Fall

Fall 

2013 

Look Inside for Fall Fun: 

School’s Day Out Events – pages 11 & 16 

Winter Break Escape – page 13 

Hawaii Trip – page 24 

Homecoming Dance – page 25 

Big Value Programs – page 33 

nedsra.org

Table of Contents 

3-9 

10-15 

16 

17-18 

19-22 

23-29 

30-32 

33 

34 

35-42 

General Information 

Youth – Intellectual Disability or Autism 

Youth – Physical Disability or Visual Impairment 

Youth/Adult – Adaptive Sports 

Youth/Adult – Special Olympics 

Adult – Intellectual Disability 

Adult – Physical Disability or Visual Impairment 

Member Partner Special Events 

Support 

Forms 

Let's choose a BETTER word! 

NEDSRA is now using the word “INTELLECTUAL” 

instead of "mental" as we define our youth and 

adult disability groups. In keeping with current 

trends in the field, this term is more respectful 

and appropriate in reference to individuals with 

this type of challenge. 

Larry Roesch/NEDSRA 

Special 

Recreation 

Wednesday, 

September 11 

_____ 

Save the date! 

Register now! 

This premier golf outing is one you won’t want to miss! Plan on joining 

us for an incredible day of golf and fun with friends, all while supporting 

NEDSRA’s programs and services. With the generous support of the Roesch 

family and auto dealerships, along with the Bensenville Park District, the 

22nd Annual Roesch/NEDSRA Golf Classic will be a huge success! 

You won’t want to miss it! Register online at nedsra.org or contact 

Karen Lesniak at 630-620-4500 for more details. 

NEDSRA 

22 

LARRY ANNUAL ROESCH 

SECOND TWENTY 

GOLF CLASSIC 

3

General Information 

Office Location and Hours 

NEDSRA Administrative Offices 

1770 W. Centennial Place, Addison, IL 60101 

Phone: 630-620-4500 

Fax: 630-620-4598 

NEDSRA’s regular office hours are 8:30 a.m. to 5:00 p.m., 

Monday through Friday. 

nedsra.org 

Drop Box/Mail Box: 

For your convenience, 

a drop-off box to place 

registration materials is located to the right of NEDSRA’s 

front entry door. 

What is NEDSRA? 

NEDSRA provides sports, recreation, and leisure 

opportunities to adults and children with disabilities. By 

working cooperatively with eight park districts and three 

villages, NEDSRA serves more than 4,000 individuals each 

year. Call to learn about our programs at 630-620-4500. 

Financial assistance is available for qualified applicants. 

Proudly Serving the Residents of: 

Addison Park District, Bensenville Park District, Butterfield 

Park District, Village of Glendale Heights, Itasca Park 

District, Lombard Park District, Medinah Park District, 

Oakbrook Terrace Park District, Village of Schiller Park, 

Village of Villa Park, Wood Dale Park District 

Watch For 

This Symbol 

$ 

BVP 

BIG VALUE PROGRAM 

Our BIG VALUE PROGRAMS always have a 

registration fee of $10 or less! That’s lots of bang 

for your buck! 

Si Usted Habla Español 

Si usted habla español y desea más información 

sobre los programas y servicios de NEDSRA, por 

favor marque 630-576-4010 y pregunte por Nora 

Sandoval. Nora está disponible para servirle 

durante el horario de NEDSRA, de Lunes a Viernes 

de 8:30 a.m. a 5:00 p.m. 

3 

Registration Information 

Important Dates: 

August 29 – Early Bird Drawing 

Register and pay by August 29 and you will 

automatically be entered into a drawing to win a $50 

NEDSRA program certificate! Each paid program 

registration = one entry! 

More programs = more chances to win! 

Fall Registration Deadline: 

September 6 (unless otherwise noted) 

Register by deadlines to avoid cancelled programs. 

Programs Begin: September 21 

Winter Brochure Online: November 8 

Registration is Easy – 

Find forms at the back of the brochure. 

• Complete the Registration Form 

Please remember to sign the bottom of the form. 

• Complete the Annual Information Form 

The Annual Information Form is valid for one year. 

Once a form is on file, you do not need to fill one 

out again until it has been in place for a year or if 

there are changes in the status of information. The 

Annual Information Form provides valuable details 

to our staff, to assist in keeping each participant 

safe and successful in our programs. Thank you for 

your careful attention to this form and its details. 

• Turn the Registration Form and Annual Information 

Form, along with payment, to the NEDSRA Office 

Once an Annual Information Form is on file, you 

may also fax the form to our office or register over 

the phone directly with our registrar. You may pay 

the registration fees with a credit card at this 

time, if you choose. If you would like to set up a 

payment plan, please contact Nora Sandoval at 

630-576-4010. 

Early Bird Raffle 

WIN $50 

NEDSRA program certificate! 

Congratulations to Heidi Edmier of Addison, 

the winner of the Summer Early Bird Raffle!

Call Us. We Can Help. 

Lisa Barrera, CTRS, Recreation Coordinator - Support Staff, Day Camps, Interns, lbarrera@nedsra.org, 630-576-4039 

Beth Corso, Senior Recreation Coordinator - Adults ID, Trips, Special Events, bcorso@nedsra.org, 630-576-4030 

Paul Fasano, CTRS, Recreation Coordinator - Social Clubs, pfasano@nedsra.org, 630-576-4032 

Maggie Goode, Recreation Coordinator - Cultural Arts, TREC, School Services, mgoode@nedsra.org, 630-576-4036 

Carrie Henry, CPRP, Recreation Coordinator - Adults PD/VI, Youth-at-Risk, chenry@nedsra.org, 630-576-4031 

Adam Kramer, CPRP, Recreation Coordinator - Adaptive Sports, Youth PD/VI, akramer@nedsra.org, 630-576-4037 

Lori Miller, CTRS, Recreation Manager - Adults VI, lmiller@nedsra.org, 630-576-4034 

Ann Roytek-Rylko, CPRP, Recreation Manager - Inclusion, Safety/Risk Management, aroytek@nedsra.org, 630-576-4033 

Sean Tovey, CPRP, CTRS, Recreation Coordinator - Special Olympics, Interns, stovey@nedsra.org, 630-576-4035 

Laurine Machynia, Administrative Assistant/Receptionist, lmachynia@nedsra.org, 630-576-4012 

Sue Martellotta, Administrative Services Manager, smartellotta@nedsra.org, 630-576-4022 

Cathie Marron, Administrative Assistant, cmarron@nedsra.org, 630-576-4020 

Nora Sandoval, Administrative Assistant, nsandoval@nedsra.org, 630-576-4010 

Karen Lesniak, Director of Fund Development, klesniak@nedsra.org, 630-576-4017 

Lisa Deets, CTRS, Superintendent, ldeets@nedsra.org, 630-576-4040 

Jeena Greenwalt, CPRP, Executive Director, jgreenwalt@nedsra.org, 630-576-4023 

Suggested Ages & Abilities 

NEDSRA offers most programs and special events to 

targeted age and ability groups so that programs can 

be designed to meet individual needs. Anyone wishing 

to participate in a program that does not appear to 

match his or her specific age or ability is encouraged 

to contact the NEDSRA office for additional information 

and to determine whether reasonable accommodations 

can be made. 

NEDSRA Behavior Code 

The following guidelines have been developed to make 

NEDSRA’s programs safe and enjoyable for everyone. 

Additional rules may be developed for particular 

programs as deemed necessary by staff. Staff, 

participants, volunteers and parents shall: 

• Show respect to all participants, staff, volunteers 

and parents 

• Refrain from using foul language 

• Refrain from causing bodily harm to other 

participants, staff or parents 

• Demonstrate respect for equipment, supplies 

and facilities 

• Represent NEDSRA in a manner that is 

consistent with the goals, objectives and ethics 

of the Association 

In addition, bullying behavior of any nature will not 

be tolerated. 

ID Card 

Name: John Smith 

Address: 123 Main St. 

ADULT PARTICIPANTS 

Please remember to 

bring a photo ID to all 

NEDSRA events. 

4 

Putting People First 

NEDSRA encourages the concept of putting people 

first. No eligible participant shall be denied equal 

access to programs, activities, services or benefits 

on the basis of race, gender, creed, national origin 

or disability, or be limited in the exercise of any right, 

advantage or opportunity. 

Inclusion Services 

Not every person with a special need or disabling 

condition will require NEDSRA programming. In some 

cases it will be appropriate for NEDSRA staff to work 

in cooperation with our member partners to advise 

and/or assist residents wishing to participate in 

recreational programs offered by their local park district 

or recreation department. We strongly encourage 

that inclusion be considered as a recreational option. 

• One-to-one consultation 

• In-service training with park district and village 

recreation staff 

• Assistance with the aid of leisure buddies 

• Provisions of community resources 

These services are provided to residents at no cost. 

We will do everything possible to make your inclusion 

experience a success. For more information, contact 

Ann Roytek-Rylko, Inclusion Manager, 630-576-4033. 

Discipline 

A caring and positive discipline approach will be used. 

NEDSRA reserves the right to dismiss a participant, 

staff, volunteer or parent if it is in the best interest of 

the Association. Each situation will be evaluated on 

its own merit.

NEDSRA Board of Trustees 

Chairman Cecelia Sullivan, Village of Glendale Heights 

Vice Chairman Mark McKinnon, Addison Park District 

Board Secretary Laura Barron, Oakbrook Terrace Park District 

John Bealer, Village of Schiller Park 

Steve Cherveny, Bensenville Park District 

Bruce Baum, Medinah Park District 

Paul Friedrichs, Lombard Park District 

Greg Gola, Village of Villa Park 

Matt Ellman, Wood Dale Park District 

Maryfran Leno, Itasca Park District 

Larry Reiner, Butterfield Park District 

Board Meetings 

The NEDSRA Board of Trustees holds public 

meetings at NEDSRA on a monthly basis. For 

a detailed calendar of Board meetings, please 

visit nedsra.org or contact us at 630-620-4500. 

Vision 

An agency of excellence, demonstrated by 

member partners working cooperatively with 

Board, staff and the community to enhance 

the quality of life for each individual. 

Mission 

To serve as an integral partner with our member 

park districts and villages to positively impact 

individuals with disabilities through diverse 

recreation opportunities and community services. 

Our Core Values: Service with Compassion • Excellence and Quality • Integrity • Commitment • Fun 

Resident/Non-resident Policy 

NEDSRA programs are supported by user fees, 

grants and donations, and subsidies from 11 

partner communities through tax dollars. As a 

result, individuals residing within NEDSRA’s 11 

partner communities are eligible for resident rates 

and are ensured registration priority. Non-resident 

registrations will be processed after the registration 

deadline. Additionally, residents qualify for doorto-door 

transportation when applicable and may 

qualify for fee assistance. 

Program Fees 

Each program description in the brochure lists a 

registration fee. 

• All participants residing in one of NEDSRA’s 

partner communities are eligible for the resident 

fee – “Res. Fee.” 

• Participants residing outside of one of NEDSRA’s 

partner communities are considered non-residents. 

Non-resident fees are 50% more than the 

resident fee. 

• Some programs list a “Fee for All.” For these 

specifi c programs, non-residents as well as 

residents, register for this one fee. 

For questions regarding this policy, contact 

Lisa Deets, Superintendent, at 630-576-4040. 

5 

Satisfaction Guaranteed Policy 

We feel it is our responsibility to provide you with the 

best, most enjoyable and highest quality recreation 

services possible. If your experience with NEDSRA is 

not 100% satisfactory, please let us know and we will 

remedy the situation. 

Van Pickup and Drop-off Disclaimer 

Depending on registrations received, pickup and dropoff 

locations may be subject to change or cancellation 

if a two-person minimum is not met. Be sure to mark 

your registration form if you will be using a pickup point. 

Program Cancellations 

NEDSRA reserves the right to cancel any program, 

activity or event which does not meet minimum 

enrollment. Should a program be cancelled by 

NEDSRA, a full refund will be issued. 

Brochure Changes/Error Disclaimer 

Due to the large amount of information provided in 

NEDSRA brochures, errors and changes may occur. 

We apologize for any errors and will make every 

effort to advise participants of any program changes 

and corrections as quickly and effi ciently as possible. 

Inclement Weather Policy 

Programs may be cancelled due to severe or 

prohibitive weather. All participants will be notified if a 

program is cancelled. A maximum of one session per 

program will be rescheduled if possible. If a make-up 

session is not possible, a prorated refund will be issued.

Promptness is Appreciated 

We ask that participants arrive no earlier than 15 

minutes prior to the start of a program or scheduled 

pickup time, and that they are picked up promptly at 

the end of a program or scheduled drop-off time. Being 

early or late is detrimental to the quality and success 

of our activities and the safety of our participants. 

Program Fee Refund Policy 

If a participant withdraws from a program, a full refund 

is issued if requested two (2) days prior to the program’s 

start. If the refund is requested due to unforeseen 

circumstances such as hospitalization, relocation, or 

death in the family, a refund may be approved beyond 

this time frame. In these situations, written documentation 

may be required. 

All refunds granted after a program has begun will be 

prorated based on the number of remaining sessions. 

If a program involves the purchase of tickets, contracted 

services, or non-returnable items, the cost of these 

may be deducted from the refund amount. Refunds 

may be issued as a credit toward future programs or 

in the form of a check. 

Financial Assistance 

We believe all residents, regardless of financial 

limitations, should have access to NEDSRA’s programs. 

We offer a financial assistance program so that 

financial need is not an obstacle to having fun. Partial 

assistance is available for a maximum of two programs 

per season. For information, contact Nora Sandoval 

at 630-576-4010. 

6 

Illness Policy 

NEDSRA has the right to refuse any participant who 

is ill or has a fever. If a participant becomes ill during 

a program, a parent/guardian or emergency contact 

will be notified and asked to pick up the participant. 

Communicable Disease Policy 

For the protection and safety of both employees and 

participants, NEDSRA maintains specific policies 

and procedures on individuals with communicable 

diseases. These policies are available for review by 

the public at NEDSRA’s offi ces. 

Your Safety is Important 

To ensure the safety of our participants, we appreciate 

your adherence to the following guidelines: 

1. NEDSRA staff is responsible for the safety of 

program participants during designated program 

times. Please adhere to scheduled drop-off and 

pickup times. 

2. Participants enrolled in NEDSRA programs will 

not be released to anyone other than a parent, 

guardian or family member without prior written 

consent from the parent/guardian. 

3. When arriving at or departing from program sites, 

parents should check in with a NEDSRA staff 

member before leaving or taking a participant home. 

4. A child or minor will be allowed to walk home from 

a program location only if written permission from 

the parent/guardian has been received. 

5. For programs involving door-to-door transportation, 

NEDSRA staff will pick up and drop off at the 

participant’s driveway. Arrangements should be 

made to accommodate participants from this point. 

