C-U Special Recreation Fall 2012

7/31/2019 C-U Special Recreation Fall 2012

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Fall 2012


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CUSRGeneral InformationHays Recreation Center1311 W. Church St.Champaign, IL 61821Phone: 217-239-1152Fax: 217-373-7951711 RelayE-Mail: [email protected]: www.cuspecialrecreation.comOfce Hours: Mon-Fri, 8am-5pmOfce Closed: September 3; Novermber 12, 22, 23;

December 24, 25

Inclusive ProgramsThrough CUSRCUSR and its member park districts believe thatall individuals should be provided with leisureopportunities that allow for performance at theirhighest level of ability. We understand that notevery person who has a special need desires

CUSR programming. In cooperation with theChampaign Park District and the Urbana ParkDistrict, CUSR staff will be happy to assistand advise any resident who is interested inparticipating in local park district programs. CUSRwill provide the type of support deemed necessarfor successful participation. Support may includetraining with the park district staff members,consultation with the individual and the individualfamily members, and the assistance of a supportstaff member. CUSR provides all inclusion serviceat no cost to the individual. For more information,please contact CUSR.

Our MissionOur ve year mission is to advocate for andprovide access to a full range of recreational

opportunities for people with disabilities tofocus on, further dene and provide our coreprograms to create partnerships that will increaseparticipation and programs, ensure nancialviability for growth and position CUSR to expandits number of member agencies.

Our VisionCUSR exists to ensure that people with disabilities,within our member agencies, have access to a full

range of recreational services.We create equal access to recreation, which isintegral to a higher quality of life. We create aware-ness and advocate acceptance of people withdisabilities in their communities so they more fullyparticipate in recreation and all aspects of society.

Invite Us To SpeakCUSR staff members are knowledgable in manydisability-related issues and topics. Let us talk to

your group about the Americans with DisabilitiesAct, integration, and the future of specialrecreation. An overview of CUSRs mission,trends in recreation and many other topics areavailable to you with a simple phone call. Call theCUSR ofce at 217-239-1152 to set up a meeting.

Program HistoryCUSR is an intergovernmental cooperative madeup of the Champaign and Urbana Park Districts,that was founded in 1985. CUSR provides yearround leisure and recreation opportunities forchildren and adults with disabilities. Our missionis to enhance participants abilities in enjoyablerecreational, leisure, and social settings. CUSR

participants explore new areas of interest, makenew acquaintances, and learn lifetime leisure skilOur services include inclusive and cooperativeprograms, special events, after school programs,overnights, trips, Special Olympics, summer daycamps and much more.

Americans with DisabilitiesAct (ADA)CUSR complies with the Americans with Disabiliti

Act (ADA) which prohibits discrimination on thebasis of a disability. CUSR will make reasonableaccommodations in recreation programs to enablparticipation by an individual with a disabilitywho meets essential eligibility requirements. Therecreation programs offered by CUSR will beavailable in the most integrated setting appropriatfor each individual. If you have any questionsregarding the ADA, or believe you have beenunfairly discriminated against by CUSR, pleasecontact the CUSR Director at 217-239-1152.


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Whats Inside...After School .................................3Youth & Teen Programs ...............3

Adult Programs ............................6Special Events ...........................11Trips ...........................................14Special Olympics .......................15

Athletics .....................................16Registration Form ......................19Waiver and Release...................20Special Olympic Application .......21CUSR Information ......................23

For a large-print version of this brochure, contact the CUSR ofce at 239-1152.

CUSR StaffDawn Schaefer, MS, CTRS - Director

Hannah Sheets, MA, CTRS - Athletics Coordinator

Jessica Brutti, CTRS - Adult Coordinator

Lisa Morand, CTRS - Youth & Teen Coordinator

Cindy McGrath - Receptionist

Program Locations

Champaign

CUSR OfceHays Recreation Center / Eisner Park

1311 W. Church St. 217-239-1152Arrowhead Lanes1401 N. McKinley 217-352-5288

Franklin Middle School817 N. Harris Ave. 217-351-3819

Jupiters at the Crossing2511 Village Green Pl. 217-366-8300

Spalding Recreation Center910 N. Harris 217-398-2577

Stephens Family YMCA2501 Fields South Dr. 217-359-9622

Western Bowl917 Francis Dr. 217-359-1678

SavoySavoy Recreation Center402 W. Graham Dr. 217-359-3550

UrbanaBrookens Gymnasium1776 E. Washington 217-344-9583

Anita Purves Nature Center1505 N. Broadway 217-384-4062

Phillips Recreation Center505 W. Stoughton 217-367-1544

Urbana Indoor Aquatic Center102 E. Michigan 217-384-7665

Find us on Facebook and stay connectedChampaign-Urbana Special Recreation

CUSR staff, from left to right: Lisa Morand, Cindy McGrath,Jessica Brutti, Dawn Schaefer, and Hanah Sheets


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All residents of Champaign-Urbana areimportant to us! If you are new to the area,Champaign-Urbana Special Recreation invitesyou to come in and nd out what we havegoing on for you and other members of yourfamily. Throughout the year, we provide a large

variety of social, recreational, cultural and sportsactivities for all ages and abilities. To learn moreabout what we have to offer, give us a call at217-239-1152. We will be happy to explain anyprogram or service that is of interest to you. Asa potential program participant, we would like tomeet with you and your family!

