7:00pm-9:00pmRegistration Deadline: October 26, 2012Z7060-4 F 12/7 7:00pm-9:00pmRegistration Deadline: November 30, 2012BowlingCome join a great group of people once aweek for a fun, non-competitive eveningof bowling. Bowling includes 2 games ofbowling and shoes.*NO BOWLING 11/22*Location: Pinsters Bowl & Bar, Zion, ILAge: 8 & OlderMin/Max: 10/50Fee: $6.50R per day / $9.75NR per day$75R per session / $112.50 NR per sessionReg. Deadline: August 30, 2012CODE DAY DATE TIMEZ7040 Th 9/6-11/29 4:00pm-5:30pmZION In House FunBingo NightsEverybody lovesBINGO! Join ustwice a month for afun filled evening ofBingo and prizes.**Register fornights you are available or just dropon in with your $2**Location: Special Rec Room, Leisure CenterAge: AllMin/Max: 5/30Fee: $2R per session / $3NR per session$14R for 9 sessions / $21NR for 9 sessionsCODE DAY DATE TIMEZ7158-1 Tu 9/11 5:30pm-6:30pmZ7158-2 Tu 9/25 5:30pm-6:30pmZ7158-3 Tu 10/9 5:30pm-6:30pmZ7158-4 Tu 10/23 5:30pm-6:30pmZ7158-5 Tu 11/6 5:30pm-6:30pmZ7158-6 Tu 11/20 5:30pm-6:30pmZ7158-7 Tu 12/4 5:30pm-6:30pmZ7158-8 Tu 12/18 5:30pm-6:30pmZ7158-9 All 8 sessions $14R / $21NRWii Fun ClubWii is the latestcraze in gaming!It is great exercisewith its interactivegames, works onfine motor skills,great for workon hand – eyecoordination & agreat way to makenew friends! Comejoin us for some WiiFUN!ZION Sports & FitnessAerobicsBasketballThis class is taught by a certifi ed aerobicsinstructor. You will work out to fun musicwhile working on balance, muscle strength,flexibility, & endurance. This class is evengreat for those with mobility issues. Differentinstruments will be used to help everyone besuccessful in this class!Location: Rooms 3 & 4, Leisure CenterAge: 13 & OlderMin/Max: 10/30Fee: $30R / $45NRReg. Deadline: Spetember 12, 2012CODE DAY DATE TIMEZ7069 W 9/26-12/12 5:00pm-6:00pmAnyone for a game of hoops? Come join the Northstars for an exciting and fun-filledseason of basketball. We will work on basic skills, rules of the game, and learn how to playthe different positions involved in the game.*Must have a current Special Olympics Application on file** No Basketball on 12/25 & 1/1*Location: Leisure Center, Sports Arena Age: 13 & OlderMin/Max: 7/15 Fee: $55R / $83NR Reg. Deadline: October 10, 2012CODE DAY DATE TIMEZ7035 Tu 11/6-3/18 6:00pm-7:00pmZION • 847-740-5500 • www.zionparkdistrict.comLocation: Special Rec Room, Leisure CenterAge: 13 & OlderMin/Max: 4/8Fee: $18R / $27NRCODE DAY DATE TIMEZ7057 M 10/1-10/29 5:00pm-7:00pmNSSRA BowlingTournamentDo you go bowling every week? How abouttrying the NSSRA bowling tournament? Thisis a fun filled day of meeting new people andbowling. This tournament is great practice forthe Special Olympics tournament.**Must be involved in SRSNLC bowlingprogram to attend**Location: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 5/10Fee: $22R / $33NRReg. Deadline: October 26, 2012CODE DAY DATE TIMEZ7042 Sa 12/1 8:30am-2:00pm

Take the evening off, get out of the house, andcome on out for great food at local restaurants!9/19 – Golden Panda, Antioch, IL10/16 – Savana House, Wadsworth, IL11/12 – Taco El Norte, Gurnee, ILMeet at: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 4/12Fee: $25R per outing / $37NR per outingZION Fun EatsDiner’s ClubCODE DAY DATE TIMEZ7104-1 W 9/19 5:00pm-9:00pmRegistration Deadline: September 5, 2012Z7104-2 Tu 10/16 5:00pm-9:00pmRegistration Deadline: October 2, 2012Z7104-3 M 11/12 5:00pm-9:00pmRegistration Deadline: October 29, 201219Anyone for a home cooked breakfast to getyour Saturday started? We’ll cook the food,you just show up and fill your belly. Nothingcould be better than that.Please be on time for this event, breakfastwill be served promptly at 10:00 a.m.Location: Rooms 3 & 4, Leisure CenterAge: 8 & OlderMin/Max: 10/50Fee: $6R per breakfast / $9NR per breakfastBreakfast ClubLasagna Christmas DinnerCome celebrate the holiday season with a great catered mealand great friends!Please be on time for this event, dinner will be servedpromptly at 5:00 p.m.Location: Rooms 3 & 4, Leisure CenterAge: 8 & OlderMin/Max: 10/50Fee: $10R / $15NRReg. Deadline: November 30, 2012CODE DAY DATE TIMEZ7168 W 12/19 5:00pmCODE DAY DATE TIMEZ7148-1 Sa 9/22 10:00amRegistration Deadline: September 14, 2012Z7148-2 Sa 10/27 10:00amRegistration Deadline: Ocrober 19, 2012Z7148-3 Sa 11/17 10:00amRegistration Deadline: November 9, 2012Z7148-4 Sa 12/8 10:00amRegistration Deadline: November 30, 2012Get gussied up and let’s go have a fabulousseafood dinner at Joe’s Crab Shack in Gurnee, IL.Meet at: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 4/12Fee: $40R / $60NRReg. Deadline: November 15, 2012CODE DAY DATE TIMEZ7017 Th 12/6 5:00pm-9:00pmFancy Night OutZION • 847-740-5500 • www.zionparkdistrict.com