6. If you will not attend a program for which you 

registered, please notify the NEDSRA offi ce. 

NEDSRA Hotline 

Receive up-to-date information with the touch of a 

button when you call NEDSRA: 

• program changes/cancellations 

• transportation 

• weather issues 

Active Duty Military Fee 

Assistance Policy 

Fee assistance is now available to active duty 

military personnel and their dependents residing 

in NEDSRA’s member partner communities. For 

details, contact Nora Sandoval at 630-576-4010.

Facility 

Directory 

For directions to a facility or to learn about transportation 

options to programs, please contact Lori Miller at 

630-576-4034 or lmiller@nedsra.org. 

Bensenville Water Park 

1000 West Wood Street 

Bensenville 

630-766-7946 

Bensenville Community Public Library 

200 South Church Road 

Bensenville 

630-766-4642 

Blackhawk Middle School 

250 South Church Road 

Bensenville 

630-766-2601 

Bluthardt Recreation Center 

9638 Irving Park Road 

Schiller Park 

847-671-8580 

Brunswick Zone 

558 North Avenue 

Glendale Heights 

630-858-1300 

Butterfield Park District 

21W730 Butterfield Road 

Lombard 

630-858-2229 

Butterfield School 

2S500 Gray Avenue 

Lombard 

630-827-4000 

Cabin Nature Center 

111 South Wood Dale Road 

Wood Dale 

630-860-1111 

Community Recreation Center 

120 East Oak Street 

Addison 

630-833-0100 

Club Fitness 

1776 West Centennial Place 

Addison 

630-889-2150 

Deer Grove Leisure Center 

1000 West Wood Street 

Bensenville 

630-766-7015 

Eaglewood Resort & Spa 

1407 Nordic Road 

Itasca 

630-773-3510 

Fenton High School 

1000 West Green Street 

Bensenville 

630-766-2500 

Glendale Heights Sports Hub 

250 Civic Center Plaza 


630-260-6060 

Glenwood Academy 

1525 Bloomingdale Road 


630-871-2300 

Heritage Center 

1S325 Ardmore 

Oakbrook Terrace 

630-627-6100 

Iowa Community Center 

338 North Iowa Avenue 

Villa Park 

630-834-8970 

Itasca Recreation Center 

350 East Irving Park Road 

Itasca 

630-773-2257 

Lake View Nature Center 

17W063 Hodges Road 


630-941-8747 

Links & Tees 

900 West Lake Street 

Addison 

630-543-3111 

Lombard Community Building 

433 East St. Charles Road 

Lombard 

630-953-2370 

Lombard Lagoon 

430 Marcus Avenue 

Lombard 

Lombard Log Cabin 

16 th & Main Street 

Lombard 

Madison Meadows 

Madison Street & Ahrens Avenue 

Lombard 

7 

Mario Parente Theater 

1S325 Ardmore Avenue 


630-627-6100 

NEDSRA 

1770 West Centennial Place 

Addison 

630-620-4500 

Paradise Bay Waterpark 

437 East St. Charles Road 

Lombard 

630-627-6127 

Recreation Complex 

111 East Foster Avenue 

Wood Dale 

630-595-9333 

Schiller Park Community Center 

4501 North 25 th Avenue 

Schiller Park 

847-671-8580 

Sensei Steve’s Karate Center (new address) 

341 South Ardmore Avenue 

Villa Park 

630-834-6344 

Stardust Bowl 

37 East Lorraine Avenue 

Addison 

630-833-1040 

Sunset Knoll Recreation Center 

820 South Finley Road 

Lombard 

630-620-7322 

Terrace View Park 

17W063 Hodges Road 


630-941-8747 

Thorndale Recreation Center 

22W130 Thorndale Road 

Medinah 

630-893-2560 

Villa Park Police Station 

11 West Home Street 

Villa Park 

630-834-7447 

Wood Dale Bowl 

155 West Irving Park Road 

Wood Dale 

630-766-6800

Annual Service Report 

NEDSRA 

Annual 

Service 

Report 

2012-2013 

Looking back on the 2012-2013 

year of service, we are proud of 

the accomplishments we have 

made as a NEDSRA team. We 

continue to meet the unique needs 

of our community members with 

disabilities. Our service remains 

strong and our vision remains 

clear. We are committed to 

providing extraordinary services 

to extraordinary individuals by 

“Putting the Person” first. Please 

feel free to stop by the NEDSRA 

offi ce to pick up a copy of the 

Annual Service Report, or you 

may access it at nedsra.org. 

Jeena Greenwalt 

Executive Director 

Tom Connolly, from the Medinah 

Park District, was honored for 

20 years of service to NEDSRA. 

Gratitude is extended to our support staff 

at the annual Reach for the Stars banquet. 

Special awards of recognition were presented to 

Veronica Urban (Superstar Volunteer), 

Colleen Cline (Rising Star) and 

Michelle Lindgren (Shining Star). 

8

Distinct Individuals – 

Disabled Only 

2011/12 

3,006 

2010/11 

2,730 

2012/13 

3,255 

596 Total Programs Implemented 

95% Program Success Rate 

110 Inclusions Facilitated 

114,671 Service Hours 

9,987 Total Registrations Received 

9272 + 715 group services 

registrations 

4,309 Total Distinct Individuals Served 

Adult 43% 

Seniors 

5% 

Preschool 16% 

Registrations 

by Age Group – 

Disabled Only 

Youth 36% 

NEDSRA programs 

continued to be received 

with much enthusiasm as our 

success rate hit an all-time high 

of 95% (programs implemented 

versus offered). Participation from the 

Hispanic community more than doubled 

from the prior year as a result of specifi c 

outreach efforts to these individuals. 

9

Youth 

Intellectual 

Disability 

or Autism 

Early Intervention 

These classes are designed for a 

“parent-tot” experience; therefore, 

an adult (over the age of 18) must 

accompany your child each week to 

make each program wonderful for 

your child. 

Sensory Art F130229 

Now 5 weeks! 

Youth with an Intellectual Disability or Autism, with a parent or guardian 

Don’t miss out on this interactive 5-week art program where your child will create fun artwork 

while using their fi ve senses. This program will help with many sensory issues and will improve 

social interaction skills; so let’s get dirty and enjoy some messy fun! Please bring an old T-shirt or 

smock for your child to wear each week. 

Contact: Maggie Goode 

Location: Iowa Community Center, Villa Park 

Age Day Date Time Res. Fee 

1-5 Tues 9/3-10/1 10:00am-10:45am $19 

Registration deadline: 8/30 

Play and Learn F130231 


Come stimulate your senses, improve fine and gross motor skills and socialize with others at the Bensenville 

Public Library. During this early childhood program, children will get to build amazing creations, climb through 

tunnels, work on puzzles and so much more! Come out and learn while you play! 

Contact: Lori Miller 

Location: Bensenville Community Public Library 


1-5 Fri 9/20-10/18 10:00am-10:45am $10 

BVP 

$ 


Beginner’s Basketball F130230 


During this class, parents and tots will have the opportunity to learn the game of basketball together. Children 

will learn the basics of dribbling, passing and shooting in this fun and interactive program. 


Location: NEDSRA 


1-5 Tues 10/15-10/29 10:00am-10:45am $14 


10

School’s Day Out – 

Johansen’s Pumpkin Farm F130163 

Youth with an Intellectual Disability or Autism 

On this day off school, we will be traveling to Johansen’s 

Pumpkin Farm in Bolingbrook. We will be picking out a 

pumpkin, visiting the petting zoo and having our lunch at 

the farm! We will then take our pumpkin that we carefully 

chose back to NEDSRA to carve and decorate. Please 

provide a sack lunch for this program. 


Location: Meet at NEDSRA 


4-8 Mon 10/14 9:00am-3:30pm $50 


Pool School 


Let an experienced NEDSRA staff design a swim program 

to match your level of experience. Whether you are an 

advanced swimmer, at an intermediate level, or just 

beginning – we will create a one-on-one weekly lesson 

for you! Please register for the specific program number 

and time. This program fills very quickly; sign up early so 

you won’t miss a minute of pool fun! A maximum of 10 

participants will be allowed in each session. 


Location: Club Fitness, Addison 

Age Day Date Res. Fee 

3-16 Mon 9/16-11/4 $88 

Program # 

F130101 7:00pm-7:30pm 

F130102 7:30pm-8:00pm 

F130103 8:00pm-8:30pm 

F130104 8:30pm-9:00pm 

Makeup session, if needed: 11/11 

School’s Day Out – Science 

Technology Museum F130162 


Join all your NEDSRA friends for another exciting field trip! 

We will be visiting the Science Technology Museum in 

Aurora, where we will be able to experience tons of 

hands on science experiments, over 200 interactive 

exhibits, an outdoor science park, and much more! Make 

sure to bring your lunch to the program because we are 

going to be eating while we are at the museum. Sign up 

early and don’t miss out on this fun filled day! 

Contact: Paul Fasano 



8-18 Mon 10/14 9:00am-3:30pm $50 


Jr. Super Sports F130108 


Get your gym shoes on, because we’re heading to the gym 

to play some of our favorite sports! Each week, focusing 

on a different sport, participants will learn the rules, 

practice basic skills, and then we’ll finish with a friendly 

game. Whether baseball, volleyball, or basketball is your 

favorite, this is a perfect program for participants who need 

to get some exercise while having fun! This program also 

serves as a stepping stone for those participants who are 

interested in joining Special Olympics. 

Contact: Carrie Henry 

Location: Deer Grove Leisure Center, Bensenville 


6-12 Tues 10/1-10/29 4:30pm-5:30pm $21 


Van Pickup/Drop-off Departs Returns 

Medinah Park District 4:00pm 6:00pm 

Holiday Party with Santa F130175 

Youth of all Abilities and Siblings 

Santa has set aside a special day just for our 

NEDSRA friends to start the holiday season 

with a big Ho-Ho-Ho!! He’ll be joining us at 

the Lombard Community Building after we 

spend some time making crafts, singing some 

holiday songs and enjoying a hot lunch. 

We have a hunch the big guy in red will be 

handing out presents too! Be sure to join us 

for this popular and oh-so-festive event that 

is sure to put you in that holiday mood! 

Contact: Lisa Barrera 

Location: Lombard Community Building 

Age Day Date Time 

3-12 Sat 12/7 11:30am-1:00pm 


FREE! 

Deck the Halls Ornament Creations 

Studio For Kids F130164 


Show off your creative and artistic skills during 

this special holiday program! For three weeks, 

we will be making all sorts of different holiday 

ornaments to be hung on the Christmas tree 

at the annual Medinah Park District event, 

“Deck The Halls!” Don’t forget to sign up for 

this fun family holiday event, please look at 

page 33 for “Deck The Halls” event details. 


Location: Thorndale Recreation Center, Medinah 


5-12 Tues 11/5-11/19 5:30pm-6:30pm $19 


11

Youth 

Intellectual Disability or Autism 

Kids Klub 

Youth with an Intellectual Disability or Autism and Friends 

PARENTS: Please note that Kids Klub 1 and Kids Klub 2 are now established by specifi c 

participant ages. Kids Klub 1 is for ages 4-7, while Kids Klub 2 is for ages 8-12. Please 

register for the appropriate section of Kids Klub. Due to the individual attention given to 

participants in this popular program, groups and outings are not inter-changeable. Please 

contact Paul Fasano if you have questions or concerns. 




Age Day Res. Fee 

4-7 (Kids Klub 1) Sat $77 

8-12 (Kids Klub 2) Sat $77 

Kids Klub 1 F132600 Van Pickup/Drop-off Departs Returns 

9/21 Fun Flatables NEDSRA 4:00pm 7:30pm 

10/5 Down on the Farm NEDSRA 4:00pm 7:00pm 

10/19 Pumpkin Picassos NEDSRA 4:00pm 7:00pm 

11/2 Mighty Music Makers NEDSRA 4:00pm 7:00pm 

Kids Klub 2 F132601 Van Pickup/Drop-off Departs Returns 

9/28 Fun Flatables NEDSRA 4:00pm 7:30pm 

10/12 Down on the Farm NEDSRA 4:00pm 7:00pm 

10/19 Pumpkin Picassos NEDSRA 4:00pm 7:00pm 

11/9 Mighty Music Makers NEDSRA 4:00pm 7:00pm 

*Note: Both Kids Klub 1 and Kids Klub 2 will meet on October 19. 

Fun Flatables, Bloomingdale 

Fun Flatables is an indoor, year-round, inflatable party ‘n play center located in Stratford Square Mall. At this 

activity participants will be able to jump, climb, slide, play, and race their way around this amazing soft playground 

facility. After everyone has had a “fun-flatable” time, we will head over to the food court and enjoy a light meal. 

Down on the Farm, West Chicago 

Come on down to a place where first generation German immigrants started a farm in 1883, now known as 

Sonny Acres Farm. Sonny Acres is known as a pumpkin farm where family and friends can enjoy a pleasant fall 

outing together in celebration of harvest time, take a wagon/hayride, play in the Kiddie Koral, pick a pumpkin, 

and get a chance to feed some animals at the petting zoo. This will be a true down on the farm experience! 

Overalls and flannel shirts are welcome. 

Pumpkin Picassos, NEDSRA 

Now is the chance to see your creative potential. We will be taking our pumpkins previously picked at Sonny 

Acres Farm and turning them into works of art just in time for Halloween. Let’s have fun carving our pumpkins 

while learning a bit about this strange, orange-colored squash fruit. If time permits, we may even bake the 

seeds for a snack to enjoy. 

Mighty Music Makers, NEDSRA 

It’s time to rock at this Mighty Music Makers program. Here is your opportunity to express yourself though 

music! There will be many instruments available to play and even equipment to amplify your singing 

voice. Everyone will also have the chance to make a musical instrument of their own so the music won’t 

stop when it’s time to head home. 

12

Super Saturdays F130105 


What better way to start your weekend, than with all your 

friends at NEDSRA? These “super” Saturdays are filled 

with lots of fun! We’ll play games, do arts and crafts, enjoy 

some music therapy, go swimming and maybe even visit 

with some trained therapy dogs. Before we go home, we’ll 

end our morning with a snack. 




5-12 Sat 9/21-10/26 9:30am-11:30am $62 


Oak Brook Terrace Park District 9:00am 12:00pm 

Horseback Riding Lessons F130107 

Youth with an Intellectual Disability, Physical Disability 

or Autism 

Saddle up, horse lovers! Our good friends at Palatine 

Stables are waiting to provide awesome horseback riding 

lessons for us yet again! Everyone will receive a 30-minute 

horseback riding lesson, along with some meet-and-greet 

time with the other animals in the barn. We’ll break for a 

healthy snack while we share our experiences of the day 

with each other. Long pants and closed-toe shoes must be 

worn. Register early to secure your spot, as this program is 

limited to 10 participants. 