Welcome

RegistrationA CUSR registration form must be used.You may register for CUSR programs at theselocations:

Hays Recreation Center1311 West Church Street, Champaign

Bresnan Meeting Center706 Kenwood Road, Champaign

Douglass Community Center512 E. Grove Street, Champaign

Leonhard Recreation Center2212 W. Sangamon Drive, Champaign

Springer Cultural Center301 N. Randolph Street, Champaign

Or register online at www.cuspecialrecreation.com*Please note: Online registration is not live, sodoes not guarantee entry into program.

Full payment must be received upon registrationunless specic arrangements have been madewith the CUSR ofce. Registrations will notbe processed if a fee balance remains from aprevious season. Registrations are accepted inperson at the locations listed above, through mail,and by fax (217-373-7951). When faxing, pleaseinclude credit card information so we may processthe registration. Coordinators and programleaders MAY NOT receive payment or registrationforms at programs. CUSR does not prorate forlate registration. Exceptions may be made forpeople who are new to the community.

Non-Resident Program FeesParticipants that do not pay property taxes inChampaign or Urbana will be required to pay 50%more than residents for programs. The NR listednext to the program fee is the Non-Resident fee.

CUSR Transportation PolicyOur doortodoor routes need to have aminimum of 2 registrants to run. If a route iscancelled, a phone call will be made to theparticipant and their caregiver, and a full refundwill be issued to the participants account.

MedicationAt times participants may require assistance takingmedication during programs. If the participant isunable to self-medicate or take the medication priorto or after the program, CUSR requires additional

paperwork and pre-packaged medication must bedelivered to our ofce prior to the program.

Certied Therapeutic

Recreation Specialist (CTRS)The CUSR full-time program staff are all CertiedTherapeutic Recreation Specialists. This certicatiodemonstrates that each of these individuals,through education, experience, and passing aknowledge-based examination, has met the minimurequirements for practice in therapeutic recreation.The national exam for Therapeutic RecreationSpecialists is based on knowledge from the NationaJob Analysis Study for Therapeutic Recreation whicdenes the important skills and knowledge necessafor minimum competency in the therapeutic recreatipractice.

CUSR employs experienced professionals whounderstand the level of skill, both physical and menneeded to participate fully and safely in the programthey plan. Therefore, CUSR reserves the right to

determine if a program is suitable for an individual.Staff may serve as a resource to suggest alternateprogramming.


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www.cuspecialrecreation.com 3

Early Childhood

After School ProgramAges 5-22

Come join your friends for an afternoon lledwith games, sports, arts and crafts, cooking,and eld trips. We will offer an amazing, as wellas safe, atmosphere where we will laugh, play,grow and learn new skills.

GOALS: To improve verbal and social skills,build new friendships and gain self-condenceand independence. To expand knowledge ofleisure activities.

Date Time Program IDSept. 4, 2012- 2:30-5:30pm 232104-A1

May 24, 2013Day: Monday-FridayLocation: Spalding Recreation CenterFee (R/NR): $192/$288Min/Max: 8/15Deadline: One week prior to month starting*No Program:September 27October 25-26November 22-23December 24-January 4January 7, January 21

February 18March 15, March 18-22, March 29

April 26

NOTE: This program runs following theChampaign Unit 4 schedule.

Developmental

Play Group

Ages 2-6 with parent/guardianPlay is a great way to address many therapeuticgoals all while smiling and laughing. These smallgroups explore the many aspects of play that willallow your child to laugh, learn and grow. Theclasses will be held at the Stephens Family YMCAin the Family Adventure Center and SensoryRooms. Parents will be actively involved for halfof the class and will be allowed to have some timein the Resource Library to network with the otherfamilies involved. Classes will be led by a RecreationTherapist.

Registration taken at the Stephens Family YMCA.

Music TherapyAges 0-6 with parent/guardian

The goal of music therapy is to use specicallydesigned music and music activities to accomplishnon-musical goals. Learning through musictherapy is a great way to have fun, interact socially,encourage communication through singing,movement, expressiveness and to learn new skills.Class is lead by a Board Certied Music Therapist.Come ready to sing, move and try out someinstruments.

Registration taken at the Stephens Family YMCA.

New!

New!

Youth and Teen


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Youth & TeenSpecial Events Urbana Indoor

Aquatic CenterAges 7-13

Urbana Indoor Aquatic Center is a great place

to splash around and have some fun! We willenjoy the zero-depth entry, water geysers, amushroom waterfall, and slides. So get on yourbathing suit and come join us for a good time!Please eat lunch before you come and be inyour swimsuit.

GOALS: Increase socialization and peerinteraction, explore different activities within awater setting, and improve swim skills.

Date Time Program IDSeptember 29 1:30-3pm 232401-A1

Day: SaturdayLocation: Urbana Indoor Aquatic CenterFee (R/NR): $17/$25.50Min/Max: 4/8Deadline: September 21Transportation: Drop off at Aquatic Center at1:15pm, pick up at 3pm

Curtis Apple OrchardAges 6-13

Come and join your friends as we explore the orcharand pick our own apples! There will be a variety ofapples to choose from; Jonathan, Golden Delicious,Red Delicious, Red Fuji and more. Apples range fromvery sweet to tart so there will surely be an apple foryour taste bud! CUSR will pay for lunch. Please bringmoney for apples and any other souvenirs.

GOALS: To increase independence and decisionmaking skills, to increase socialization, and to explorour senses.