20Jerry Smith’s Pumpkin FarmLet’s go pick out a pumpkin. Come enjoy awide display of pumpkins decorated as someof your favorite characters and a hayride.Please bring a sack lunch with you.ZION Weekend FunLunch andMini GolfLet’s hit Kaiser’s Pizza for a great pizza andthen head over to People’s Choice and get ina round of mini-golf.Meet at: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 6/12Fee: $15R / $23NRReg. Deadline: September 28, 2012CODE DAY DATE TIMEZ7018 Sa 10/20 10:00am-1:00pmMeet at: Special Rec Activity Room,Leisure CenterAge: 8 & OlderMin/Max: 6/12Fee: $25R / $38NRReg. Deadline: November 30, 2012CODE DAY DATE TIMEZ7171 Sa 12/15 11:00am-3:00pmSRACLCWinterWonderlandWinter is upon us and there is nobetter way to stay warm than to dancethe night away at SRACLC’s WinterWonderland Dance at the SullivanCenter in Vernon Hills.Meet at: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 4/12Fee: $18R / $27NRReg. Deadline: November 16, 2012CODE DAY DATE TIMEZ7063 F 12/14 6:00pm-10:00pmThe Water WorksEnjoy a leisurely day of swimming at The Water Works. Take a dip in the zero-depthand lap pools, brave one of three water slides, plunge into the diving pool, or simplytake a spin through the rapid channel…at The Water Works in Schaumburg it can besummer every day. Please bring a swimsuit, towel, money for the concession stand,and warm clothes for the ride home.Meet at: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 4/12Fee: $32R / $48NRReg. Deadline: October 19, 2012CODE DAY DATE TIMEZ7077 Sa 11/3 10:00am-5:00pmAll AboardHead to Roma’s Ristorante & Lounge in EastTroy for a fabulous pizza lunch before takinga ride back in time on the East Troy ElectricRailroad. Take in the gorgeous Wisconsinlandscape on the one hour relaxing roundtrip ride with a short excursion at The ElegantFarmer Depot.Meet at: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 4/12Fee: $30R / $45NRReg. Deadline: September 3, 2012CODE DAY DATE TIMEZ7061 Sa 9/15 9:15am-5:00pmSlumber PartyZION • 847-740-5500 • www.zionparkdistrict.comGrab your best P.J.’s and your sleeping bagfor the SRSNLC Slumber Party! It will be a funnight of games, movies, friends & pizza. Aletter will be mailed 2 weeks prior to event withmore information about the slumber party.OPTIONALsmallair mattress or sleeping pad.Meet at: Special Rec Activity Room,Leisure CenterAge: 16 & OlderMin/Max: 4/8Fee: $25R / $38NRReg. Deadline: October 26, 2012CODE DAY DATE TIMEZ7088 F-Sa 11/16-17 6:00pm-11:00am

Dennys & MatineeJoin us for a great breakfast at Denny’s inGurnee and then after go catch a fl ick atGurnee Cinema.Meet at: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 4/8Fee: $27R / $41NRCODE DAY DATE TIMEZ7161-1 F 9/14 10:00am-3:00pmReg. Deadline: August 31, 2012Z7161-2 F 10/19 10:00am-3:00pmReg. Deadline: October 5, 2012Z7161-3 F 11/16 10:00am-3:00pmReg. Deadline: November 2, 2012Z7161-4 F 12/21 10:00am-3:00pmReg. Deadline: December 7, 2012OktoberfestLuncheonCelebrate German heritage at SRSNLC’sOktoberfest luncheon.Dine on traditional German dishesincluding brats, sauerkraut,boiled red potatos, brat rolls,apple pie and more.Kick back and enjoy games, activities,and prize raffles.Meet at: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 4/12Fee: $18R / $27NRReg. Deadline: September 22, 2012CODE DAY DATE TIMEZ7075 Sa 10/6 10:15am-2:00pmZION Out-N-AboutVolo BogLet’s take an adventure to the Volo Bog StateNatural Area in Ingleside, IL. to explore theonly “quaking” bog in Illinois to have an openwater center. After our journey, we will go toTammy’s in Spring Grove for lunch.