6-18 Sat 9/28-11/2 11:30am-2:00pm $110 

No program: 10/5 


Karate for Kids F130106 


Through this 6-week program, participants will be 

introduced to basic Karate concepts and moves. Karate 

promotes self-confidence, self-control, self-defense and 

provides a safe and fun social experience. Kids at all 

levels are encouraged to join, so sign up today! 


Location: Sensei Steve’s Karate Center, Villa Park 


6-16 Sat 9/21-11/2 11:00am-12:00pm $28 

No program:10/19 

Cub Scouts F132619 

Youth of All Abilities 

Why join the Cub Scouts? Because Cub Scouting is fun! 

Cub Scouts do fun things, go neat places, belong to a 

pack, make awesome stuff, wear cool uniforms, and earn 

awards. As a Cub Scout you will be part of NEDSRA’s 

own pack #437. Our pack relies heavily upon parent 

volunteering with weekly den meetings, and especially 

with annual events such as popcorn sales, camping, and 

the pinewood derby. The program fee includes all Thursday 

den meetings, supplies, and special events. Don’t miss 

out on the excellent program opportunities that Cub Scout 

Pack #437 has to offer! 



Age Day Time Res. Fee 

7-15 Thurs 6:30pm-8:00pm $180 

Dates: 9/26, 10/10, 10/24, 11/7, 11/21, 12/12, 1/9, 1/23, 

2/6, 2/20, 3/6, 3/20, 4/3, 4/17, 5/1 


Winter Break Escape 


Looking for something fun and exciting to do over winter break? Winter Escape is broken up into two sessions, 

one that occurs after Christmas and the other after New Years, with each session being two days. Activities will 

include a field trip, arts and crafts, gym time and baking snacks! If your child requires medication during the 

program, please fill out the Medication Release Form and bring it with the medication on the fi rst day of the 

program. Please pack a sack lunch each day. 



Session 1 F130150 


6-18 Thurs & Fri 12/26, 12/27 9:00am-3:30pm $64 

Session 2 F130151 


6-18 Thurs & Fri 1/2, 1/3 9:00am-3:30pm $64 

Sign up for both sessions and receive a $10 discount! 


13

Youth 

Intellectual Disability or Autism 

Teen Scene F130302 Now 4 sessions! 

Youth with Autism 

Calling all teenagers! Teen Scene gets preteens and teens with autism out and about in the 

community, while socializing and having fun with NEDSRA friends. We will have some fantastic 

events planned and will mail out a detailed schedule closer to the starting date. You can be sure 

that movies, bowling, arcade games, and sporting events are just a few of the ideas we have! 




10-18 Fri 9/27, 10/11, 11/8, 12/6 6:30pm-9:30pm $70 

Petite Picassos F132206 


Art is a wonderful way to express yourself, relax and develop fine motor skills. This program is 

tailored to meet the individual needs of each participant and offer unique art experiences that each 

participant will be successful at. This sensory-based program is facilitated by NEDSRA’s art therapist. 

Don’t miss out on this opportunity to discover new talents and interests in your child. 



Age Day Date Time Res Fee 

8-15 Tues 10/8-10/29 5:00pm-6:00pm $39 


Cheer Crew F130165 


How can you get a workout and show your spirit while making new friends – by being a part of NEDSRA’s Cheer 

Crew! We’ll spend the first few weeks learning the cheers and creating banners to support our team. We’ll then be 

ready to show off our talents and spread some team spirit at NEDSRA’s Jr. Basketball games. 


Location: Itasca Recreation Center 


8-18 Sat 11/2-1/25 1:00pm-2:30pm $98 

No program: 11/30, 12/7, 12/28 


Parents Night Out – Pajama Party F133008 

Youth with an Intellectual Disability 

Parents, take this opportunity for a night out! NEDSRA will take care of everything while you’re out. We have 

planned a night of pizza making, cookie decorating, movie watching and, of course, popcorn eating all in 

our PJs. 

Contact: Beth Corso 



8-15 Sat 11/23 6:00pm-9:00pm $10 


14 

$ 

BVP 

BIG VALUE PROGRAM

TGIF F132602 


“Thank Goodness It’s Friday” (TGIF) has a unique season ahead 

of us. For this season there will be an overnight program! That’s 

right, for this season we will be able to say “Thank Goodness It’s 

Friday…and Saturday!” We will be staying at the Comfort Suites 

in Oakbrook Terrace, and the overnight will include a pool party, 

pizza dinner, a big screen movie, and gaming tournament! The 

next morning, we will enjoy a great buffet breakfast at the hotel 

and return to NEDSRA by 10:30 a.m. Details on the overnight will 

be arranged after the registration deadline on 9/6. The remaining 

two weeks of the program will be on November 1 and November 15, 

which will be in-house activities at NEDSRA. 



Age 13-18 Res. Fee $87 

Date Activity and Time Van Pickup/Drop Off Departs Returns 

Fri-Sat, Overnight Party NEDSRA 6:00 pm 10:30 am 

9/20-9/21 6:30pm-10:30am Lombard Community Building 6:30 pm 10:00 am 

Fri,11/1 Activity and Time TBA Lombard Community Building 6:00 pm 9:30 pm 

NEDSRA 6:30 pm 9:00 pm 

Fri,11/15 Activity and Time TBA Lombard Community Building 6:00 pm 9:30 pm 

NEDSRA 6:30 pm 9:00 pm 

Youth Fitness Club F130109 


There’s an exciting new club out there, Youth Fitness Club! 

This club will focus on improving your health and physical 

condition. Each week you will work on a variety of things 

including weight training, cardio exercise, and aqua 

exercise! You will receive a home exercise workout 

manual and log book to keep track of your progress! 

Contact: Lisa Barrera 



8-18 Thurs 10/3-10/31 5:30pm-7:00pm $36 


Lego Build Off F130110 


Come out and join us at the Bensenville Public Library 

for some Lego fun! Each week you will be given a limited 

number of Legos and a specific theme, then using your 

creative imagination, you will create a Lego masterpiece! 

Prizes and snacks will be included during this program. 


Location: Bensenville Community Public Library 


10-18 Mon 10/21-11/18 5:30pm-6:30pm $12 


15 

Junior Theater Troupe F132202 


If you are interested in getting on stage and expressing 

yourself through song and dance, this is the program for 

you. Join NEDSRA’s popular Theater Troupe for Juniors 

to get the same experiences but on a smaller scale. You 

will benefit from being mentored by the same staff and 

adult participants who are all seasoned veterans with this 

program. Learn lines, songs and dance moves and be 

part of the two night finale performances in March. This 

is a great program to help boost self-esteem, confi dence 

and encourages social interaction with peers. 


Location: Mario Parente Theater, Oakbrook Terrace 

Age Day Date Time Res Fee 

13 & up Thurs 11/7-12/19 5:30pm-6:30pm $39 



Check out our 

Member Partner Special Events! 

See page 33 for details. 

We're invited!

Youth/Adult 

Physical 

Disability 

or Visual 

Impairment 

Adam Kramer, CPRP 

Recreation Coordinator 

Adaptive Sports, 

Youth – Physical Disability 

or Visual Impairment 

akramer@nedsra.org 

630-576-4037 

Outdoor Escape F130201 

Youth and Adults with a Physical Disability 

Before Old Man Winter heads to Chicagoland, check out this opportunity to get out of the house 

and enjoy an afternoon relaxing with your friends. We will be heading to a local park for an afternoon 

of outdoor activities and games. Of course we won’t send you home hungry. NEDSRA will provide 

an afternoon snack on the Fox River. 

Contact: Adam Kramer 


Age Day Date Time Fee For All 

5-35 Sat 10/5 3:00pm-7:00pm $27 


School’s Day Out – Apple Holler F130200 


It’s Columbus Day, what better time to participate in an adventure 

outdoors? Like Columbus, we will embark on our journey to 

explore a “new world.” We will be heading north to the ever 

popular Apple Holler in Racine, WI. Once we arrive, we will 

disembark the van and prepare ourselves for excitement 

while exploring this exciting orchard; games, projects, and 

provisions await our arrival. We will be all set for a great day 

of exploration and excitement. 



Age Day Date Time Fee For All 

5-35 Mon 10/14 9:00am-4:00pm $45 


16

Youth/Adult 

Adaptive Sports 

Wheelchair Basketball – 

Opportunities for Everyone 

Take this opportunity to gain new friends and improve your life skills 

through the game of basketball. This sport is open to anyone with 

a mobility impairment, regardless of whether you are ambulatory 

or use a wheelchair. All players must play from a sports chair for 

games and practices, but don’t worry, NEDSRA has plenty of sports 

chairs available for use. New players are always welcome! Contact 

Adam Kramer at 630-576-4037 or akramer@nedsra.org today for 

more information. 

JR Bulls – Youth Wheelchair Basketball F131000 

Youth with a Physical Disability 

Junior Varsity – Basketball season is BACK, and the NEDSRA Junior Bulls are looking 

to continue their success! We will start with practices and then play games throughout 

the Midwest in our quest to continue impressing at the National Tournament. 

Preparatory – The JR Bulls Prep team is perfect for our newcomers and athletes under 

age 12! We will start with basic skills at practices, and put them to the test as we play 

games throughout the Midwest. 



Age Day Date Time Fee for All 

5-21 Sat 9/21-3/1 12:30pm-2:30pm $350 

No program: 11/30, 12/28 


Save $15 – Register by 8/26 

Check out all the 

fun the NEDSRA 

JR Bulls have had 

in past years on 

Facebook at the 

“NEDSRA Junior 

Wheelchair Bulls 

Fansite” or 

www.jrbulls.org 

Chicagoland Cruisers – 

Adult Wheelchair Basketball F131010 


The Chicagoland Cruisers are looking for some new faces 

to help complete their team. If you are a newcomer, please 

come meet the team. We have tons of fun on the court 

and just as much on the sidelines. It’s a great way to make 

new friends and learn new skills. We will practice and 

get back into shape first, then compete in several local 

tournaments later in the season. 



Age Day Time Fee for All 

12 & up Sat 3:00pm-5:00pm $175 

Dates: 11/2, 11/16, 11/23, 12/7, 12/21, 1/4, 1/25, 2/1, 2/8, 3/1, 3/15 

17 

Wheelchair Basketball Open Gym F131001 


Each session of open gym will allow athletes to learn a 

new skill and apply it to a game setting. Emphasis will be 

on fun as always, but this will also be a great opportunity 

to get more exercise and develop your skills. Come join us 

on the court. 




5 & up Thurs 10/10-12/19 6:00pm-8:00pm $64 


Registration deadline: 10/4

Youth/Adult 

Adaptive Sports 

Adaptive Sports Sampler F131012 

Youth and Adults with a Physical Disability, Family and Friends 

Join us for a four-week Paralympic sports experience. Each week a new sport will be 

introduced and you will have the chance to try it. Encourage your friends and family to attend 

and learn more about Paralympic sports. NEDSRA will provide the equipment and instruction 

each night as you try wheelchair hockey, soccer, handcycling, and a week where you decide 

the sport. This is your chance to ask questions, test equipment, and meet peers in a relaxing, 

informative environment. Each sport will be adaptable to any individual’s skill or ability level. 


Location: Thorndale Recreation Center, Medinah 


5 & up Tues 11/5-11/26 6:30pm-8:00pm $29 


Adaptive Powerlifting F131006 

Youth and Adults with a Physical Disability or Visual Impairment 

Join NEDSRA’s specialized staff for 10 weeks of personalized health, wellness, and fitness training. 

Individualized goals will be established to ensure appropriate assistance and guidance; ultimately providing 

a thorough workout each week. Don’t miss your chance to learn about fitness while getting in shape or 

training for your sport of choice. 




8 & up Wed 10/9-12/18 6:30pm-8:00pm $62 


Quad Rugby F132007 


What is Quad Rugby? It is a Paralympic sport played by individuals with a spinal cord injury, cerebral palsy, 

or an amputation that affects three or more limbs. The object is to get past opponents and score a goal by 

crossing the end line with possession of the ball. We are always looking for interested individuals; join us to 

check out rugby. 




14 & up Wed & Sun 9/4-12/18 Wed - 8:00pm-10:00pm 

Sun - 9:00am-1:00pm 

18

Youth/Adult 

Special Olympics 

As part of NEDSRA’s goal to provide the best customer service 

to all our participants, we have changed the fee structure for our 

Special Olympics sports. The fee now includes the Special Olympics 

District or Area Qualifier tournament registration fees. If you register 

for a Special Olympics sport, you will not have a separate registration 

Sean Tovey, CPRP, CTRS 


Special Olympics, Interns 

stovey@nedsra.org 

630-576-4035 

form and fee for the tournament at the end of the season. This will save time, effort and money on the part of our 

participants, families and group home staff. Additional tournaments may require registration and fees depending on 

each individual sport. Contact Sean Tovey at 630-576-4035 or stovey@nedsra.org if you have any questions 

or concerns. 

Huskies Basketball Training Camp F131718 

Youth and Adults with an Intellectual Disability 

Whether you want to try basketball for the first time or are a 

seasoned Huskies basketball veteran looking for some extra 

gym time, this is the program for you. Get a feel for the 

court, your new teammates or work on the chemistry 

you built last year in Huskies Basketball Training Camp. 

NEDSRA coaches will teach you basic basketball skills 

and fundamentals of court play. This will allow you an 

opportunity to get ready for the 2013-2014 Basketball 

season, which begins in November. All athletes are 

welcome, sign up today! 

Contact: Sean Tovey 



8 & up Sat 9/21-10/26 10:00am-11:30am $30 


Villa Park Police Station 9:30am 12:00pm 

Huskies Jr. Basketball Team F131731 

Youth with an Intellectual Disability 

Our basketball coaches are ready to turn you into the next 

basketball superstar! This program emphasizes sportsmanship, 

conditioning, and learning fundamental rules and skills. 

The team will compete against teams from other Special 

Recreation Associations, and participate in the Special 

Olympics Area 5 and ITRS Tournaments in January and 

February. A detailed schedule of practices and games will 

be provided within the first few weeks of the season. 


Location: Community Recreation Center, Addison 


8-14 Sat 11/2-2/15 1:00pm-2:30pm $115 

No program: 11/30, 12/28, 1/4 


Lombard Community Building 12:30pm 3:00pm 


19

Youth/Adult 


Huskies Bowling Team F131701 


STRIKE or SPARE, we don’t care! Come join us this fall and watch the leaves and pins fall at 

the same time. Bowling is a great social game that will also improve eye-hand coordination, 

gross motor skills and overall body mechanics. You will walk away with new friends, a higher 

average, and a great sense of accomplishment. 