Date Time Program IDOctober 13 11am-12:30pm 222404-A1

Day: SaturdayLocation: Curtis Apple OrchardFee (R/NR): $18/$27Min/Max: 6/12Deadline: October 5Transportation: Drop off at Hays Center at 10:40amand pick up at Hays Center at 12:45pm

Martial Arts(formerly Taekwondo)

Ages 16-35Come experience the art ofTaekwondo and gain overallexposure to the martial arts.CUSR has partnered withTina and Jeff Newberry of Leaders for Life/Newberrys Martial Arts in order to providea comprehensive curriculum. This class willbe taught by instructors who have years ofexperience teaching martial arts to individualswith and without disabilities. This program willoffer a balanced physical and mental workout.NOTE: A uniform is required to participate.The fee does not include a uniform. The costfor a uniform is $45 payable to Leaders for LifeMartial Arts. Uniform sizes will be determined atthe rst class and you will receive your uniformat the second class. Promotion tests (at anadditional cost) are optional, but recommended.

I am passionate about providing an atmospherewhere children and adults will never be madefun of or criticized ... a place where everyonewill be made to feel like champions.

Master Tina Newberry

GOALS: To increase concentration and balance,and improve coordination, gross motor skills,endurance, exibility, and balance. It will alsofocus on self-condence and self-defense.

Date Day Program IDSeptember 12- Wednesday 232806-A1December 26

Time: 6-6:45pmLocation: Stephens Family YMCA, 2501 Fields

South Drive, Champaign located off WindsorRd, over the bridge at I-57. Classroom 118.Fee (R/NR): $161/$241.50Min/Max: 4/12Deadline: September 7

Scholarships &Payment Plans

Available


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Youth & TeenSpecial Events

Winter Break CampAges 7-High School Graduate

Looking for something fun to do over yourWinter Break? Then your search is over,because this program provides fun for all.

Activities include playing games, cooking,making cool projects, and a eld trip. Pleasebring a lunch daily.

GOALS: To enhance social skills, learn newleisure activities, and increase independence.

Date Day Program IDDecember 26-28 Wed-Fri 232603-A1

December 31 Mon 232603-A2January 2-4 Wed-Fri 232603-A3

Time: 9am-3pmLocation: Spalding Recreation CenterFee (R/NR): December 26-28: $106/$159

December 31: $36/$54January 2-4: $106/$159

Min/Max: 6/12Deadline: December 17

Pottery PlaceAges 13-18

If you enjoy painting pottery then Pottery Place isthe place for you. Come and enjoy the relaxingand inspiring space with your friends where youcan create your own piece of pottery and use yourcreativity. Studio time is included in the fee as well as$12 for a piece to pick out. If you wish to spend morethan $12 please bring your own money.

GOALS: To increase independence, to enhancecreativity, and to improve ne motor skills.

Date Time Program IDDecember 15 10:30-11:30am 222405-A1

Day: SaturdayLocation: Pottery Place

Fee (R/NR): $19/$28.50Min/Max: 6/12Deadline: December 10Transportation: Meet at Pottery Place at 10:15amand pick up at 11:30am

Lunch ClubAges 13-18

Whats for lunch today? Come and join your friendsas we head out and experience different restaurantsand food around town. CUSR will pick up the tab for

lunch; you just have to join the club!GOALS: To increase socialization, work on moneymanagement skills, and learn dining etiquette skills.

Date Location Program IDSeptember 22 Pancheros 232402-A1October 20 MonicalsNovember 17 Zas (on Neil)December 8 El Toro (on Springeld)

Day: SaturdayTime: 11:30am-12:30pmFee (R/NR): $52/$78Min/Max: 6/12Deadline: One week prior to programTransportation: Drop off at Hays Center at 11:10amand pick up at Hays Center at 12:45pm


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Adults ~ Monday

Computers 101Ages 16+

Microsoft Word, Access, Excel, emaildoes thisall sound confusing to you? Would you like to learnmore? Then come on over and learn how its done.Please register for one session per date. Newlearners take priority in registration.

GOALS: To enhance ne motor skills and increasecomputer knowledge.

Date Program ID Sess 1 Sess 2 SessSeptember 17 232606 A1 A2 A3October 8 232606 A4 A5 A6November 19 232606 A7 A8 A9December 10 232606 B1 B2 B3

Day: MondayTime: Session 1: 4-4:30pm

Session 2: 4:30-5pmSession 3: 5-5:30pm

Location: Hays Recreation CenterFee (R/NR): $7/$10.50Min/Max: 1/3Deadline: 1 week prior to program

CUSR Transportation PolicyOur Door-to-Door routes need to have a minimumof 2 registrants to run. If a route is cancelled, aphone call will be made to the participant and theircaregiver and a full refund will be issued.

Cookin Across the WorldAges 18+

Measure, chop, stir and cook! Join us as weprepare recipes from across the world. We willhave themed dinners where we will learn aboutdifferent cultures and how they prepare theirmeals. Themes include Italian, Mexican, and

Chinese. You will receive a recipe book of themeals we prepared that evening to try at home.

GOALS: To enhance cultural awareness,develop appropriate dining etiquette, andimprove cooking skills.

Date Program ID Transportation IDSeptember 10 242537-A1 242537-T1

October 1 242537-A2 242537-T2

November 5 242537-A3 242537-T3

December 3 242537-A4 242537-T4

Day: MondayTime: 5:30-8:30pmLocation: Hays Recreation CenterFee (R/NR): $22/$33Min/Max: 4/10Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

3 Nights/ 4 Days in

Louisville KentuckyDo you like baseball, horses and adventure?If so start saving now for our trip to LouisvilleKentucky for fall of 2013. There we will bevisiting the Kentucky Derby Museum, LouisvilleSlugger Museum, and the Louisville MegaCavern were we will be taking a tour of theunderground caves and zip lining. Look forwardto more information in our upcoming brochures!