*Please wear good walking shoes*Meet at: Special Rec Activity Room,Leisure CenterAge: 13 & OlderMin/Max: 4/12Fee: $25R / $38NRReg. Deadline: August 22, 2012CODE DAY DATE TIMEZ7090 F 9/7 9:00am-3:00pmMilwaukee Domes & Water Street BreweryCheck out Milwaukee’s living landmark—the Mitchell Park Horticultural Conservatorycommonly referred to as “the domes”. Experience a desert oasis, a tropical jungle, andspecial floral gardens all in one morning. Complete your day with a relaxing lunch atthe Water Street Brewery.Meet at: Special Rec Activity Room,Leisure CenterAge: 15 & OlderMin/Max: 4/8Fee: $35R / $53NRReg. Deadline: October 1, 2012CODE DAY DATE TIMEZ7087 W 10/10 9:00am-4:00pmDave & BustersZION • 847-740-5500 • www.zionparkdistrict.com21Enjoy lunch and an afternoon playing gamesat Dave and Buster’s in Wauwatosa, Wisconsin.Lunch and a $20 Power Card is included—participants may bring extra money to reloadtheir Power Card.Meet at: Special Rec Activity Room,Leisure CenterAge: 18 & OlderMin/Max: 4/8Fee: $42R / $63NRReg. Deadline: October 10, 2012CODE DAY DATE TIMEZ7079 W 10/24 10:00am-4:00pmYou’ll find something wet, wild and wonderful wherever you walk at Shedd.The galleries are home to creatures from the Waters of the World – rivers and reefs, GreatLakes and small ones, and the global ocean. Immerse yourself in the Caribbean Reef,Amazon Rising’s flooded forest, the Oceanarium’s Pacific Northwest coast and Wild Reef’sIndo-Pacific reef. Go totally polar in Polar Play Zone and check out Shedd’s aquatic show.Lunch is included.Meet at: Special Rec Activity Room,Leisure CenterAge: 15 & OlderMin/Max: 6/8Fee: $62R / $93NRReg. Deadline: November 16, 2012CODE DAY DATE TIMEZ7156 Tu 12/4 10:00am-5:00pmShedd Aquarium

22Wellness GuidelinesParticipation Guidelines When Illness OccursIn consideration of the other participants and the SRSNLC staff,to prevent the spread of contagious illnesses, it is recommendedthat participants refrain from attending programs when any ofthe following conditions exist:1. Fever of 100 degrees or higher.SRSNLC General InformationLINDENHURSTPARK DISTRICT:ROUND LAKEPARK DISTRICT:BELVIDERERECREATION CENTERWaukegan:Monday - Friday9:00 am - 5:00 pmMon.-Fri. – 8:30 am - 7:30 pmSaturday – 9:00 am - 12:00 noonMon.-Fri. – 9:00 am - 9:00 pmSaturday – 9:00 am - 2:00 pm2. Vomiting within the last 24 hours.3. Persistent diarrhea in conjunction with other symptoms.ZIONLEISURE CENTER:Mon.-Fri. – 9:00 am - 6:00 pmSaturday – 8:00 am - 2:00 pm4. Contagious rash or a rash of unknown origin.5. Persistent cough and/or cold symptoms.6. “Pink Eye” (conjunctivitis) or discharge from the eye.7. Symptoms of mumps, measles, chicken pox, strep throat,flu, impetigo, Coxsackie virus, head lice, mites, and ringworm.8. Runny nose with yellow or green discharge WHICHINDICATES INFECTION.9. Fatigue, due to illness, that will hinder participation andenjoyment in the program.Please notify the SRSNLC office if the participant contracts anycontagious illness that will affect his/her attendance at theprogram. Participants should return to programs at the doctor’srecommendation, or, if not under a doctor’s care, whenthe symptoms have clearly passed.Spanish Interpreters AvailableIf you need to contact us about program information,Spanish interpreters are available at our Waukegan office(847) 360-4700 and our Round Lake office (847) 546-8558.Please detach the Registration Form and complete in detail.The full registration fee is due before the registration deadline.Call your local office for alternate payment plans. Register inperson or mail the registration with check or money orderpayable to your local Park District. Complete the attachedAnnual Information Form in the winter season only unless thisis a new registration or information has changed.Medication DistributionParents and guardians are asked to dispense medication on theirown, outside of program hours, if at all possible. If a medicationneeds to be administered by SRSNLC Staff, a Permission to DispenseMedication form must be completed. In all cases, medicationdispensing can only be administered, changed, or modified bycompleting a Permission to Dispense Medication form.All athletes MUST signSportsmanship ContractSi necesita ponerse en contacto con nosotros para pedirinformaticiõn sobre nuestros programas en español,tenemos traductores disponibles en la oficina deWaukegan al (847) 360-4700 la oficina de Round Lake al(847) 546-8558.LINDENHURST • ROUND LAKE • WAUKEGAN • ZION