Location: Wood Dale Bowl 


8 & up Sat 9/21-11/9 1:30pm-3:00pm $68 

Huskies Motor Activities Training Program F131750 

Youth and Adults with Multiple Impairments 

This is a unique Special Olympics opportunity geared toward athletes with signifi cant cognitive and 

physical disabilities. This program provides an array of adapted and experiential activities that mimic 

the basic skills needed to participate in traditional Special Olympics sports. Activities such as tennis 

ball throw, target bowling with a ramp, and basket toss will help develop and improve the basic skills 

needed for softball, bowling, and basketball. Upon completion, participants will feel a sense of accomplishment 

and self-worth regardless of ability level. On November 6, the group will compete in the Special 

Olympics MATP Games at Moraine Valley College. 




8 & up Tues 10/15-10/29 7:00pm-8:00pm $40 


Huskies Snowshoeing Clinic F131708 

Youth and Adults with an Intellectual Disabilty 

Have you always wondered what it would be like to race with those funny-looking shoes strapped to your feet? 

Here’s your chance to find out what it’s really like! Those funny-looking shoes are snowshoes and they were created 

to help people move around in deep snow. Think of it like our track team, only in cold weather. Sign up for this brief 

training program to see if you would like to brave the weather in our longer, more intense Special Olympics season! 




8 & up Sun 10/6-10/13 3:00pm-4:00pm $12 

Huskies Snowshoeing F131712 


Sunday afternoons at NEDSRA, the perfect setting for a day of snowshoeing! Learn the basics of this chilly 

Special Olympics sport and prepare for the Special Olympics District competition in January. Have fun 

socializing while getting a workout at the same time! NEDSRA will provide snowshoes. Please dress warmly. 

Don’t forget thick socks, hats, scarves and mittens. Please note, the program will be held with or without snow. 




8 & up Sun 10/20-1/5 3:00pm-4:00pm $80 

No program: 12/1, 12/22, 12/29 

Registration deadline: 10/14 20

Huskies Gymnastics Team F131717 


Athletes will choose from either artistic gymnastics or 

rhythmic gymnastics. Artistic gymnastics includes 

tumbling, acrobatics and limited apparatus skills. Rhythmic 

gymnastics introduces dance while using hoops, ribbons, 

balls and ropes. You will improve your overall health 

and fitness through cardiovascular exercises, as well as 

increase your coordination, strength and flexibility. Athletes 

will train for the Special Olympics District competition in 

March. Competition details will be handed out as the event 

nears. Don’t miss this opportunity to try out this exciting 

sport. Please wear comfortable workout clothes to practice. 




8 & up Sun 11/3-3/9 11:00am-12:00pm $92 

No program: 12/1, 12/22 or 12/29 


Huskies Swim Clinic F131713 


Swimming is one of the best ways that you can exercise. 

Combine that with the training regimen for our swim team 

and you have a great workout that prepares you for the 

Special Olympics swim meet! Test the waters of our 

Huskies Swim Team in this training to see if you have 

what it takes to be a Huskies Swimmer! 




8 & up Mon 10/21-10/28 7:00pm-8:00pm $12 


Huskies Swim Team F131714 


Dive in and train with the Special Olympics Swim 

Team! Swimmers will improve their overall fitness and 

perfect existing skills, before moving on to flip turns and 

competitive strokes. Swimmers will participate in local 

tournaments and train for the 2014 Special Olympics 

Summer Games in June. Swimmers must be able to 

swim one length of the pool in order to be on the team. 




8 & up Mon 11/4-3/3 7:00pm-8:00pm $120 

No program: 12/23, 12/30 


Villa Park Police Station 6:30pm 8:30pm 


21 

Huskies Powerlifting F131704 


NEDSRA wants to “pump you up!” Whether you want to 

tone, strengthen, build muscles or improve your overall 

fitness level, this program is for you. Don’t miss this 

opportunity to achieve your personal fitness goals, gain 

confidence and have fun at the same time! Athletes will 

be divided into workout groups based on their ability level 

and desired goals, and will be using various weight and 

aerobic machines. Individual progress will be monitored to 

maximize your potential. 




15 & up Wed 9/25-11/6 6:30pm-8:00pm $64 


Lombard Community Building 5:30pm 8:30pm 

NEDSRA 6:00pm 8:45pm 

Huskies Unified Bowling F131702 


Attention Special Olympics bowlers! Team up with 

students from Elmhurst College for a season of 

competition and camaraderie this fall. Our Unifi ed 

Sports program expands sports opportunities for athletes 

seeking new challenges while promoting inclusion in the 

community. This is also a great chance for our regular 

bowlers to get some extra alley time while making and 

competing against new friends from the community. 




15 & up Sun 10/13-11/17 1:00pm-2:00pm $49 


Huskies Basketball Team F131709 


“Hoop” it up in our popular basketball league and build 

teamwork, physical fitness, hand-eye coordination and 

socializing skills. Athletes will be divided into teams based 

on player’s ability. Throughout the season, each team will 

compete against teams from other Special Recreation 

Associations and participate in the Special Olympics 

Area 5 and ITRS Tournaments in January and February. 

A detailed schedule of practices and games will be 

provided within the first few weeks of the season. 




15 & up Tues 11/5-2/18 6:30pm-8:00pm $115 

No program: 12/24, 12/31 


Fenton High School 5:30pm 8:30pm 



Youth/Adult 


Booster Club Supporting NEDSRA’s Special Olympics Sports 

Athletes who train for, and compete in, Special Olympics (SO) sports gain self-confi dence, 

pride, heightened physical skills and a sense of accomplishment. Thanks to the Booster 

Club Supporting NEDSRA’s Special Olympics Sports, our athletes have access to the 

training, equipment, transportation, and competitions that will help them achieve their 

Special Olympics dreams. Booster Club members provide volunteers for training programs 

and special events, and sponsor fundraisers to purchase items such as warm-up jackets 

and sports bags for the athletes. Through its fundraising efforts, the Booster Club also 

sponsors the annual Sports Banquet, Bocce Tournament, as well as picnics, parties and 

treats throughout the year. Together, staff and Boosters instill pride, spirit, and camaraderie 

in all NEDSRA Special Olympics athletes, families, and friends. If you would like to learn 

more about upcoming Booster meetings, activities, fundraisers, or volunteer opportunities, 

contact Lynn Klufetos at 630-627-4854, my3kids1954@comcast.net or Rosalie Scrivo at 

630-495-8951, Rose_lee1956@yahoo.com. 

Special Olympics Medical Form Information 

In order for an athlete to compete in Special Olympics 

sports, a current Special Olympics medical form must be 

on file at the NEDSRA office. It is valid for two years from 

the date the doctor signs the form. Medical forms cannot 

be faxed, NEDSRA must have the original form in order for 

it to be valid. Please feel free to contact Sean Tovey at 

stovey@nedsra.org or 630-576-4035 to see when your 

athlete’s application expires. Please use the application found 

on page 41 of this brochure. 

Illinois 

Fall Special Olympic Sports Dates 

Outdoor Sports Festival 

September 8-9................................... Special Olympics 

Softball & Golf State Tournament – Decatur 

Basketball 

December 4.......................... Medical Applications due 

for Basketball 

January TBA....................................Special Olympics 

Jr. Basketball District Tournament 

January TBA........Special Olympics Sr. Basketball 

District Tournament 

February 15........ITRS Jr. Basketball Tournament 

February 16......ITRS Sr. Basketball Tournament 

Bocce 

September 28....Area 5 Bocce Tournament – 

Northlake 

Bowling 

October 20.......... Sectional Bowling Tournament – Addison 

December 7................... State Bowling Tournament – Peoria 

Floor Hockey 

October 3.......... Medical Applications due for Floor Hockey 

November 9............... Special Olympics State Floor Hockey 

Tournament – Chicago 

Snowshoeing 

November 28... Medical Applications due for Snowshoeing 

Volleyball 

September 6............ Medical Applications due for Volleyball 

September 22... Area 5 Volleyball Tournament – LaGrange 

October 6........................ ITRS Volleyball Tournament – TBA 

October 26-27..................................... Fall Games – Rockford 

22

Adult 

Intellectual Disability 

Maggie Goode 


Cultural Arts, TREC, 

School Services 

mgoode@nedsra.org 

630-576-4036 

Adults with an Intellectual Disability 

TREC is a recreation-based program developed to meet the unique needs of transition-aged 

individuals with an intellectual disability who desire to reach their full potential through recreational 

and leisure activities and community involvement. The program provides opportunities 

which challenge the individual but also ensures success and a positive experience. TREC 

strives to maintain and develop social skills and life skills in order to provide individuals with 

positive experiences within their community, and assist with the transitions occurring in their 

post-school years of life. TREC provides opportunities for self-discovery, self-advocacy and fun 

through community-based volunteer opportunities, recreation activities and peer interactions. 

TREC Eligibility Requirements 

• Individuals must be between the ages of 18 and 32. 

• Individuals must be able to successfully function in a 1:6 staff ratio. 

• Individuals are expected to demonstrate appropriate behavior with peers, staff and community members. 

• Individuals must actively participate in all aspects of the program schedule and demonstrate fl exibility. 

• Individuals must be able to use the restroom and change themselves independently. 

• Individuals must be able to eat independently. 

All interested participants need to complete an intake assessment prior to registering for this program. The 

purpose of the intake assessment is to evaluate the unique needs and skills of each participant. This information 

is used to develop the individual’s goals for the program and ensure successes throughout the year. 

Payment plans may be established. An initial registration fee of $100 is required to reserve a spot in the program 

and is non-refundable. This $100 fee will be credited to your program balance. 

Please contact Maggie Goode if you are interested in the program and to schedule an intake assessment at 

630-576-4036 or mgoode@nedsra.org. 

NEDSRA Van Pickup/Drop-off Departs Returns 

NEDSRA 8:00am 4:00pm 

Iowa Community Building 8:30am 3:30pm 

23 

2014 Schedule 

Individuals must commit to one year of participation. 

TREC meets on Mondays, Wednesdays, Thursdays 

and Fridays. Individuals can choose the days they 

wish to participate. 

Time: 9:00am-3:00pm 

Location: Itasca Park District 

Session 1: January 6 – April 11 

(Spring Break: April 14 – April 25) 

Session 2: April 28 – June 27 

(Memorial Day Break: May 26 – June 6) 

Session 3: July 7 – August 29 

(Labor Day Break: September 1 – September 12) 

Session 4: September 15 – December 19 

(Thanksgiving Break: November 24 – December 5)

Adult 


Guys Day Out: Air Classics 

Air and Space Museum and Wings F131161 


Beth Corso 

Senior Recreation Coordinator 

Adults – Intellectual Disability, 

Trips, Special Events 

bcorso@nedsra.org 

630-576-4030 

Join your NEDSRA buddies for a day of fun as we head to the Air Classics Air and Space Museum 

in North Aurora. You can sit in an A-7 from the Gulf War and climb into the pilot's seat of a UH-1 

Huey helicopter. The museum's collection includes aircraft, vehicles, uniforms and aviation mem 

orabilia from the 1930s to the present. After the museum, we will enjoy lunch at Buffalo Wild Wings. 




18 & up Sun 9/29 9:00am-4:00pm $56 

Girls Day Out: Jonamac Orchards and Breakfast F131163 


Hey ladies, it’s time to get those walking shoes on because we’re heading to the Jonamac Orchards in 

Malta to pick some apples. Before arriving at the orchard, we will make a stop at Cracker Barrel for a 

tasty breakfast. Your breakfast, admission and peck of apples are included in your fee. Please bring 

money for souvenirs and a snack. 




18 & up Sun 9/29 9:00am-4:00pm $56 

ALOHA and MAHALO, NEDSRA! Maui Bound W141601 


ALOHA! That’s right we are heading to Maui, Hawaii for eight nights and nine days at the Napili Point Resort, 

where you’ll enjoy ocean view condominium accommodations. While in Hawaii, we will twist and turn on the 

road to Hana and stop at the black sand beach at Wainapanapa State Park, view the sites of a volcanic crater at 

Haleakala National Park, visit the towering emerald peaks of Iao Valley State Park, shop and observe the wind 

surfers in the rustic town of Paia, view breathtaking waterfalls, hula at the ever popular Maui Luau and swim and 

lay on the beaches of Maui. Fee includes all admissions, meals, souvenir t-shirt and hotel accommodations. 

Please bring money for shopping and souvenirs. 



18 & up Sun-Mon 2/2-2/10 $2,850 

Due to the advance planning required for a trip of 

this magnitude, all payments are non-refundable. 


NEDSRA VAN TRANSPORTATION 

Departs NEDSRA 6:00am Sunday, February 2 

Returns to NEDSRA 6:30am Monday, February 10 

Payment Plan 

Due 

11/1 $1,200 

12/6 $ 825 

1/31 $ 825 

24

SRA Homecoming Dance F133011 


Grab your friends and join us for the all SRA Homecoming 

Dance. This is a chance to meet friends from other Special 

Recreation Associations and enjoy an evening of dancing, 

fun, and food! A live band will be in attendance to perform 

all your favorite tunes! Snacks and refreshments will be 

available throughout the evening. Since this is a formal 

affair, we suggest that the gentlemen wear dress slacks 

and collared shirts, and the ladies wear skirts or party 

dresses. The highlight of the evening is the King and 

Queen Court and the crowning of the King and Queen. 


Location: York Township Building 

1502 S. Meyers Road, Lombard, 630-620-2400 


13 & up Fri 10/18 7:00pm-9:30pm $18 


SRA Theater Outing F132210 


NEDSRA is joining with other local Special Recreation 

Associations for an afternoon at the Metropolis Performing 

Arts Center in Arlington Heights to take in the classic 

musical, A Christmas Carol. Filled with songs you love 

and know, we are renting out the entire theater for the 

afternoon only! Prior to the show we will enjoy a dessert 

reception with our SRA friends. Tickets are limited, so sign 

up early! 




18 & up Sun 12/8 1:00pm-7:00pm $38 


Halloween Masquerade Ball F133010 


Happy Halloween! Dance the evening away at NEDSRA’s 

Halloween Masquerade Ball! Come dressed in your 

goofiest, scariest or most creative costume and win 

a prize. There will be a costume contest with winners 

announced at the end of the evening. Refreshments and 

snacks will be provided to keep up your energy for all the 

fun. Music provided by a rocking D.J. and dancing will 

round out the evening. Be sure to wear your dancing 

shoes with your costume! Thank you to the Lombard 

Junior Women’s Club for sponsoring this event! 




18 & up Sat 10/26 6:00pm-8:00pm $14 




25 

Bowling Bonanza F133007 


Join your friends at NEDSRA for an 

afternoon of bowling and pizza. Strike or spare, we don’t 

care. The only thing we care about is that you’re having 

fun! The bowling admission and pizza is included in the 

fee. 