TRIP FOR FALL OF 2013


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Adults ~ WednesdayJumpin at JupitersAges 18+

Have you and your friends been looking for a nightwhere you can play some pool, enjoy arcade games,and win some prizes? If you have, meet us atJupiters at the Crossing for a night of that and muchmore. CUSR will pay for one game of pool. Please

bring money for food and arcade games.GOALS: To increase money management skills,and enhance social skills with peers and communitymembers.

Date Program ID Transportation IDSeptember 17 242524-A1 242524-T1October 8 242524-A2 242524-T2November 19 242524-A3 242524-T3December 10 242524-A4 242524-T4

Day: MondayTime: 7-9pm

Location: Meet at Jupiters at the CrossingFee (R/NR): $17/$25.50Min/Max: 4/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Hays HangoutAges 18+

Fill the evening with a night of cards, Wii, board

games and more. At Hays Hangout you will do justthat and socialize with all of your friends from CUSR.Snacks are included.

GOALS: To enhance socialization with peers and turntaking skills.


Day: MondayTime: 6:30-8pmLocation: Hays Recreation CenterFee (R/NR): $7/$10.50Min/Max: 4/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Dancing in DecaturAges 21+CUSR will be venturing out to enjoy anevening of dancing and snacks at the Knightsof Columbus in Decatur, Illinois. Join us as wedance the night away and of course meet newfriends. Admission is included; you just need tobring your dancing shoes!

GOALS: To enhance socialization with peersand meet new people.


October 3 243003-A2 243003-T2November 7 243003-A3 243003-T3December 5 243003-A4 243003-T4

Day: WednesdayTime: 5:15-9:15pmLocation: Meet at Hays Recreation CenterFee (R/NR): $13/$19.50Min/Max: 6/24Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10


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Adults ~ Wednesday

Diners ClubAges 18+

Join us as we go out to different restaurants aroundtown for dinner. CUSR will be picking up your dinnertab! At Diners Club you will be able to socialize withyour friends and enjoy a GREAT dinner.

GOALS: To enhance socialization with peers,increase money management skills, and diningetiquette.

Date Restaurant Program IDSeptember 6 Old Chicago 242504-A1October 4 Oishi 242504-A2November 1 Monicals (Mattis) 242504-A3December 6 Ruby Tuesdays 242504-A4

Day: ThursdayTime: 6-7:30pmLocation: Meet at restaurantFee (R/NR): $100/$150 for all four venues$41/$61.50 for each individual venueMin/Max: 4/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10 each;$40 all fourTransportation ID: 242504-T1; T2; T3; T4

Adults ~ Thursday

Healthy Snacking

Ages 18+Join us as we learn and prepare healthy snacks.We will be working on proper proportions, balancedsnack choices, and of course enjoying our creations.If you are looking for a healthier alternative when itcomes to snacking, this program is perfect for you!

GOALS: To develop appropriate dining etiquette,improve cooking skills, and improve awareness ofnutritional decisions.


October 11 243404-A2 243404-T2November 8 243404-A3 243404-T3December 13 243404-A4 243404-T4

Day: ThursdayTime: 4:30-6pmLocation: Hays Recreation CenterFee (R/NR): $8/$12Min/Max: 6/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Martial Arts(formerly Taekwondo)Ages 16-35

Come experience the art ofTaekwondo and gain overallexposure to the martial arts.CUSR has partnered withTina and Jeff Newberry of Leaders for Life/Newberrys Martial Arts in order to providea comprehensive curriculum. This class willbe taught by instructors who have years ofexperience teaching martial arts to individualswith and without disabilities. This program willoffer a balanced physical and mental workout.NOTE: A uniform is required to participate.

The fee does not include a uniform. The costfor a uniform is $45 payable to Leaders for LifeMartial Arts. Uniform sizes will be determined atthe rst class and you will receive your uniformat the second class. Promotion tests (at anadditional cost) are optional, but recommended.

I am passionate about providing an atmospherewhere children and adults will never be madefun of or criticized ... a place where everyonewill be made to feel like champions.


GOALS: To increase concentration and balance,and improve coordination, gross motor skills,endurance, exibility, and balance. It will alsofocus on self-condence and self-defense.


Time: 6-6:45pmLocation: Stephens Family YMCA, 2501 FieldsSouth Drive, Champaign located off Windsor

Rd, over the bridge at I-57. Classroom 118.Fee (R/NR): $161/$241.50Min/Max: 4/12Deadline: September 7


Available


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Adults ~ Friday

Karaoke and DancingAges 18+

ATTENTION all singers and dancers. Come onover as CUSR brings out the karaoke machinefor a night of dancing and singing. With lots ofmusic to choose from, its sure going to be agood time. Snacks will be provided.

GOALS: To increase socialization skills andturn-taking skills.

Date Program ID Transportation IDOctober 12 242518-A1 242518-T1November 16 242518-A2 242518-T2

Day: FridayTime: 6:30-8pmLocation: Hays Recreation CenterFee (R/NR): $7/$10.50Min/Max: 4/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Blackout B-I-N-G-OAges 18+

Come one, come all for a night of Bingo! You willenjoy hanging out and socializing with your friends

and may even win some prizes!