SRSNLC Code of Conduct & Behavior ExpectationsBehavior ExpectationsSRSNLC promotes the concept of “equal fun for everyone.” However, certain rules have been established toensure the safety and enjoyment of all people. The following guidelines have been developed to help makeSRSNLC programs safe and enjoyable for all participants. SRSNLC participants are expected to demonstrateappropriate behavior during programs. The basic behavior code of conduct insists that participants shall:1. Show respect to all participants and staff, and take direction from staff.2. Refrain from using abusive or foul language.3. Refrain from causing bodily harm to self, other participants, or staff.4. Show respect to equipment, supplies, and facilities.A positive approach will be utilized regarding discipline. Individual behavior management plans may bedeveloped on the advice of parents, staff or other professionals. If inappropriate behavior occurs, promptresolution will be sought, specific to each individual situation. SRSNLC reserves the right to dismiss aparticipant whose behavior endangers the safety of him/her self or others.23Consequences of Unacceptable BehaviorParticipants may be subject to any of the following actions for unacceptable behavior. Below is a guidelinefor progressive discipline; however, the progression may be accelerated or slowed based on the severity andfrequency of the unacceptable behavior.ConferenceUnacceptable Behavior Warning Time Out Loss of Privileges Suspension ExpulsionImproper use of materials__________________________________________________________________________________________or equipment.❑✔ ❑✔ ❑✔ ❑✔ ❑✔Disrespect of participants,__________________________________________________________________________________________staff, or the public.❑✔ ❑✔ ❑✔ ❑✔ ❑✔Objectionable gestures;profane, vulgar or❑✔ ❑✔ ❑✔ ❑✔__________________________________________________________________________________________objectionable language.___________________________________________________________________________________________Fighting❑✔ ❑✔ ❑✔ ❑✔Damage or destruction ofPark District property or❑✔ ❑✔ ❑✔__________________________________________________________________________________________property of others.__________________________________________________________________________________________Theft❑✔ ❑✔ ❑✔Smoking; possession or use___________________________________________________________________________________________of alcohol or illegal drugs.❑✔ ❑✔ ❑✔Harassment or abuse of__________________________________________________________________________________________fellow participants or staff❑✔ ❑✔ ❑✔___________________________________________________________________________________________Possession of weapons❑✔❑✔Other acts which may bedetermined to beunacceptable by the❑✔❑✔ ❑✔ ❑✔program supervisorFor issues that are not major we may issue a participant progress report. This is in no way a behavioral warning;it is simply to inform you of something that may have happened during a program. For example, a participantmay soil their pants. We will issue a progress report to inform the parent/guardian of the incident and how itwas handled.LINDENHURST • ROUND LAKE • WAUKEGAN • ZION

24SRSNLC Athlete-Sportsmanship ContractThe following Sportsmanship Contract is to be signed byall SRSNLC - Athletes for all Special Olympic sport seasons.The Sportsmanship Contract is a code of conduct that allathletes must follow while participating in all Special Olympicsports. This contract must be signed and dated by theGeneral Informationathlete and returned to the coach at the beginningof EACH sport season. The athlete will not beallowed to compete/participate until the contractis signed. Coaches will document any violations ofthe contract on a tracking form for each athlete.SRSNLC Athlete - SPORTSMANSHIP CONTRACTThe Sportsmanship Contract is an agreement of sportsmanlike conduct that athletes will follow while participating inSRSNLC Special