$ 

BVP 



18 & up Sun 11/17 1:00pm-3:30pm $10 


NEDSRA Bingo Night F133009 


BINGO! Come enjoy a night of bingo at the NEDSRA 

Bingo hall! Snacks will be served, please eat dinner before 

arriving. All of our bingo winners will go home with prizes, 

but everyone will leave the bingo hall knowing they just had 

a great time with their NEDSRA friends. Sign up today! 



$ 

BVP 



18 & up Fri 12/6 6:00pm-9:00pm $9 


A Holiday Getaway in the City F131600 


All aboard NEDSRA friends, we will be heading to the city 

by train! We have planned a great little getaway on the 

Magnificent Mile Downtown Chicago. We’ll be staying at 

the Holiday Inn Express on the Magnificent Mile. Come 

enjoy adventures at Navy Pier’s Winter Wonderland, 

ride on the ever popular Navy Pier Ferris Wheel and tour 

Christkindlmarket-Chicago, which is the largest traditional 

Christmas market outside of Europe. We will laugh all 

night long at the comedy of Second City, and, of course, 

enjoy holiday shopping, so get your lists ready friends! Your 

fee includes all admissions, meals and hotel accommodations. 

Please bring money for shopping and souvenirs. 



18 & up Sat-Mon 12/14-12/16 $370 


NEDSRA VAN TRANSPORTATION 

Departs NEDSRA 9:00am Saturday, December 14 

Returns to NEDSRA 4:45pm Monday, December 16

Adult 


Theater Troupe F132201 


Presenting the Theater Troupe, celebrating it’s 10-year anniversary! Don’t be shy, get in the 

spotlight, grab a microphone, and use your imagination! You will audition for various roles, 

learn fun choir numbers, and master choreographed dances! Improve self-expression, 

communication, confi dence, and give yourself an outlet for your creativity. The program 

concludes with two fabulous performances on March 20 and 21. 


Location: Mario Parente Theater, Oakbrook Terrace 


13 & up Thurs 9/19-3/13 6:30pm-9:00pm $150 

No program: 11/28, 12/26, 1/2 



Bowl Appetit F131162 


Strike or spare, we don’t care, we just want you to have a striking good time! This bowling program 

is for the non-competitive leisure bowler. Each week you will bowl two games and travel to a local 

restaurant for dinner before heading back to Stardust Bowl for pickups. Your bowling admission and 

dinner are included in the fee. 

Contact: Ann Roytek-Rylko 

Location: Stardust Bowl, Addison 


13 & up Thurs 9/26-11/7 4:30pm-7:30pm $129 


Stardust Bowl 4:30pm 7:30pm 

Karate F131116 


Learn self-confidence, self-control, and self-defense through the art of Karate. This 8-week program will reintroduce 

the basic Karate concepts and moves, so beginners, as well as continuing students are always welcome. 


Location: Sensei Steve’s Karate Center, Villa Park 


13 & up Sat 9/28-11/16 12:00pm-1:00pm $40 


NEDSRA 11:30am 1:15pm 

Wood Dale Bowl N/A 1:30pm 

26

––– Save $5 on each program when you sign up for both at once! ––– 

Fitness, Fruit, Friends and Fun F131117 


Come try out new workout techniques that are 

NEW 

PROGRAM 

DAY! 

fun and will get your heart pumping. Each participant will 

receive an individual health and fitness plan that they will 

work on during the program. Participants will get to try a 

variety of cardio machines, enjoy a nice walk outside on the 

path and learn new techniques to achieve optimal health and 

fitness. Each meeting will include helpful health tips regarding 

good eating and life choices that participants can work on 

outside of the program. The first week of the program 

a healthy cookbook will be distributed. Please dress in 

comfortable fitness apparel. Don’t forget your water bottle! 




18 & up Wed 10/2-11/6 6:00pm-7:15pm $36 



(after Cooking Basics program) 

Cooking Basics: Healthy Fall Favorites F131118 


Grab your apron and your whisk; it’s time to get healthy! 

Wow, there’s nothing better than a great workout and then 

dinner. Come join your NEDSRA friends after the fitness 

program and make a healthy dinner. Participants will 

continue to learn new recipes, kitchen safety, healthy 

eating habits while increasing independence and life 

skills. All participants will receive a healthy cookbook at 

the program. 




18 & up Wed 10/2-11/6 7:15pm-8:45pm $68 


Villa Park Police Station ------ 9:00pm 

Holiday Party & Gift Exchange F133031 


Let’s get together to celebrate the holiday season! NEDSRA 

is hosting the Annual Holiday Party and Gift Exchange, 

full of seasonal traditions and good cheer. We will enjoy 

festive appetizers, holiday crafts, fun games, and a gift 

exchange. Participants are asked to bring a wrapped, 

unisex gift for the exchange valued at no more than $5.00. 




18 & up Fri 12/20 6:30pm-9:00pm $16 




LEISURE FOR LIFE 

Deck the Halls Ornament Creations Studio 

F131164 

All Abilities 

Join your friends as we create ornaments to be hung on 

the Christmas tree at the Annual Medinah Park District 

Deck the Halls event. Come with your holiday ornament 

ideas because the first week we will travel to the craft store 

to pick out our supplies for our special tree. Please look at 

page 33 for event details. We hope to see you there! 




18 & up Wed 11/20-12/4 6:30pm-8:00pm $22 




SNL – Saturday Night Leisure 

“Del Rhea’s Chicken Shack” F131146 


Come join your friends for a delicious dinner on the ever 

popular Route 66. We will enjoy great conversation and 

a tasty meal at Del Rhea’s Chicken Shack. Your dinner is 

included in the fee. 




30 & up Sat 11/16 5:30pm-8:30pm $29 


27 

Holiday Shopping and More F131147 


Join your friends as we get an early start on our holiday 

shopping. We will enjoy shopping and lunch at Woodfield 

Mall and the Aurora Prime Outlet Mall. Please bring money 

for shopping purchases. Your lunch is included in the fee. 




30 & up Sat 11/16-11/23 9:30am-3:30pm $50 


Adult 


Day Trippers F131120 


Our Day Trippers program encourages independence 

and development of life skills, with the 

guidance of NEDSRA staff. We will visit local 

museums, volunteer in our community, and 

participate in a variety of fun and engaging 

recreation activities, all while reinforcing life skills 

and socialization. This program is a good option for individuals who do not 

meet the eligibility requirements for the TREC program. 




18 & up Tues 10/8-11/12 8:30am-3:30pm $165 


Deer Grove Leisure Center, Bensenville 9:00am 

3:00pm 

10/8 Blackberry Farm – Please pack a lunch 

10/15 Fit and Healthy, Club Fitness – Lunch provided by NEDSRA 

10/22 Train and Lizzadro Rock Museum, Elmhurst – Please pack a lunch 

10/29 Participants Choice! Details to come. – Lunch provided by NEDSRA 

11/5 Feed My Starving Children Community Day – Lunch provided by NEDSRA 

11/12 Adler Planetarium, Chicago – Please pack a lunch 

Paul Fasano, CTRS 


Social Clubs 

pfasano@nedsra.org 

630-576-4032 

Young Adult Club F132603-F132607 

Suggested Ages: 19-26 


Come and check out the Young Adult Club. This club is the perfect place to hang out with friends while 

having a ton of fun! Please pay special attention to the variation in pickup and drop-off times and locations. 

Fee: See individual listing or register for all five for $103 residents, SAVING $5! 



Date Activity 

Program # Res. Fee Pickup/Drop-off Departs/Returns 

Location 

9/20 Bug House Studio in Skokie F132603 $29 NEDSRA 5:30pm 10:00pm 

Finished sculptures will be LCB 6:00pm 9:30pm 

returned after curing in the kiln 

10/4 ATHS Varsity Football Game F132604 $17 NEDSRA 6:00pm 10:00pm 

Bring money for concessions LCB 6:30pm 9:30pm 

10/25 Pumpkin Pick ‘N Carve F132605 $21 NEDSRA 6:00pm 9:30pm 

at Sonny Acres Farm and NEDSRA LCB 6:30pm 10:00pm 

11/1 Dinner at TGIF in Bloomingdale F132606 $27 NEDSRA 6:00pm 10:00pm 

Bring money if you want dessert LCB 6:30pm 9:30pm 

11/15 Cardio and Karate with Sensei Larry F132607 $14 NEDSRA 6:30pm 9:00pm 

at Club Fitness and NEDSRA LCB 6:00pm 9:30pm 

* Lombard Community Building (LCB) 

28

Friday Night Recreation F132608-F132612 



This is an action-packed social club that meets on Friday evenings. Sign up only if you plan to have FUN! 

Please pay special attention to the variation in pickup and drop-off times and locations. 

Fee: See individual listing or register for all five for $103, SAVING $5! 



Date Activity Program # Res. Fee Pickup/Drop-off 

Location* 

Departs/Returns 

9/27 Karaoke Competition at NEDSRA F132608 $16 VPPS 6:00pm 9:30pm 

Debuting our new SingStand 2! NEDSRA 6:30pm 9:00pm 

Snacks and prizes included 

10/11 2013 Scarecrow Fest in St. Charles F132609 $19 NEDSRA 6:00pm 11:00pm 

Tickets for rides included. Bring money VPPS 6:30pm 10:30pm 

for snacks 

10/25 Halloween Dance at Maine-Niles F132610 $21 NEDSRA 6:00pm 9:30pm 

Association of Special Recreation VPPS 6:30pm 10:00pm 

Costumes are encouraged 

11/8 Taylor Street Pizza and Oberweis Ice F132611 $28 NEDSRA 5:30pm 10:00pm 

Cream in Bartlett VPPS 6:00pm 9:30pm 

11/22 Annual Thanksgiving Celebration at F132612 $24 NEDSRA 7:00pm 10:00pm 

NEDSRA. Come hungry for a big meal! VPPS 6:30pm 10:30pm 

Saturday Night Cruisers F132613-F1326117 

Suggested Ages: 36 & up 


Make Saturday nights the highlight of your week by cruzin’ with your pals at this exciting social club! 

Please pay special attention to the variation in pickup and drop-off times and locations. 

Fee: See individual listing or register for all five for $103 residents, SAVING $5! 



Date Activity Program # Res. Fee Pickup/Drop-off 

Location* 

Departs/Returns 

9/21 Race Night at Sycamore Speedway F132613 $23 NEDSRA 5:30pm 11:00pm 

Bring money for concessions VPPS 6:00pm 10:30pm 

10/12 2013 Scarecrow Fest in St. Charles F132614 $19 NEDSRA 6:00pm 11:00pm 

Tickets for rides included. Bring money VPPS 6:30pm 10:30pm 

for concessions 

10/19 Wii Wheel of Fortune and Trivia at F132615 $14 NEDSRA 7:00pm 9:00pm 

NEDSRA. Prizes and snacks included VPPS 6:30pm 9:30pm 

11/2 Dinner at Noodles & Company in F132616 $28 NEDSRA 6:00pm 9:30pm 

Oakbrook Terrace VPPS 6:30pm 9:00pm 

11/22 Annual Thanksgiving Celebration at F132617 $24 NEDSRA 7:00pm 10:00pm 

(FRI) NEDSRA. Come hungry for a big meal! VPPS 6:30pm 10:30pm 

* Villa Park Police Station (VPPS) 

29

Adult 

Physical 

Disability 

or Visual 

Impairment 

Carrie Henry, CPRP 


Adults – Physical Disability 


chenry@nedsra.org 

630-576-4031 

Bowling Club F131206 

Adults with a Physical Disability or Visual Impairment 

Strike it up and join Bowling Club! Develop upper body strength and coordination, while 

socializing with current and new NEDSRA friends. A bowling ramp is available for your use, if you 

choose. We’ll bowl two games and work to improve our weekly averages, so don’t hesitate to sign 

up! A light snack will be provided to keep up your bowling energy. 


Location: Brunswick Zone, Glendale Heights 


18 & up Fri 9/27-10/25 1:00pm- 3:00pm $83 

Door-to-door transportation offered to NEDSRA residents for an additional $40. 

Horseback Riding F131205 


Giddy Up! It’s time to get back on the horse at the Hanson Riding Center in Burr Ridge! The benefi ts of 

therapeutic riding are proven to be endless, and horseback riding for the disabled is recognized as one of the 

more progressive forms of therapy. Riding a horse helps strengthen spine and pelvic muscles, improves posture 

and coordination and increases joint mobility. Please note that long pants and closed-toed shoes must be worn. 




18 & up Sat 9/28, 10/12, 10/19, 11/9 11:45am-3:15pm $130 


A.R.T. (Art for Recreation & Therapy) F132205 

Adults with a Physical Disability or with a Visual Impairment 

Do you enjoy expressing yourself through paint, clay or pastels? This program will expose you to a variety of 

art materials and experiences as we explore our creative sides. This relaxing program lets you work at your own 

pace while socializing with friends and creating beautiful master pieces. You don’t need to be a Picasso to 

benefit from this program. Sign up and discover your hidden talents! 




18 & up Fri 11/1-11/22 1:00pm-3:00pm $66 



30

––– Save $5 on each program when you sign up for both at once! ––– 

Adaptive Fitness F131202 


Improve your overall mobility, strength, and endurance 

with this fitness class. NEDSRA staff will set up individual 

fitness plans for each participant based on specific needs 

and interests. Come benefit from an individual workout 

plan designed just for you. Itasca offers a track, new and 

improved weight machines, aerobic equipment and free 

weights. A snack break will be included each week, along 

with some discussion on healthy eating and lifestyle tips. 


Location: Itasca Park District 


18 & up Tues 9/17-11/5 10:00am-11:30am $70 

Door-to-door transportation offered to NEDSRA residents 

for an additional $64. 

Water Exercise and Aerobics F131201 


The therapeutic benefits of being in the water include 

improved gross motor function, flexibility, balance, strength 

and overall cardiovascular well-being. Water Exercise 

and Aerobics is the perfect program that will meet all your 

fitness needs. NEDSRA staff will speak with each of you 

about your personal fitness goals and will help you reach 

them! 




18 & up Thurs 9/19-11/7 Noon-1:00pm $96 

Door-to-door transportation offered to NEDSRA residents 

for an additional $64. 

Lincoln Park Zoo F131204 


The Lincoln Park Zoo is the only zoo located in downtown Chicago. The Zoo is situated on 35 acres of land with 

1,200 animals representing 230 species. The Lincoln Park Zoo is one of the nation’s oldest zoos which offers, a 

children’s zoo, carousel, paddle boats, restaurants, and a large variety of animals. Please bring money for lunch. 

Contact: Ann Roytek-Rylko 



18 & up Wed 9/25 10:00am-4:00pm $49 

Door-to-door transportation available to NEDSRA residents for an additional $8. 