GOALS: To enhance socialization with peers andturn-taking skills.


Day: ThursdayTime: 6:30-7:30pmLocation: Hays Recreation Center

Fee (R/NR): $11/$16.50Min/Max: 6/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Movie NightAges 18+

Bring out your inner critic! Join us as we choose

movies to watch at the Hays Center, or feel freeto bring your own movies from home to sharewith us! CUSR will provide snacks, you just needto be ready for some entertainment!

GOALS: To enhance socialization with peers,increase listening and comprehension skills.


Day: FridayTime: 6:30-8:30pmLocation: Hays Recreation CenterFee (R/NR): $7/$10.50Min/Max: 4/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10


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AdultsDay Programs

Too Fit to QuitAges High School Graduate-35

Looking for something to do during the day? Whynot spend the early afternoon with your friendsfrom CUSR and work out! At our tness class wewill explore yoga, stretching, strength training,endurance and much more.

GOALS: To increase gross motor skills, gainknowledge of proper tness techniques, andimprove overall physical tness.

Date Time Program IDSeptember 4- 10:30-11:30am 243401-A1December 20

Days: Tuesdays/ThursdaysLocation: Spalding Recreation CenterFee (R/NR): $50/$75 for all sessionsMin/Max: 6/15Deadline: One week prior to program

Luncheon BunchAges High School Graduate-35

Whats for lunch today? Join us as we head outand experience different restaurants around town.CUSR will pick up your tab for lunch, you just have

to join the club!GOALS: To increase money management anddining etiquette skills, and increase socializationamong peers.

Date Location Program IDSeptember 5 Pancheros 243402-A1September 19 El Toro (Springeld) 243402-A2October 3 Monicals 243402-A3October 17 OCharleys 243402-A4November 7 Zas (Springeld) 243402-A5November 21 Tafes 243402-A6December 5 Old Chicago 243402-A7

December 19 Groups Choice 243402-A8

Day: WednesdayTime: 11:30am-1pmLocation: Meet at the restaurantFee (R/NR): $35/$52.50 monthly or $135/$202.50for all 8 sessionsMin/Max: 6/12Deadline: One week prior to program

Out and AboutAges High School Graduate-35

Join CUSR as we take a day trip once a month toplaces near and far. Any admissions and meals areincluded in the fee.

GOALS: To increase socialization among peers,increase money management skills, and enhancecommunity awareness.

Date Location ProgramSeptember 14 Decatur Zoo and Lunch 243403-AOctober 12 The Great Pumpkin Patch 243403-ANovember 16 Cook the Day Away 243403-ADecember 7 Scrapbook Sensations 243403-ASession 1:Decatur Zoo and LunchDay: FridayTime: 9am-2pmLocation: Meet at theHays Recreation Center

Fee (R/NR): $32/$48Min/Max: 6/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10Transportation ID: 243403-T1

Session 2: The Great Pumpkin Patch in ArcolaDay: FridayTime: 12:30-4pmLocation: Meet at the Hays Recreation CenterFee (R/NR): $13/$19.50Min/Max: 6/12

Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10Transportation ID: 243403-T2

Session 3: Cook the Day AwayDay: FridayTime: 2-4pmLocation: Meet at the Hays Recreation CenterFee (R/NR): $21/$31.50Min/Max: 6/12Deadline: 2 week prior to programDoor-to-Door Transportation Fee: $10

Transportation ID: 243403-T3

Session 4: Scrapbook SensationsDay: FridayTime: 2-4pmLocation: Meet at the Hays Recreation CenterFee (R/NR): $8/$12Min/Max: 6/12Deadline: 2 week prior to programDoor-to-Door Transportation Fee: $10Transportation ID: 243403-T4


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SeptemberSpecial Events

Sports Club

Ages 18+ATTENTION SPORT FANS! CUSR has the perfectclub for you! We will be attending two sporting eventsthis summer. Cost of your ticket is included. You willneed to bring money for snacks.

GOALS: To increase socialization and moneymanagement skills.

Date Location and ProgramNovember 20 Parkland Womens BasketballTBA Parkland Womens Volleyball

Session 1: Parkland Womens BasketballDay:TuesdayTime: 4:45-7:45pmLocation: Meet at Hays Recreation CenterFee (R/NR): $19/$28.50Min/Max: 6/12Deadline: 1 week prior to programProgram ID: 242807-A1Door-to-Door Transportation Fee: $10Transportation ID: 242807-T1

Session 2: Parkland Womens VolleyballDay: TBATime: TBALocation: Meet at Hays Recreation CenterFee (R/NR): $19/$28.50Min/Max: 6/12Program ID: 242807-A2Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10Transportation ID: 242807-T2

Chili and Bingo Night

in DecaturAges 18+

Join us as we travel to Decatur to visit with ourfriends as we play BINGO and eat some deliciouschili. There will be some great BINGO prizes!

GOALS: To enhance socialization with peers andmake new friends.


Day: FridayTime: 5-9pmLocation: Meet at Hays Recreation CenterFee (R/NR): $27/$40.50Min/Max: 6/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Fighting Illini

Bass Fishing ClinicAges 13+

Come cast away with the University of IllinoisBass Fishing Club! Club members will instructyou on how to cast and other shing techniqueswhile we try to catch some sh at Crystal Lake.This program is sponsored by the Fighting IlliniBass Fishing Club and will be staffed by clubmembers. CUSR staff will be in attendance forprogram supervision. Note: This is a catch andrelease program. All sh will be released backinto Crystal Lake.