Olympics. Please take a moment to review this form, sign it and return to your coach. This contract isin place to ensure that all athletes are treated with respect and so that they feel like an important part of the team.1. I will respect others, including my teammates, coaches, andopponents. This means I will treat others the way I wouldwant to be treated.2. I will encourage my teammates on the court, on the bench,and on the van/bus. I will encourage them with kind wordsand cheer on my team on the court, on the bench, and on thevan/bus.3. I will listen when the coaches speak and will not questiontheir coaching decisions (i.e. player positions). This meansI will pay attention when a coach is speaking or explainingdirections. I will ask a coach if I have any questions.4. I will try my best while on the court, giving 100% at alltimes. This means I will pay attention and take the game/practice seriously (i.e. no goofing off).5. I will trust in my teammates and my own playing abilitieson and off the court. This means that I will not talk badabout their playing abilities or yell at them if they have a“bad game” or “bad play.”6. I will tell the coaches if I hear or see unsportsman-likeconduct from other teammates. I will not be considered a“tattle teller” if I do this. I must be honest when telling thecoaches about what I have seen or heard.7. I will return my entire uniform within two weeks of the endof the sports season. Failure to do so will result in a fine of$60 per uniform and potential suspension from futureSRSNLC programs.“Positives” of following this contract are asfollows:• Team has better chance of winning• You and your team will have more funThe consequences for not followingcontract are as follows:1. If any unsportsman-like conduct is seen/reported during agame, on the van/bus or at practice, the athlete will receivea warning and a brief time out.2. If unsportsman-like conduct is seen/reported for a 2 nd timeduring a game, practice or van/bus ride, the athlete will bebenched for the rest of the game (or half of the next gamehe/she is present at, if during a practice or on bus).3. If unsportsman-like conduct is seen/reported for a 3 rd timein a game, practice or on the van/bus, the athlete will bebenched for the entire next game he/she is present at. Theathlete will be encouraged to cheer on the team, but isotherwise expected to sit in silence.4. If the athlete continues to show unsportsman-like conductafter the 1st game suspension, he/she will continue to besuspended from play until the undesired conduct hasstopped.5. If the athlete is suspended from more than 3 games, he/shewill be suspended for the rest of the Season.6. If several athletes do not follow the Sportsmanship Contract,the coaches have the authority and right to forfeit gamesand tournaments.I agree to follow the above Sportsmanship Contract.Athlete’s Signature:_________________________________________________Date___________________LINDENHURST • ROUND LAKE • WAUKEGAN • ZION

APPLICATION FOR PARTICIPATION IN SPECIAL OLYMPICS ILLINOISValid Application for Participation is mandatory for all competitors605 E. Willow St. Normal, IL 61761-2682 309-888-2551ATHLETE INFORMATION MEDICAL CLEARANCEAthlete Name (last name, space, first name)SO ILL Rev. 8-1-10BirthdateM M D D Y YSO ILL OFFICE ONLYPLEASE CHECK MEDICAL INFORMATIONAgency NameAthlete’s Mailing AddressAthlete’s CityParent’s/Guardian’s (Please Circle One) Home AddressParent’s/Guardian’s CitySex (M or F)Does athlete have Down Syndrome?Yes NoIf yes, have x-rays of the C1-C2 vertebraebeen taken and examined?Yes NoDate of x-rayIs the athlete clear of Atlantoaxial Instability?Yes NoState Zip CodeEthnicity-Parent’s/Guardian’sHome TelephoneHEALTH INSURANCE & EMERGENCY INFORMATION (Required for Processing)Person to be contactedin case of emergencyWhite Black/African AmericanHispanic/Latino OtherMedical Insurance CompanyAsianStateZip Code- -EmergencyContact Phone ( )Policy Number-Does the athlete have or is the athlete:Heart Problems Yes NoDiabetic Yes NoEpileptic/Seizures Yes NoBlind Yes NoDeaf Yes NoHepatitis Yes NoOtherCurrent Medication DosagePARENT AND/OR GUARDIAN AUTHORIZATION AND MEDIA RELEASEI, on my own behalf or as