Saturday Socializers F131203 



Contact: Carrie Henry Res. Fee: $105 


Date Activity Time Location 

9/21 Saddle Up Saloon, Naperville 7:00pm-10:30pm Meet at NEDSRA 

Let’s dance the night away at Saddle Up Saloon. Don’t forget to put your cowboy boots on so you can 

kick it up with your fellow dancers. Please bring money for dinner. 

10/5 Pyramid Club, Addison 7:00pm-10:00pm Meet at NEDSRA 

Hey Pyramid Club lovers…it’s time to get out to play billiards, darts, bags, listen to some good music 

and, of course, have a great time socializing with friends. Please bring money for food and drinks. 

10/26 Halloween Masquerade Ball 5:00pm-7:30pm Lombard Community Building 

Dress in your favorite Halloween costume and be the hit of the party at NEDSRA’s Halloween 

Masquerade Ball. Prizes will be awarded for funniest, scariest and most creative costumes. 

11/23 Thanksgiving Feast 7:00pm-10:00pm NEDSRA 

There are many things to be thankful for. Let’s celebrate our friendships together. Please bring a dish to 

pass for our feast. We will also be participating in a varity of games and activities throughout the evening. 

12/7 Applebee’s, Addison 7:00pm-10:00pm Meet at NEDSRA 

Let’s enjoy a nice and relaxing evening at Applebee’s restaurant. If you have a taste for terrific comfort 

food you are definitely in for a treat. Please bring money for dinner. 

31

Adult 

Physical Disability 


Scarecrow Fest F131209 


NEDSRA will be traveling to the 28th Annual Scarecrow Fest in St. Charles. Can you think of 

a better way to enjoy a great autumn day than celebrating a Scarecrow Fest tradition? There 

are so many fun activities, such as scarecrow building, ice cream eating contest, listening to 

great music and more for all to experience. Please bring money for lunch. 




18 & up Sun 10/13 10:00am-3:00pm $36 


Door-to-door transportation available to NEDSRA residents for an additional $8. 

Mall of America F131207 


We are off to the Mall of America in Bloomington, Minnesota for three nights and four days of shopping 

fun and more! We will enjoy shopping at the World’s Largest Mall, visit the House of Comedy, and view 

over 10,000 sea creatures at the SEA LIFE Minnesota Aquarium and enjoy some delicious food at local 

restaurants. A packing list and waiver will be mailed after the registration deadline. 



18 & up Thurs-Sun 11/14-11/17 $560 


NEDSRA Van Transportation 

Departs NEDSRA 9:00am Thursday, November 14 

Returns NEDSRA 7:00pm Sunday, November 17 

Holiday Happenings F131208 


Ring in the Holiday Season! We will spend the day holiday shopping at Yorktown Mall for those special holiday 

gifts. Then we will get into the holiday spirit while enjoying a luncheon show, “Making God Laugh-A Holiday Family 

Comedy,” at Pheasant Run in St. Charles. Finally, enjoy the Holiday Luncheon and Gift Exchange with your 

NEDSRA friends. Sign up early to save your spot for the holiday merriment. 

Wed 12/4 Shopping at Yorktown Mall – Bring money for lunch 10:00am-4:00pm 

Thurs 12/12 Making God Laugh – A Holiday Family Comedy 11:15am-5:00pm 

Wed 12/18 Holiday Luncheon – Bring a small grab bag gift 11:00am-3:00pm 

Res. Fee: $134 




Door to door transportation offered to NEDSRA residents for an additional $24. 

32

Member Partner 

Special Events 

Lombard Park District: Fall Fest F133003 

All Abilities, Family and Friends 

The nip in the air and the colorful leaves can mean only 

one thing ... it’s time for Fall Fest! This FREE event for 

families has something for everyone including games, a 

moon bounce, hayrides, face painting, candy hunt and 

much more! Boo Bingo will be held in the Community 

Building from 2:00-3:00 p.m. Stop by the Pumpkin Patch 

and each child can pick their very own pumpkin to take 

home or participate in a decorating contest. Please note 

that the Park District has limited decorating supplies so 

make sure to bring extra decorating supplies if participants 

want to be creative! Winners will be announced at 

3:45 p.m. or at the conclusion of the event. 




ALL Sat 10/5 1:00pm-4:00pm 


Addison Park District: Candy Carnival F133004 


Join us for a night of Halloween fun at our 5th Annual 

Candy Carnival. Children ages 10 and under will play 

games to win candy! We will have a variety of games for 

children to play such as boo buckets, bat bean bag toss, 

ghoulish putting green, candy walk, pumpkin sack races, 

howlin’ hula hoops and more! We will also have a moon 

jump for kids to jump in. Come in your Halloween costume 

to participate in our costume contest that starts at 6:30 p.m. 

Prizes for the most original, scariest and funniest costumes 

in three age categories, 3 and under, 4-7 years, and 8-10 

years. 



BVP 

$ 


FREE! 


3-15 Wed 10/30 5:30pm-7:00pm $5 


$ 

BVP 

BIG VALUE PROGRAMS 

Itasca Park District: Halloween Celebration 

F133005 


The Itasca Park District and Village of Itasca are excited to 

invite your family to an afternoon of Halloween activities. 

Free games, pumpkin decorating, and bounce house are 

among some of the fun events. Participants are encouraged 

to bring canned food items or nonperishable food 

items for the Itasca Food Pantry. 


Location: Springbrook Nature Center 

130 Forest Avenue, Itasca 

(Rain Location: Itasca Recreation Center) 


3-15 Sat 10/26 1:00pm-3:00pm 


FREE! 

Medinah Park District: Deck the Halls F133006 


Come decorate an outdoor Christmas Tree with your 

friends from NEDSRA. After the outdoor tree decorating, 

come inside and get into the holiday spirit. Visit Chicagoland 

Dog Rescue’s “Claus and Paws,” a picture event with 

Santa. Bring your kids or your pooch to have their picture 

taken with Santa to support a great cause! Proceeds from 

photos go to help CDR rescue more dogs! Then stay for 

some hot chocolate and holiday treats and make a special 

holiday craft to take home. 


Location: Thorndale Recreation Center 

Medinah 

$ 

BVP 



ALL Sat 12/7 11:00am-2:00pm $10 


33

Support 

NEDSRA’s Loyal Supporters 

NEDSRA receives tremendous support throughout 

the year. We would like to recognize the following 

organizations, businesses, agencies and 

individuals that made contributions from April 

through June 2013. 

We thank you for your generous contributions. 

Autotrader.com – Barry Brandt 

Billie Bertuca 

Friends of Handicapped Children 

Kiwanis Club of Addison 

Kiwanis Club of Bensenville/Wood Dale 

Kiwanis Club of Villa Park 

Knights of Columbus Father Boecker Council 6090 

Knights of Columbus Holy Ghost Council 10325 

Knights of Columbus St. Matthews Council 9893 

Kohl’s Store 65 

Kohl’s Store 66 

Tony Larrocia 

Lions Club of Lombard 

Lombard Area Chamber of Commerce and Industry 

Lyndex Nikkon 

Oakbrook Terrace Park District 

Oberweiler Foundation 

Porter Pipe & Supply Co. 

Rotary Club of Lombard 

St. Vincent De Paul Society of Christ the King Church 

State of Illinois 

WalMart Foundation 

Thank you Porter Pipe & Co. 

The 1st Annual Car and Motorcycle Show on June 20 

generated over $400 in support of NEDSRA! Ralph, 

Ray, and Paul Strzewski were instrumental in 

selecting NEDSRA as the recipient of funds 

generated through raffles sales and donations. 

We are grateful for the support and look forward 

to the continued success and growth of this 

outstanding event! 

Summer Camps Benefit From 

Foundation Support 

Hat’s off to the Oberweiler Foundation for helping 

make summer camp experience memorable and 

fulfilling to over 60 campers. NEDSRA is grateful for 

the outstanding support received from the Oberweiler 

Foundation for five consecutive years. 

34th Annual Track & Field Meet 

Receives Support! 

NEDSRA would like to thank the following sponsors and 

contributors who generously supported the 34th Annual 

Track and Field Meet on May 18. The success of the meet 

is in part due to their financial support and donations. 

Thanks for helping make this day so special for nearly 

200 athletes! 

Corporate Sponsors 

Autotrader.com – Barry Brandt 

AXA Advisors, LLC 

Beaird Group 

Canon U.S.A. 

Culver’s of Addison & Lombard 

Kohl’s Cares – Associates In Action 

Sam’s Club – Addison 

Community Service Clubs & Organizations 

Bensenville Lions Club 

Friends of Handicapped Children 

Itasca Lions Club 

Kiwanis Club of Addison 

Kiwanis Club of Bensenville/Wood Dale/Franklin Park 

Kiwanis Club of Villa Park 

Lombard Chamber of Commerce and Industry 

Oakbrook Terrace Lions Club 

Rotary Club of Lombard 

Knights of Columbus 

4th Degree Dr. Thomas Dooley Assembly Color Guard 

Ave Maria Council 4456 – Schiller Park 

Damen-Hildebrand Council 650 – Addison 

Father McDonald Council 1911 – Elmhurst 

St. Matthew Council 9893 – Glendale Heights 

St. Peter the Apostle Council 10884 – Itasca 

Christ the King Council – 11027 

Father Boecker Council 6090 – Lombard 

Villa Park Council 8365 – Villa Park 

Holy Ghost Council 10325 – Wood Dale 

Other Donors 

Coca-Cola Bottling Company 

Dr. Pepper-Snapple Group 

Mario’s Deli and Food Mart 

Pepsi-Cola Bottling Company 

Progressive Communications 

Republic Bank – Addison 

Sam’s Club – Addison 

Skyline Balloons 

34

Annual Information Form 

To register for any NEDSRA programs, an Annual Information Form must be annually updated and filed with NEDSRA. 

Once an updated form is on file, you may fax or phone in your program registration. 

Return this form to NEDSRA, 1770 W. Centennial Place, Addison, IL 60101. Attention: Registrar. 

Participant Information (please print) 

First, Middle & Last name_____________________________________________________________Nickname____________________________ 

Address ______________________________________________City___________________________State______________ZIP______________ 

Phone ______________________________ E-mail ____________________________________________________________________________ 

Date of Birth ____/_____ / _____ Gender ______ Height __________ Weight _________ Hair Color _________Eye Color _______________ 

Race* _____________________ Primary Language Used at Home ______________________ T-shirt size __________ Shoe Size ____________ 

*For identification purposes only. 

Primary Disability ____________________________________ Secondary Disability ________________________________________________ 

Current Medications/Dose/Frequency_______________________________________________________________________________________ 

_______________________________________________________________________________________________________________________ 

Allergies ________________________________________________________________ Dietary Restrictions ____________________________ 

Is participant subject to seizures? ________Type & frequency _____________________________________ Date of last seizure ___ /___ / ___ 

What action do you take in the event of a seizure? ____________________________________________________________________________ 

_______________________________________________________________________________________________________________________ 

If participant has Down Syndrome, has he/she been tested for Atlanto-Axial Instability? Yes No 

If yes, were results positive? ____________ If so, please attach a copy of medical exam. 

School/Place of employment __________________________________________Teacher/Supervisor ____________________________________ 

Group Home/Residential Facility ______________________________________Manager/Caseworker __________________________________ 

Emergency Information (Parent or Guardian) 

First, Middle & Last name ___________________________________________________ Relationship ______________________________ 

Street, City and Zip Code _________________________________________________________________________________________________ 

Phone # Home __________________ Work __________________ Cell _________________ E-mail ___________________________ 

Place a checkmark beside the phone number you would like us to use first. 

Secondary Emergency Contact ___________________________________________ Relationship _____________________________________ 

Phone # Home __________________ Work __________________ Cell _________________ 

Place a checkmark beside the phone number you would like us to use first. 

Doctor’s Name _______________________________ Doctor’s Phone _______________________ Hospital Affiliation ___________________ 

Daily Living Skills 

Eating Eats independently Needs to be monitored Needs assistance Explain ___________________________________ 

Bathroom Toilets independently Needs to be monitored Needs assistance Explain ___________________________________ 

Dressing Dresses independently Needs some assistance Cannot dress independently 

Mobility Walks independently Uses manual wheelchair Uses motorized wheelchair Uses other assistive device for mobility 

Explain _________________________________________________________________________________________________________________ 

Communication Verbal/speaks clearly Verbal/speech is difficult to understand Has difficulty expressing needs Gestures/points 

Uses sign language Uses hearing devices/hearing aides Uses a communication board/schedule/pictures 

Explain _________________________________________________________________________________________________________________ 

Swimming Swims independently Can swim a little Cannot swim at all Extreme fear of water 

Interaction/Socialization Skills 

Social Interaction Initiates social interaction on own Socializes with verbal prompting Avoids social interactions 

Explain__________________________________________________________________________________________________________________ 

Prefers Being Alone with Peers with Adults Explain ________________________________________________________ 

Is Most Successful in Large groups Small groups Other Explain _____________________________________________________ 

Responds Better to Males Females Either Explain ______________________________________________________________ 

Please list any sensory issues your child/the participant may have: ________________________________________________________________ 

_________________________________________________________________________________________________________________________

Behaviors/Conduct 

Following Directions Can follow directions independently Needs verbal prompting 

Needs step-by-step assistance; Explain________________________________________________________________________________________ 

Please check all that apply Short attention span Easily distracted Hyperactivity Tendency to run or wander off 

Oppositional/defiant Manipulative Verbal outbursts Instigates behavior Self-abusive behaviors 

Tantrums/meltdowns Physical aggression to others Steals 

List other inappropriate behaviors here: _______________________________________________________________________________________ 

If you checked yes to any behaviors above, please provide a detailed explanation: ________________________________________________________ 

__________________________________________________________________________________________________________________________ 

What are the known triggers to the behaviors above? ________________________________________________________________________________ 

_________________________________________________________________________________________________________________________ 

Does the participant respond to specific behavior management techniques used at home, school or work? Yes No Explain 

__________________________________________________________________________________________________________________________ 

__________________________________________________________________________________________________________________________ 

Does the participant have any unusual fears or concerns? Yes No 

Explain____________________________________________________________________________________________________________________ 

__________________________________________________________________________________________________________________________ 

Personal Interests/Goals 

Favorite quiet activities ____________________________________ Favorite active games ________________________________________________ 

Least favorite activities ________________________________________________________________________________________________________ 

Favorite food ________________ Favorite color _______________ Hobbies _________________________________________________________ 

Reasons for participating (please check all that apply) 

Physical activity Socialization/friendships Group interaction Skill development Motor development 

Creativity/Self-expression Self-esteem/Confidence Responsibility Entertainment FUN! 