Due to the clubs other commitments, theexact date of the program will not be knownwhen the brochure is printed. Please contactthe CUSR ofce in August for more information.

GOALS: To increase hand-eye coordination andexposure to a new leisure activity.

Date Time Program IDTBD 4:30-6:30pm 232901-A1

Day: FridayLocation: Crystal Lake Park Fishing DockFee (R/NR): Free! *All participants attendingmust register.Min/Max: 8/20Deadline: Thursday before program


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OctoberSpecial Events

Conklins Barn II

Dinner TheatreAges 21+Move Over, Mrs. Markham is the play we will beheading to see in Goodeld, Illinois. There you willenjoy a wonderful buffet dinner followed by the play.Cost of meal and play included.

GOALS: To enhance socialization with peers and gaicultural experience.

Date Program ID Transportation IDOctober 14 243013-A1 243013-T1

Day: SundayTime: 10:30am-5pmLocation: Meet at Hays Recreation CenterFee (R/NR): $60/ $90Min/Max: 6/12Deadline: 2 weeks prior to programDoor-to-Door Transportation Fee: $10

Halloween PartyAges 18+

Ghosts, goblins, and more! Come on out to CUSRsannual Halloween Party. We will be playing games,enjoying a tasty snack, dancing, and having acostume contest, so wear your best costumes!

GOALS: To enhance socialization skills with peers.

Date Program ID Transportation IDOctober 31 272504-A1 272504-T1

Day: WednesdayTime: 6-8pmLocation: Hays Recreation Center

Fee (R/NR): $16/$24Min/Max: 6/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Apple and Pork Festival

Ages 18+Join us as we venture out to Clinton, Illinois fortheir annual Apple and Pork Festival. There wewill look at all of the booths and see what thevendors have to offer. Please bring money foryour lunch and souvenirs.

**Must be able to walk long distances

GOALS: To increase money management skillsand social skills within the community.

Date Program ID Transportation ID

September 29 243017-A1 243017-T1Day: SaturdayTime: 9am-2pmLocation: Hays Recreation CenterFee (R/NR): $37/$55.50Min/Max: 6/12Deadline: One week prior to programDoor-to-Door Transportation Fee: $10

SeptemberSpecial Events

Find us on Facebook and stay connectedChampaign-Urbana Special Recreation

Curtis Orchard and LunchAges 18+

Join us as we spend the afternoon at CurtisOrchard to pick apples and shop. We will theneat lunch at the caf located at the apple orchard.CUSR will be picking up your tab for lunch.Please bring money for Curtis Orchard.

GOALS: To enhance socialization with peers,increase money management skills and diningetiquette.


Day: SundayTime: 10:45am-1:15pmLocation: Meet at the Hays Recreation CenterFee (R/NR): $25/$37.50Min/ Max: 6/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10


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NovemberSpecial Events

Dinner and

Cosmic BowlingAges 18+

Looking for things to ll your Saturday nights?CUSR staff will choose the restaurant based onsome local favorites and then head to ArrowheadLanes for Cosmic Bowling. CUSR will pay foryour dinner and two games of bowling.*NOTE: STROBE LIGHTS MAY CAUSESEIZURE ACTIVITY

GOALS: To improve gross motor coordination,turn-taking skills, and socialization with peers.

Date Program ID Transportation IDNovember 17 242527-A1 242527-T1

Day: SaturdayTime: 7-11pmLocation: Meet at Hays Recreation CenterFee (R/NR): $39/ $58.50Min/Max: 4/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Holiday Shopping and Lunch

at Orland Park MallAges 18+

Do you have too much holiday shopping and notenough time to get it all in? Put your worries aside andspend the afternoon shopping with your friends fromCUSR. We will be heading out to Orland Square Mall toshop and look at all of the holiday decorations. CUSRwill pick up your tab for lunch; you just have to bringyour shopping list and money for gifts.

GOALS: To enhance decision making skills. Improvebudgetary and money management skills.

Date Program ID Transportation IDNovember 10 242901-A1 242901-T1

Day: SaturdayTime: 8am-4pmLocation: Meet at the Hays Recreation CenterFee (R/NR): $35/$52.50Min/Max: 6/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10


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Adult Trips

St. Louis OvernightAges 21+

On our St. Louis overnight we will be visiting the St.

Louis Science Museum and gambling at the QueensCasino. Lodging, meals and admission is included.Please bring money for souveniers. NOTE: Must bean adult 21 or over to attend and bring a state issuedphoto I.D.

GOALS: To enhance decision making skills, andimprove budgetary and money management skills.

Date Program IDOctober 6-7 243023-A1

Day: Saturday-Sunday

Time: Leaving the Hays Center at 9am on October 6Returning at noon on October 7.Location: Meets at the Hays Recreation CenterFee (R/NR): $185/ $277.50Min/Max: 6/10Deadline: 9/5

DecemberSpecial Events

Pottery PlaceAges 18+

Paint the evening away with your friends from

CUSR as we head out to Pottery Place. CUSRwill pay for your paint, studio time, and one pieceof pottery. Just bring your creativity!

GOALS: To increase artistic expression andsocial skills.

Date Program ID Transportation IDDecember 14 242525-A1 242525-T1

Day: FridayTime: 6:30-8pmLocation: Meet at Pottery PlaceFee (R/NR): $32/$48Min/Max: 6/24Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Winter Wonderland BallAges 18+Walking in a Winter Wonderlandjoin us as wecelebrate the holidays at our Winter WonderlandBall. Dinner will be served and the dance oorwill be open.