the undersigned parent and/or legal guardian of the above named applicant (hereafter referred to as the “Entrant”), hereby request permission for theEntrant to participate in Special Olympics programs. I acknowledge that Special Olympics will screen all entrants using the Sex Offender Public Registry and the Child Murder andViolent Offender Against Youth Registry and understand that entrants listed on either Registry will be denied participation. I affirm that this Entrant has never been on said Registriesor, if Entrant was listed on either Registry but has since been removed, I will contact Special Olympics Illinois for instructions before submitting this application.I represent and warrant to you that the Entrant is physically and mentally able to participate in Special Olympics, and I submit herewith a subscribed medical certificate. I understand thatif the athlete has Down Syndrome, he/she cannot participate in sports or events which, by their nature result in hyper-extension, radical flexion or direct pressure on the neck or upperspine unless a full radiological examination establishes the absence of Atlantoaxial Instability. I am aware that the sports and events for which this radiological examination is requiredare equestrian sports, artistic gymnastics, diving, pentathlon, high jump, alpine skiing, soccer, soccer skills, powerlifting squat and butterfly stroke and diving starts in swimming.On behalf of the Entrant and myself, I acknowledge that the Entrant will be using facilities at his/her own risk and I, on my own behalf, herby release, discharge and indemnifySpecial Olympics from all liability for injury to person or damage to property of myself and Entrant.In permitting the Entrant to participate, I am specifically granting permission to Special Olympics Illinois to use the likeness, voice and words of the Entrant in television, radio, films,newspapers, magazines and other media, and in any form not heretofore described, for the purpose of advertising or communicating the purposes and activities of SpecialOlympics and in appealing for funds to support such activities. I understand that by signing below I consent for the Entrant to participate in the Special Olympics Healthy AthletesProgram that provides individual screening assessments of health status and health care needs. The Entrant has no obligation to participate and I understand the Entrant shouldseek his/her own medical advice and assistance and Special Olympics is not responsible for the Entrant’s health.If I am not personally present at Special Olympics activities in which the Entrant is to compete, so as to be consulted in case of necessity, you are authorized on my behalf and atmy account to take such measures and arrange for such medical and hospital treatment as you may deem advisable for the health and well-being of the Entrant.I, THE UNDERSIGNED ADULT ENTRANT, have read and fully understand theprovisions of the above release and/or have had them explained. I hereby agree that Iwill be bound thereby and I shall defend Special Olympics Illinois and hold it harmlessfrom disaffirmation thereof.EntrantWitness DateAthlete’s Email AddressI, THE UNDERSIGNED PARENT AND/OR GUARDIAN of the above specifiedEntrant, have read and fully understand the provisions of the above release and haveexplained them to said Entrant. I hereby agree that I and said minor will be boundthereby, and I shall defend Special Olympics Illinois and hold it harmless from anydisaffirmation thereof by said minor.Signature of Parentand/or Legal Guardian(Check appropriate box)Print Name DateParent’s Email AddressAllergies to medication, if any:Date of last Tetanus shot:I have examined the above-named Entrantand, in my opinion, there is no mental orphysical reason why he or she should notparticipate in the Special Olympics sportstraining and competition program. Furtherinformation will be forwarded if required.Current medication, if any, is specified withdosage on this application.Examination DateDoctor’s SignaturePrint NameAddressCity State ZipPhone ( )Original parent/guardian and doctor signatures are required by the office of Special Olympics Illinois. Faxed signatures will not be accepted.