Please identify any specific goals parents/guardians would like to see worked on: ________________________________________________________ 

_________________________________________________________________________________________________________________________ 

Mandatory Waiver & Release. Northeast DuPage Special Recreation 

Association is committed to conducting its recreation programs and activities in 

a safe manner and holds the safety of participants in high regard. NEDSRA 

continually strives to reduce such risks and insists that all participants follow 

safety rules and instructions that are designed to protect the participants’ safety. 

However, participants and parents/ guardians of minors registering for programs 

must recognize that there is inherent risk of injury when choosing to participate 

in recreational activities. You are solely responsible for determining if you or 

your minor child/ward are physically fit and/or skilled for the activities 

contemplated by this agreement. It is always advisable, especially if the 

participant is pregnant, disabled in any way or recently suffered any illness, 

injury or impairment, to consult a physician before undertaking any physical 

activity. NEDSRA carries no accident coverage on participants and the cost of 

medical attention and/or hospitalization will be the sole responsibility of the 

individual in question and/or their parent or guardian. 

Warning of Risk. Despite careful and proper preparation, instruction, medical 

advice, conditioning and equipment, there is still a risk of serious injury when 

participating in any recreational activities. Not all hazards and dangers can be 

foreseen. Participants must understand that certain risks, dangers and injuries 

due to acts of God, inclement weather, slipping, falling, equipment failure, and 

failure in supervision, premises defects and all other circumstances inherent to 

recreational activities exist. In this regard, it must be recognized that it is 

impossible for NEDSRA to guarantee absolute safety. 

Photos/Video Authorization and Consent. I hereby authorize and give my 

consent to NEDSRA to photograph/video me or my child/ward, and without 

limitation to use such photographs/video to promote/ advertise the services, 

programs, and facilities of NEDSRA without consideration of any kind. 

36 

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 this program, 

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 this program (including transportation 

services, when provided). When registering by fax, it is understood that the 

facsimile registration document (including waiver and release of all claims) shall 

substitute for and have the same legal effect as the original form. I recognize and 

acknowledge that there are certain risks of physical injury to participants in this 

program, and I voluntarily agree to assume the full risk of any and all injuries, 

damages or loss, regardless of severity, that my minor child/ward or I may 

sustain as a result of said participation. I further agree to waive and relinquish 

all claims I or my minor child/ward may have (or accrue to me or my 

child/ward) as a result of participating in this program against NEDSRA, 

including its officials, agents, volunteers and employees (hereinafter collectively 

referred as “NEDSRA”). I do hereby fully release and forever discharge 

NEDSRA from any and all claims for injuries, damages, or loss that my minor 

child/ward or I may have or which may accrue to me or my minor child/ward 

and arising out of, connected with, or in any way associate with this program. 

Personal Information Authorization Consent. I further authorize NEDSRA to 

release personal contact information to other parents/ participants when deemed 

appropriate including names, addresses and phone numbers. I have read and 

fully understand the above important information, warning and assumption of 

risk, waiver and release of all claims and photo/video and personal information 

authorization and consent. 

______________________________________________________________________________________ 

____________________________________ 

Participant Signature (If under 18, parent or guardian signature above) 

Date 

Print name, if signed by parent or guardian: ______________________________________________________________________________________ ___

Registration Form 

M F 

Please Print Participant’s First Name Last Name Sex Weight Height 

Address City Disability 

Zip Code Area Code Home Phone Number Participant E-Mail Address Birth Date 

/ / 

Area Code & Phone Number Area Code & Work Number Area Code & Pager or Cell Number 

. 

Please place a checkmark in the box next to the phone number which you would like us to use t . 

Parent/Guardian Full Name 

Parent/Guardian E-Mail Address 

Emergency Contact Full Name 

(Emergency contact should be someone other than a parent or guardian.) (Relationship to Participant) 

Area Code & Phone Number Area Code & Work Number Area Code & Pager or Cell Number 

. 

Please place a checkmark in the box next to the phone number which you would like us to use t 

MANDATORY: It is the sole responsibility of the participant (or parent/guardian) to provide NEDSRA with an Annual Information Form (AIF) containing the most current information 

regarding participant’s special medical needs, medications, allergies, etc. With a current AIF on file, you may also register by phone at 630-620-4500 or fax 630-620-4598 with a credit card. 

Program # Program Name Start Date Fee Transp. Fee OFFICE USE ONLY 

/ 

/ 

Amt. Rec’d 

Date Rec’d 

/ 

/ 

Ck 

Visa 

Cash 

MC 

CR SC 

/ 

e 

/ 

Return with check payable to NEDSRA, 1770 W. Centennial Place, Addison, IL 60101-1076. Total Fees $ 

Credit card customers: Circle one- Visa MC 

Print Cardholder’s Name 

Cardholder signature 

Ve 

Account Number Expiration date 

Mandatory Waiver 

Waiver and Release of all Claims and Assumption of Risk 

Northeast DuPage Special Recreation Association is committed to conducting its 

Please read this form carefully and be aware that in signing up and participating in 

recreation programs and activities in a safe manner and holds the safety of participants this program, you will be expressly assuming the risk and legal liability and waiving and 

in high regard. NEDSRA continually strives to reduce such risks and insists that all releasing all claims for injuries, damages or loss which you or your minor child/ward might 

participants follow safety rules and instructions that are designed to protect the participants’ sustain as a result of participating in any and all activities connected with and associated 

safety. However, participants and parents/guardians of minors registering for programs with this program (including transportation services, when provided). 

must recognize that there is inherent risk of injury when choosing to participate in 

When registering by fax, it is understood that the facsimile registration document (including waiver 

recreational activities. 

and release of all claims) shall substitute for and have the same legal effect as the 

You are solely responsible for determining if you or your minor child/ward are physically 

 

especially if the participant is pregnant, disabled in any way or recently suffered any all injuries, damages or loss, regardless of severity, 

illness, injury or impairment, to consult a physician before undertaking any physical activity. 

NEDSRA carries no accident coverage on participants and the cost of medical attention 

and/or hospitalization will be the sole responsibility of the individual in question and/or their 

parent or guardian. 

and employees (hereinafter collectively referred as “NEDSRA”). 

Warning of Risk 

from any and all claims for 

Despite careful and proper preparation, instruction, medical advice, conditioning and 

equipment, there is still a risk of serious injury when participating in any recreational to me or my minor child/ward and arising out of, connected with, or in any way associate 

activities. Not all hazards and dangers can be foreseen. Participants must understand that with this program. 

certain risks, dangers and injuries due to acts of God, inclement weather, slipping, falling, Personal Information Authorization Consent 

equipment failure, failure in supervision, premises defects and all other circumstances to release personal contact information to other parents/ 

participants when deemed appropriate including names, addresses and phone numbers. 

impossible for NEDSRA to guarantee absolute safety. 

 

Photos/Video Authorization and Consent 

assumption of risk, waiver and release of all claims and photo/video and personal 

to photograph/video me or information authorization and consent. 

my child/ward, and without limitation, to use such photographs/video in connection 

with promoting/advertising the services, programs, and facilities of NEDSRA without Participant Signature 

Date 

consideration of any kind. 

If under 18, parent or guardian signature above. 

37 

Print name above, if parent or guardian.

Formulario de Inscripción 

________________________________ ________________________________ M F _______ _______ 

(En letra de molde)Nombre del participante Apellido Género Peso Altura 

______________________________________ ______________________________________ ______________________ 

Dirección Ciudad Incapacidad 

____________ __________________________________ _________________________________ ____/___/______ 

Código postal Área y número de teléfono de casa Correo electrónico del participante Fecha de nacimiento 

Área y número de teléfono de casa Área y número de teléfono del trabajo Área y número de teléfono celular o pager 

Por favor ponga una marca en la casilla junto al número de teléfono que quisiera usemos primero 

|_______________________________________________________________ ________________________________ 

Nombre completo del padre o guardián 

Correo electrónico del padre o guardián 

________________________________________________________________________________________ ______________________ 

Contacto en caso de emergencia, nombre completo (Contacto de emergencia debe ser alguien diferente al padre o guardián) Parentesco al participante 

|Área y número de teléfono de casa Área y número de teléfono del trabajo Área y número de teléfono celular o pager 

Por favor ponga una marca en la casilla junto al número de teléfono que quisiera usemos primero 

MANDATORIO: Es la responsabilidad absoluta del participante (o padre/guardián) proveer a NEDSRA con la forma de información anual, conteniendo la 

información más reciente del participante sobre las necesidades médicas especiales, medicamentos, alergias, etc. Al tener la información al día en archivo, usted 

también puede registrarse por teléfono al (630) 620-4500 o por fax al (630) 620-4598 con tarjeta de crédito. 

del programa Nombre del programa Fecha de inicio----Costo----Costo de transporte Para Uso Oficial 

Cantidad recv. 

Fecha recv. 

Ck Efectivo CR SC 

Visa MC 

Envíe esta forma con un cheque pagable a NEDSRA, 1770 W. Centennial Place, Addison, IL 60101-1076 

CI Fecha 

COSTO TOTAL $_____________ 

Clientes con tarjeta de crédito: Marque uno: Visa ( ) MC ( ) 

Firma del poseedor_____________________________________ 

Número de cuenta _____________________________________ 

RENUNCIA MANDATORIA Y DESCARGO Noreste Dupage Asociación de 

Recreación Especial se compromete a manejar sus programas de recreo y 

vidades de una manera segura y ne en gran eeguridad de los 

pares. NEDSRA se esfuerza coente en reducir riesgos e insiste 

que todos los parcipantes sigan las reglas e instrucciones de seguridad que son 

diseñadas para proteger la seguridad de los parntes. Sin embargo, 

ardiánes de menores que se registren en programas 

deben reconocer que hay un riesgo de lesión inherente cuando eligen parcipar 

ees de recreo. Usted es el único responsable en determinar si usted o 

menor de edad es camente incapacitato para las 

das en este acuerdo. Siempre se recomienda, especialmente si 

la parcipante está embarazada, incapacitada en alguna forma o sufrió 

recientemente o padeció alguna enfermedad, lesión o menoscabo, consultar con 

un médico antes de empv NEDSRA noene seguro 

de accidente para es y el costo de atención médica yo hospitalización 

será la total responsabilidad del individuo en cu yo de su padreguardián 

AVISO DEL RIESGO 

A pesar de apropiada y cuidadosa preparación, instrucción, consejo médico, 

acondicionamiento y equipo, existe aún riesgo de daño serio cuando se 

en cualquier acvidad recreacional. No todos los riesgos y peligros pueden ser 

previstos. Los pa entender que existen ciertos riesgos, peligros y 

lesiones debidos a actos de Dios, mal empo, resbaladas, caídas, falla de equipo, 

falla de supervisión, defectos en las instalaciones y todas otras circunstancias 

inherentes ees de recreo. De este modo, se debe reconocer que es 

imposible para NEDSRA garantizar absoluta seguridad. 

AUTORIZACIÓN Y CONSENTIMIENTO PARA FOTOS/VIDEOS 

Yo, por la presente autorizo y doy mi consenmiento a NEDSRA para tomar 

de miprotegido menor de edad, y sin limitaciones para 

ideos en conexión con promociones y anuncios de servicios, 

programas e instalaciones de NEDSRA sin consideración alguna. 

Nombre del dueño de la tarjeta de crédito______________________ 

Código de verificación, parte trasera de la tarjeta ______________ 

Fecha de expiración _____________________ 

RENUNCIA Y DESCARGO DE TODO RECLAMO Y ASUNCIÓN DE RIESGO 

Por favor lea esta forma con cuidado y sepa que al inscribirse para pa 

este programa, estará expresamente asumiendo el riesgo y responsabilidad legal 

y descargando y renunciando a todo reclamo por lesiones, daños o pérdida que 

usted o su niñoor de edad pudiera sostener como resultado de su 

pcipación en cualquiera y todas vidades relacionadas y asociadas con este 

programa (incluyendo servicios de transporte, cuando proveídos). 

Si se inscribe por fax, es entendido que el documento de facsímile de 

inscripción (incluyendo el descargo de renuncia de todo reclamo) deberá s 

y tener el mismo efecto legal que la forma original. Yo reconozco y admito que 

hay ciertos riesgosra parcipantes en este programa y yo 

voluntariamente me comprometo a asumir el riesgo total de cada una y todas 

lesiones, daños o pérdidas sin importar la severidad que 

Yo o mi niñoegido menor de edad podamos sufrir como resultado de 

parcipación en este programa. Yo Además acuerdo a descargar y renunciar 

todos los reclamos que yo o mi niñotegido menor de edad podamos tener (o 

me caigan a mi o mi nirotegido) como resultado de parcipación en este 

programa contra NEDSRA, incluyendo suciales, agentes, voluntarios y 

empleados (más abajo colecvamente referido como “NEDSRA”). 

Yo por la presente, completamente libro y descargo para siempre a NEDSRA de 

cualquier y todo reclamo por daños, lesiones o pérdidas que yo o mi 

menor de edad podamos tener, que nos puedan caer sobre mi o 

or de edad que provengan de o estén conectados de 

cualquier forma asociada con este programa. 

AUTORIZACIÓN Y CONSENTIMIENTO DE INFORMACIÓN PERSONAL 

Yo además autorizo a NEDSRA a divulgar información de contacto personal a 

otros padrercipantes cuando spropiado, incluyendo nombres, 

direcciones y números de teléfono. 

Yo he leído y comndo esta importante información, advertencia 

y asumo de riesgo, renuncia y descargo de todos los reclamos y autorización y 

consenmiento de información personal foto y vídeo. 

Firma del participante ______________________Fecha_______ 

Si menor de 18 años, padre o guardián debe firmar 

38

Formulario de Información Anual 

Para registrarse para cualquier programa de NEDSRA, un formulario de información anual debe ser 

actualizado y archivado con NEDSRA. Una vez que el formulario actualizado este en archivo, usted 

puede enviar por fax o llamar por teléfono su registro para los programas. Regrese este formulario a: 

NEDSRA, 1770 W. Centennial Place, Addison, IL 60101. Atención: Secretaria de registro. 

Información del participante (Escriba en letra de molde) 

Nombre, Segundo Nombre & Apellido________________________________ Apodo_____________________ 

Dirección____________________________Ciudad________________ Estado_______ Código postal_______ 

Teléfono________________________Correo Electrónico____________________________________________ 

Fecha de Nacimiento____/____/____ Género___Estatura____Peso___Color de Pelo_____Color de ojos_______ 

Raza*___________Lenguaje usado en casa____________Talla de Camiseta______Talla de Zapato___________ 

*Con propósito de identificación únicamente 

Incapacidad Primaria__________________Incapacidad Secundaria___________________________________ 

Medicamentos actuales/dosis/frecuencia__________________________________________________________ 

___________________________________________________________________________________________ 

Alergias___________________________________________Restricciones dieté cas_______________________ 

¿Es el ipante sujeto a ataques?_________Tipo y Frecuencia__________Fecha del mo ataque__/__/__ 

¿Qué acción toma usted en caso de un ataque?____________________________________________________ 

______________________________________________________________________________________ 

¿Si el e Síndrome de Down, él/ella ha sido examinado para inestabilidad Atlanto-Axial? Si No 

Si sí, ¿fueron los resultados positivos?_____ Si así, por favor incluya una copia del examen médico. 