GOAL: To enhance socialization with peers.

Date Program ID Transportation IDDecember 1 242902-A1 242902-T1

Day: SaturdayTime: 6-9pm

Location: Hays Recreation CenterFee (R/NR): $25/$37.50Min/ Max: 4/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Timber Pointe OvernightAges 16-35

Were headed back to Timber Pointe Outdoor CenterThis falls trip will be a one-night cabin camping

trip with nature activities, arts & crafts, cooking, acampre, and more! Were happy to announce thatthis year we have increased our maximum numberof participants for this trip to ensure that everyone isable to attend.

Note: Please communicate any dietary restrictionsand additional special needs information to Hannahupon registering for this program.

GOALS: Increase self condence, improve ability tointeract with others and increase nature appreciation

Date Program IDNovember 3-4 243021-A1

Day & Time: Saturday 9:30am-Sunday 11:30amLocation: Meet at Hays CenterFee (R/NR): $89/$133.50Min/Max: 6/15Deadline: October 22


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Criteria for Participation

All Special Olympics athletes must have acurrent, completed Application for Participationin Illinois Special Olympics form on le with the

Athletics Coordinator at CUSR. This form hasfour sections:

1. Athlete Information

2. Parent / Guardian Authorization & MedicalAuthorization

3. Health Insurance and Emergency Information

4. Medical Clearance *(Must be completed by

Physician)Applications for Participation in Illinois SpecialOlympics are valid for 2 years based on theearliest signed date on the medical applicationform. Anyone interested in participating, startinga new sport, or volunteering, please contact:Hannah Sheets, CUSR Athletics Coordinator at217-239-1152.

Special Olympics

Lady Mustang Basketball

Ages 13+Lady Mustang team basketball practice will beginon December 4. Registration and a valid SpecialOlympics Medical Application must be on le atthe CUSR ofce by December 4th for all femalebasketball athletes. Teams will play a minimum ofthree games before Special Olympic competitionin March.

GOALS: To increase overall physical tness, gainknowledge of individual basketball skills and teamstrategy, and improve team cooperation skills.

Date Time Program IDDecember 4-March 17* 6-7:30pm 232808-A1

*No program December 25 and January 1

Day: TuesdayLocation: Brookens GymFee (R/NR): $59/$88.50Min/Max: 7/15Deadline: December 11Door-to-Door Transportation Fee: $110Transportation ID: 232808-T1

Mustang

BasketballAges 13+

Mustang team basketball practice will begin onNovember 6. Registration and a valid SpecialOlympics Medical Application must be on le at

the CUSR ofce by November 6th for all malebasketball athletes. Teams will play a minimum ofthree games before the Special Olympics districtcompetition in January. Any teams that qualifyfor the Special Olympics state tournament willcontinue practicing after January 15.

GOALS: To increase overall physical tness, gainknowledge of individual basketball skills and teamstrategy, and improve team cooperation skills.

Date Time Program IDNovember 6-January 15* 6-7:30pm 222815-A1

*No program December 25 and January 1

Day: TuesdayLocation: Brookens GymFee (R/NR): $59/$88.50Min/Max: 7/20Deadline: November 13Door-to-Door Transportation Fee: $110Transportation ID: 222815-T1

Special Olympics Illinois provides year around sportstraining in a variety of Olympic-type sports for youth,teens and adults with intellectual disabilities who are8 years of age or older. CUSR supports the mission ofSpecial Olympics Illinois through participation in the

following sports:

* Volleyball* Basketball* Basketball Skills

* Aquatics* Power Lifting* Bocce

* Track & Field* Softball* Bowling

Important

Special Olympic Dates

September 8-9 State Softball Tournament,Decatur

September 15 Volleyball Qualier,LaSalle

October 13 Sectional Bowling, PeoriaOctober 27-28 Fall Games, RockfordDecember 1 State Bowling, PeoriaDecember 29 Holiday Classic, Bloomington


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AthleticsMartial Arts(formerly Taekwondo)Ages 16-35

Come experience the art ofTaekwondo and gain overallexposure to the martial arts. CUSRhas partnered with Tina and JeffNewberry of Leaders for Life/Newberrys Martial Artsin order to provide a comprehensive curriculum. Thisclass will be taught by instructors who have years ofexperience teaching martial arts to individuals withand without disabilities. This program will offer abalanced physical and mental workout.NOTE: A uniform is required to participate.The fee does not include a uniform. The cost for auniform is $45 payable to Leaders for Life Martial ArtUniform sizes will be determined at the rst class and

you will receive your uniform at the second class.Promotion tests (at an additional cost) are optional,but recommended.

I am passionate about providing an atmospherewhere children and adults will never be made fun of ocriticized ... a place where everyone will be made tofeel like champions.


GOALS: To increase concentration and balance, andimprove coordination, gross motor skills, endurance,exibility, and balance. It will also focus on self-

condence and self-defense.


Time: 6-6:45pmLocation: Stephens Family YMCA, 2501 Fields SoutDrive, Champaign located off Windsor Rd, over thebridge at I-57. Classroom 118.Fee (R/NR): $161/$241.50Min/Max: 4/12Deadline: September 7

Aquafun & FitnessAges 15+

Splish-splash were gettin t in a ash! At

Aquafun & Fitness well use foam water weightsand noodles to get a great workout in the warmwater therapy pool. Come try CUSRs rstwater exercise class. The warm water will feelso good, you wont even know youre getting aworkout!