SRSNLC Seizure Questionnaire28SRSNLCDate: ____/____/____Participant’s name: ______________________________________Parent/Guardian: ____________________________Emergency Contact: __________________________Phone _____/ ______/______Phone _____/ ______/______Current Medication: Name Dosage Time of intake(including dosage) ________________________ ____________ ____________________________________ ____________ ____________Seizure type:o Absence (staring spell)o Simple Partialo Complex Partialo Atonic (drop)o Generalized (grand-mal)o Other (Explain): ________________________________________When was the date of your/your child’s last seizure? ____/____/____How long does the seizure last? ____________________How long was the longest seizure? __________________Are there any triggers that cause the onset of your/your child’s seizures? (I.e strobe lights, heat,sudden movements, noise)Explain: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________Are there any symptoms prior to the onset of your/your child’s seizure? (I.e. smells, stomachpain, fear, sounds)Explain: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________Seizure PlanPlease list below the necessary steps you would like SRSNLC to take in the event of a seizure:1. Call 911 for a seizure over _____minutes.2. __________________________________________________________________3. __________________________________________________________________LINDENHURST • ROUND LAKE • WAUKEGAN • ZION

❑2012Name:______________________________________________________________ Age:______ Birth Date:_______________Address:______________________________________________ City:_____________________ State____ Zip:__________Parent/Guardian Name:____________________________________ E-mail:_________________________________________Home Phone:_______________________________________( )Cell Phone:______________________________________________( )Mother’s Work Phone:_______________________________ ( )Father’s Work Phone:____________________________________( )❑Sex: Male Female T-Shirt Size_________________________School/Teacher/Workshop:_______________________ Supervisor:___________________________ Phone:____________________________( )Physician’s Name:_____________________________________________ Physican’s Phone:______________________________( )Address:______________________________________________ City:______________________ State____ Zip:_________EMERGENCY CONTACT (Within 20 mile radius) Other than parent/guardianName:_______________________________________________Address:______________________________________________City:_____________________________ State:____ Zip_________❑❑❑❑❑❑❑❑❑❑SRSNLC Annual Information FormRelationship:__________________________________________Home Phone:________________________________________( )Work/Cell Phone: ___________________________________( )PARTICIPANT DISABILITY (Please check all that apply)Attention Deficit Disorder: (ADD).................................Autism (A)..................................................................Behavior Disorder (BD)...............................................BiPolar (BP)..............................................................Brain Injury (BI)..........................................................Deaf/Hard of Hearing (D/HH).....................................Developmental Disability (DD).....................................Down Syndrome (DS).................................................Early Childhood (EC)...................................................❑ ❑ ❑ ❑Lindenhurst Round Lake Waukegan ZionThis information will be used for all programs during 2012.Please contact your local office if any information changes throughout the year.Yes / NoEmotionally Distressed (ED)........................................Learning Disorder (LD)...............................................Multiply Challenged (MC)...........................................Physically Challenged (PC).........................................• are orthopedic devices worn?__________________• can transfer into van seat or stadium seat.............Severe Mental Handicap (SMH).................................Trainable Mental Handicap (TMH)...............................Visually Impaired (VI).................................................Educable Mental Handicap (EMH)...............................If Down Syndrome, has participant been tested for atlanto axial instability? Yes / NoDoes your participant have atlanto axial instability? Yes / NoEMERGENCY TREATMENT PERMISSION:I acknowledge that SRSNLC does not carry medical insurance. My family’s own health insurance must assume responsibility in the event of injury.I understand that every precaution is taken to protect the safety of every participant. I agree to emergency treatment by a physician or hospital in theevent that I cannot be reached. I hereby acknowledge that the above information is accurate and I understand that it is my responsibility to informthe SRSNLC staff of any changes in the above information.❑❑❑❑Yes / NoPHOTO/VIDEO AUTHORIZATION AND CONSENT:I hereby authorize and give my consent to SRSNLC to photograph/video my child (or me), and without limitation, to use such photographs/videoin connection with promoting/advertising the services, programs, and facilities of SRSNLC, including, but not limited to its website, Facebook page,promotional materials, brochures, fl iers and other publications without consideration of any kind. I have read and fully understand the abovephoto/video authorization and consent.Signature of Parent/Guardian_________________________________________________________❑❑❑Date_____________________________Medical Insurance Company____________________________________________________________Date_______________________________Policy Number________________________________Signature of Parent/Guardian_____________________________________________