Escuela/Lugar de empleo________________________ Maestro/Supervisor___________________________ 

Hogar de Grupo/Centro Residencial______________________Gerente/Asistente Social____________________ 

______________________________________________________________________________________________ 

Información de Emergencia (Padre o Guardián) 

Nombre, Segundo Nombre & Apellido________________________________Parentesco____________________ 

Dirección, Cuidad y Código postal_______________________________________________________________ 

# Teléfono: Casa_____________ Trabajo_____________ Celular__________ Correo Electrónico__________ 

(Por favor indique cual número de teléfono prefiere que llamemos primero). 

Contacto de Emergencia Secundario_______________________________ Parentesco_____________________________ 

# Teléfono: Casa___________________ Trabajo_______________ Celular______________________________ 

(Por favor indique cual número de teléfono prefiere que llamemos primero). 

Nombre del Medico_____________________Teléfono del Medico___________ n de Hospital__________________ 

Habilidades de la Vida Diaria 

Comer: Come de manera independiente Necesita ser monitorizado Necesita asistencia Explique_____________ 

Baño: Va al baño independientemente Necesita ser monitorizado Necesita asistencia 

Explique___________________ 

Se viste independientemente Necesita alguna asistencia No se viste independientemente 

Movilidad: Camina independiente Usa silla de ruedas Usa silla de ruedas motorizada iza otro de 

ayuda para la movilidad 

Explique:_____________________________________________________________________________________________ 

Comunicación: Verbal/Habla claro Verbal/es l de entender Tiene cultad para expresar sus necesidades 

Gestos/Apunta a el lenguaje de signos iza audífonos iza una tabla de comunicación/calendario/fotos 

Explique_____________________________________________________________ 

Natación: Nada independientemente Nada un poco No puede nadar Miedo extremo al agua 

______________________________________________________________________________________________________ 

Interacción/Habilidades de Socialización 

Interacción social: Inicia interacción social por su cuenta Se socializa verbalmente pronto 

Evita interacción social 

Explique_________________________________________________________________________________ 

39

Original parent/guardian and doctor signatures are required by the office of Special Olympics Illinois. Faxed signatures will not be accepted. 

Athlete’s Email Address 

Parent’s Email Address 

Phone ( ) 

Witness Date 

Entrant 

Signature of Parent 

and/or Legal Guardian 

(Check appropriate box) 

Print Name Date 

City State Zip 

I, THE UNDERSIGNED ADULT ENTRANT, have read and fully understand the 

provisions of the above release and/or have had them explained. I hereby agree that I 

will be bound thereby and I shall defend Special Olympics Illinois and hold it harmless 

from disaffirmation thereof. 

I, THE UNDERSIGNED PARENT AND/OR GUARDIAN of the above specified 

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

explained them to said Entrant. I hereby agree that I and said minor will be bound 

thereby, and I shall defend Special Olympics Illinois and hold it harmless from any 

disaffirmation thereof by said minor. 

Address 

Print Name 

Doctor’s Signature 

If I am not personally present at Special Olympics activities in which the Entrant is to compete, so as to be consulted in case of necessity, you are authorized on my behalf and at 

my account to take such measures and arrange for such medical and hospital treatment as you may deem advisable for the health and well-being of the Entrant. 

Examination Date 

In permitting the Entrant to participate, I am specifically granting permission to Special Olympics Illinois to use the likeness, voice and words of the Entrant in television, radio, films, 

newspapers, magazines and other media, and in any form not heretofore described, for the purpose of advertising or communicating the purposes and activities of Special 

Olympics and in appealing for funds to support such activities. I understand that by signing below I consent for the Entrant to participate in the Special Olympics Healthy Athletes 

Program that provides individual screening assessments of health status and health care needs. The Entrant has no obligation to participate and I understand the Entrant should 

seek his/her own medical advice and assistance and Special Olympics is not responsible for the Entrant’s health. 

On behalf of the Entrant and myself, I acknowledge that the Entrant will be using facilities at his/her own risk and I, on my own behalf, herby release, discharge and indemnify 

Special Olympics from all liability for injury to person or damage to property of myself and Entrant. 

I represent and warrant to you that the Entrant is physically and mentally able to participate in Special Olympics, and I submit herewith a subscribed medical certificate. I understand that 

if the athlete has Down Syndrome, he/she cannot participate in sports or events which, by their nature result in hyper-extension, radical flexion or direct pressure on the neck or upper 

spine unless a full radiological examination establishes the absence of Atlantoaxial Instability. I am aware that the sports and events for which this radiological examination is required 

are equestrian sports, artistic gymnastics, diving, pentathlon, high jump, alpine skiing, soccer, soccer skills, powerlifting squat and butterfly stroke and diving starts in swimming. 

I have examined the above-named Entrant 

and, in my opinion, there is no mental or 

physical reason why he or she should not 

participate in the Special Olympics sports 

training and competition program. Further 

information will be forwarded if required. 

Current medication, if any, is specified with 

dosage on this application. 

I, on my own behalf or as the undersigned parent and/or legal guardian of the above named applicant (hereafter referred to as the “Entrant”), hereby request permission for the 

Entrant to participate in Special Olympics programs. I acknowledge that Special Olympics will screen all entrants using the Sex Offender Public Registry and the Child Murder and 

Violent Offender Against Youth Registry and understand that entrants listed on either Registry will be denied participation. I affirm that this Entrant has never been on said Registries 

or, if Entrant was listed on either Registry but has since been removed, I will contact Special Olympics Illinois for instructions before submitting this application. 

Date of last Tetanus shot: 

Allergies to medication, if any: 

PARENT AND/OR GUARDIAN AUTHORIZATION AND MEDIA RELEASE 

41 

Medical Insurance Company 

Policy Number 

Person to be contacted 

in case of emergency 

Emergency 

Contact Phone ( ) 

Current Medication Dosage 

HEALTH INSURANCE & EMERGENCY INFORMATION (Required for Processing) 

Ethnicity 

White Black/African American 

Hispanic/Latino Other 

Asian 

Parent’s/Guardian’s 

Home Telephone 

- - 

- 

- 

State Zip Code 

State 

Zip Code 

Does the athlete have or is the athlete: 

Heart Problems Yes No 

Diabetic Yes No 

Epileptic/Seizures Yes No 

Blind Yes No 

Deaf Yes No 

Hepatitis Yes No 

Other 

Athlete’s City 

Parent’s/Guardian’s City 

Athlete’s Mailing Address 

Parent’s/Guardian’s (Please Circle One) Home Address 

Agency Name 

Sex (M or F) 

Does athlete have Down Syndrome? 

Yes No 

If yes, have x-rays of the C1-C2 vertebrae 

been taken and examined? 

Yes No 

Date of x-ray 

Is the athlete clear of Atlantoaxial Instability? 

Yes No 

PLEASE CHECK MEDICAL INFORMATION 

Athlete Name (last name, space, first name) 

Birthdate 

M M D D Y Y 

ATHLETE INFORMATION MEDICAL CLEARANCE 

APPLICATION FOR PARTICIPATION IN SPECIAL OLYMPICS ILLINOIS 

Valid Application for Participation is mandatory for all competitors 

605 E. Willow St. Normal, IL 61761-2682 309-888-2551 

SO ILL Rev. 8-1-10 

SO ILL OFFICE ONLY

Instructions for Completing the Application for Participation 

The Application for Participation (App) must be filled in completely. Apps with blank sections or attachments (exception: letter 

from State Office of Guardianship, 2a below) will not be accepted. 

This App is valid for 2 years from the date of the examination date, regardless of the parent/guardian/Entrant signature date. 

Parent/guardian and doctor signatures must be original and both original signatures must be on the same App form. Faxed 

signatures, phone consents or verbal consents will not be accepted. 

If Entrant was listed on the Sex Offender Public Registry or the Child Murder and Violent Offender Against Youth Registry 

but has since been removed, contact the Special Olympics Illinois office for instructions before submitting this application. 

ATHLETE INFORMATION AND HEALTH INSURANCE & EMERGENCY INFORMATION 

1. The first two sections must be filled in completely. The ethnicity information is requested to assist in the organizational outreach 

efforts. 

PARENT AND/OR GUARDIAN AUTHORIZATION AND MEDIA RELEASE 

2. The Parent or Legal Guardian must read, sign and date the Parent/Guardian Authorization and Media Release. 

a. The section must be signed and dated as printed. Deletions or alterations to the section will result in an invalid App. 

(Exception: Deletion of the last paragraph regarding medical treatment and attachment of a letter of explanation and 24-hour emergency 

telephone numbers from the State Office of Guardianship. As of January 1, 1987, the letter of explanation must be 

attached.) 

b. Only one of the two signature blocks must be completed. Special Olympics Illinois works under the understanding that this 

section may be signed by either: 

The (biological or adoptive) parent unless the athlete has been designated a ward of the state; 

OR 

The legal guardian; this person must be legally assigned for the individual; 

OR 

The athlete if he/she is over the age of 18 and has not been designated as needing and having been assigned a legal guardian. 

A witness signature is necessary if the athlete’s signature is unrecognizable (for example, if the athlete’s signature is an “X.”) 

MEDICAL CLEARANCE 

3. The Medical Clearance section must be completed, signed and dated by a medical practitioner licensed to administer physical 

examinations by the state in which he/she practices. As of September 1, 1990, the Special Olympics Illinois Application for 

Participation is the only Medical Clearance form which will be accepted as valid by Special Olympics Illinois. 

This person, by signing the Medical Clearance, is stating that the athlete is in good health and can safely participate in Special 

Olympics sports training and competition. It is strongly suggested that the person administering the physical examination possess the 

following: 

Background and preparation in giving sports physical examinations. 

Qualifications to administer examinations that would not compromise his/her area of specialty. 

AFTER COMPLETING THE APPLICATION ... 

4. Send the original copy of the Application for Participation to the Area Director who will send the App to the Special Olympics 

Illinois Chapter office. The Chapter office will validate the Application for Participation and send a copy of the App with an 

approved stamp back to the SOAD (Special Olympics Athletic Director). An Application for Participation will not be validated until 

all information is correct and completed on the approved form. 

5. Special Olympics Illinois requires that all Applications for Participation be presented prior to and no later than the established 

Medical App deadline of a Chapter championship level event (Winter Games, State Basketball Tournament, Summer Games, 

Outdoor Sports Festival, Fall Games, Floor Hockey or State Bowling Tournament). All Apps for the event in question must be valid 

throughout the completion of that Chapter competition. 

Applications for Participation for athletes participating in District Tournaments and Sectional Tournaments must be received before 

the entry deadline or with registration materials. 

Applications not on file or in receipt by the specified deadline will not be accepted. 

42

Support Staff 

NEDSRA would like to thank the following support staff members for their time, energy and commitment 

during the summer 2013 season. 

Mallory Albright 

Angela Alvino 

Gina Alvino 

Kevin Amos 

Kristen Anderson 

Jenifer Bailey 

Megan Benhart 

Tim Bennett 

Courtney (Allen) Biggs 

Debbie Biggs 

Yvonne Blais 

Peter Bleka 

Karina Bocka 

Kristen Burke 

Elyse Christofanelli 

Colleen Cline 

Matt Corso 

Michele Coval 

Wendy Craven 

Mike Crawford 

Jacqueline Cudia 

Dave Cummings 

Matthew Cummings 

Brian Davis 

Gita Drillis-Bocka 

Ryan Fleck 

Ulises Flores 

Philip Floro 

Bruce Flowers 

Steve Fougerousse 

Colleen Fritsch 

Patrick Fritsch 

Sean Fritsch 

Jessica Fry 

Nick Fuhrman 

Carrie Gascoigne 

Sean Gascoigne 

Matt Gorecki 

Bob Griffin 

Liz Grillos 

Tom Haffey 

Jennifer Halberthal 

Brianna Harvey 

Joe Ann Hervey 

Ashley Homa 

Brian Houzenga 

James "Todd" Huber 

Laura Huber 

Patrick Hurst 

Lija Hyssong 

Mindy Jack 

Melissa Johnson 

Stacy Jones 

Katie Kaplar 

Rashad Khwaja 

Tyler King 

Mary Knudson 

Molly Lesnik 

Stephanie Lesnik 

Michelle Lindgren 

Lisa Long 

Elizabeth Luszcyk 

Susan Lycko 

David Lynch 

Annie Machynia 

Laurine Machynia 

Vicky Mann 

Jacob Metoyer 

Erin Mikulecky 

Gerard Moran 

Jennifer Mozina 

Katie Mueller 

Eileen Murphy 

Melissa Muzi 

Brady Olenek 

Alyssa Olson 

Amanda Pawinski 

Debbi Pawinski 

Sharon Pearce 

Wesley Perkins 

Carolyn Peters 

Kayla Ryndak 

Jessica Schatte 

Garren Schneider 

Alissa Schweizer 

Donna Sebok 

Linda Schutz 

Amanda Scott 

Kelly Sheridan 

Michelle Shute 

Jodie Skinner 

Thomas Snarich 

Kaitlin Staffeldt 

Matt Stearns 

Lisa Thurnall 

Sara Tomasello 

Shannon Tovey 

Anne Tully 

Veronica Urban 

Bill Werner 

Hannah Williams 

Lauren Williams 

Monica 

Wlodarkiewicz 

Maggie Wood 

Scott Zeitlin 

Kevin Zirko 

Healthy Minds Healthy Bodies 

Check out this unique and free program 

for military veterans! Qualified veterans will 

receive a free, one-year fitness membership 

at their local park district or village fitness 

center along with personal training sessions. 

In addition, free monthly socials are provided 

to network with fellow veterans and family 

members. Call Donna Allen-Sebok or 

Lisa Deets at 630-620-4500, or visit 

nedsra.org to find out if you qualify. 

43

1770 W. Centennial Place 

Addison, Illinois 60101 

Phone: 630-620-4500 

Fax: 630-620-4598 

NON-PROFIT 

ORGANIZATION 

U.S. POSTAGE 

PAID 

PERMIT #517 

ADDISON, IL 

nedsra.org 

Change service requested 

SERVING THE COMMUNITIES OF: 

Addison 

Bensenville 

Butterfield 


Itasca 

Lombard 

Medinah 


Schiller Park 

Villa Park 

Wood Dale 

Dedicated and Loyal Supporter of 

NEDSRA Programs and Services 

Thank You!

Fall

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