Does the participant receive any medication? Yes No❑❑❑❑Does participant display unusual fears? Yes No Comments:_______________________________________________• comply with verbal requests? Yes No Comments:______________________________________________• respond to specific directions? Yes No Comments:______________________________________________• have any known situations that cause behaviors? Yes No Comments:____________________________________What actions are to be taken if a particular behavior is presented?_____________________________________________________________________________________________________________________________________________________❑MEDICATION❑Medication Dosage Purpose Side Effects______________ _____________ ___________________________________ _______________________________________________ _____________ ___________________________________ _______________________________________________ _____________ ___________________________________ _______________________________________________ _____________ ___________________________________ _________________________________Does the participant seizure? Yes NoDoes the participant have asthma? Yes NoDoes the participant have allergies? Yes No❑❑❑❑❑❑❑❑❑❑❑❑❑❑HEALTH ISSUESComments:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________DIETARY ISSUES❑• respond to any reinforcement devices? Yes No Comments:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________• respond to any behavior improvement techniques? Yes No Comments:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________❑BEHAVIOR ISSUES❑❑❑❑SAFETY ISSUESGENERAL ISSUESDoes participant need assistance orientating to:people_______ place_______ time_______Does participant need assistance protecting:self_______ anticipating safety needs_______Does participant need assistance toileting:independent_______ monitor_______diapering_______ other:_____________________________________________________________________❑❑❑❑Does participant require assistance eating or drinking? Yes No Comments:________________________________• have any food restrictions? Yes No Comments:_________________________________________________• have any food dislikes? Yes No Comments:_______________________________________________• have any specific food likes? Yes No Comments:_________________________________________________• is participant Diabetic? Yes No Comments:_________________________________________________Does participant use:wheelchair_______ stroller_______ walker_______cane_______ canadian crutches_______If participant is non-verbal do they use: sign language_______communication board/book_______Does participant swim/enjoy water? Yes No❑❑

Facility Directory 31Lindenhurst FacilitiesLindenhurst Park District . . . . . . . . . . . . . . . . . . . . . . . . . .2200 East Grass Lake Rd., LindenhurstMallard Ridge Park . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Robincrest Lane, LindenhurstMillennium Park . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201 Country Place Lane, LindenhurstRound Lake FacilitiesIndian Hill Elementary / Park District Gym. . . . . . . . . . . . . . . . . . . 1920 Lotus Drive, Round Lake HeightsKristof’s Entertainment Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .421 Rollins Road, Round Lake BeachRenwood Golf Course. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 701 E. Shorewood Road, Round Lake BeachRobert W. Rolek Community Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 814 Hart Road, Round LakeRound Lake Area Park District Teen Center / Youth Center ......... 2071 N. Orchard Lane, Round Lake BeachRound Lake Area Park District Site II (Dell House). . . . . . . . . . . . .2041 N. Orchard Lane, Round Lake BeachRound Lake Area Park District Sports Center. . . . . . . . . . . . . . . . .2004 N. Municipal Way, Round Lake BeachPark School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 400 W. Townline Road, Round LakeWashington Street Tennis Courts . . . . . . . . . . . . . . . . . . . . . .22415 East Washington Street, Round LakeWaukegan FacilitiesBelvidere Recreation Center/Park Place Senior Center. . . . . . . . . . . . . . . . .412 South Lewis Street, WaukeganDouglas House . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .732 N. Genesee Street, WaukeganJane Addams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Jack Benny Drive, WaukeganSunset Bowl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2015 North Lewis Avenue, WaukeganThe Field House @ Hinkston Park. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .800 N. Baldwin Avenue, WaukeganBonnie Brook Golf Course. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2800 N. Lewis Avenue, WaukeganGreenshire Golf Course. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38727 N. Lewis Avenue, WaukeganZion FacilitiesShiloh Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Emmaus and 27th Street, ZionZion Leisure Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2400 Dowie Memorial Drive, ZionZion Benton Township High School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21st Street and Kenosha Road, ZionHermon Park Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2700 29th Street, ZionPinsters Bowl & Bar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1646 Sheridan Road, ZionPort Shiloh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1523 Shiloh Blvd., ZionShepherds Crook Golf Course . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .351 Greenbay Road, ZionLINDENHURST • ROUND LAKE • WAUKEGAN • ZION

Special Recreation Servicesof Northern Lake CountyLindenhurst Park DistrictCommunity Center2200 E. Grass Lake RoadLindenhurst, IL 60046847-356-6011847-356-6063 FaxPRST STDUS POSTAGE PAIDGurnee, ILPermit No. 60Round Lake Area Park DistrictCommunity Center814 Hart RoadRound Lake, IL 60073847-546-8558847-740-8180 FaxWaukegan Park DistrictUpton Park/Douglas House2000 Belvidere StreetWaukegan, IL 60085847-360-4760847-662-2577 FaxZion Park DistrictLeisure Center2400 Dowie Memorial DriveZion, IL 60099847-746-5500847-746-5506 Fax