GOALS: To increase gross motor coordinationand strength, and improve balance andmobility.

Date Program IDSeptember 10-October 22 232810-A1

October 29-December 17 232810-A2

*No program November 12

Day: MondayTime: 5:45-6:30pmLocation: Stephens Family YMCAFee (R/NR): $47/$70.50Min/Max: 4/8Deadline: September 3

Sign up for both sessions for $90/$135!

Swim LessonsThanks to our cooperative programagreement, swim lessons are now heldat the Stephens Family YMCA. Pleasecheck out their brochure or call217-359-9622 for more information.


Available

New!


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Teen PinsAges 13-21

Bring your friends to the bowling alley for somefun. Perfect your skills while socializing with yourfriends and meeting new ones. Participants willbe assigned to lanes and can bowl up to two

games. Note: Participants arriving late will bowl 2games or as long as time allows.

GOALS: To improve social skills and ability tointeract with others, learn and practice bowlingetiquette, and increase gross motor coordination.

Date Day Program IDSeptember 17-December 3 Mon. 232605-A1September 19-December 5 Wed. 232605-A2

*No program November 12 and November 21

Time: 4-5pmLocation: Western BowlFee (R/NR): $76/$114Min/Max: 4/25Deadline: September 24Home-Only Transportation Fee: $65Transportation ID: 232605-T1; 232605-T2

Strikes & SparesAges 21+

Bring your friends to the bowling alley for somefun. Perfect your skills while socializing with yourfriends and meeting new ones. Participants will beassigned to lanes and can bowl up to two games.Note: Participants arriving late will bowl 2 gamesor as long as time allows.

GOALS: To improve social skills and ability tointeract with others, learn and practice bowlingetiquette, and increase gross motor coordination.

Date Day Program IDSeptember 17-December 3 Mon. 222802-A1

September 19-December 5 Wed. 222802-A2*No program November 12 and November 21

Time: 4-5pmLocation: Western BowlFee (R/NR): $76/$114Min/Max: 4/25Deadline: September 24Home-Only Transportation Fee: $65Transportation ID: 222802-T1; 222802-T2

Frunner ClubAges 15+

Returning and new runners of all paces are welcomefor our fall session of Frunner Club. Training partnerswill work with you at your own pace. Enjoy the fallweather and get some exercise by training for a 5Krace in November. Please wear shoes with propersupport and weather appropriate clothing.

*Please note that the fall frunner days have changedto Sundays and Thursdays this year.

GOALS: To improve cardiovascular tness and abilityto interact with others, and increase self condence.

Date Program IDSeptember 13-November 18 242805-A1

Day & Time: Sunday: 4-5pm;Thursday: 5:30-6:30pm

Location: Sunday: Dexter Field parking lotThursday: Pavilion at Hessel Park

Fee (R/NR): $51/$76.50Min/Max: 4/10Deadline: September 7


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18

Anna FairbairnKasey BoegerRicky Waller

Allie LindemanErica VolkmannEmma HurleyLynnsey Browneld

Aimee PulsGabby Fairbairn

Allie LindemannChris HayekStephanie Reiss

AmandaMergenthalerSara AndersonChris BillingsBrittany Davidson

Ashley RobertsonBrandy RossTaylor WernsingShelbie KearfottJessica McKinnonJack MoserTara Robertson

Terrenia KentMiranda TerryAnne SheaAnne McNamaraNandi TenseRoxanne BakerYvonne FisherCourtney BrokampChelsea HartRachael Higgins

Athletics

Fitness FrenzyAges 15+

Need some extra motivation to get t? Try

exercising with a friend! Participants will bepaired with a CUSR staff who will exercise withthem for an hour, twice a week, for 8 weeks.Workouts will be planned to meet participantsindividual tness goals, and can be scheduledwhen it is convenient for both partners. Formore information on registration, please contactHannah Sheets.

GOALS: To increase gross motor coordinationand physical tness, and gain knowledge of

proper tness techniques.

Date Program IDOctober 8-December 9 232809-A1

*No program week of November 19-25

Location: TBDFee (R/NR): $213/$319.50Deadline: September 21

Thank You to

Our Support Staff!Catherine WilkieTricia LauterTaylor BatesGary ZimmermanJustin Green

Ashley BordeauxTaiesha StroudKaitlyn McKinnon

Alex AndersonAriana DymerskiAramis Kent

Kaley BarakHannah JacobsMolly ThinnesSarah MoeMara HamptonLisa StiversonSarah Prendergast

Ashley SoukShalonda PelmoreNatasha NussDonald JamesBrian BolesMary ORouke

Katelyn MyracleElizabeth HultEmma GibbensShelbie SumnerLeeann Smith

Alyssa WrightKatherine ConnorEmily GelberJanet SlaterKimberly Litcheld


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PARTICIPANT NAME

ADDRESS PHONE (H)

PHONE (W)

CITY ZIP

BIRTHDATE AGE SEX SHIRT SIZE

PRIMARY DISABILITY

PARENT/GUARDIAN PHONE (H) PHONE (C)

EMERGENCY NAME PHONE (H) PHONE (C)

DOCTORS NAME PHONE

PREFERRED HOSPITAL

ALL INFORMATION BELOW MUST BE COMPLETED FOR FORM TO BE PROCESSED.ANY FORM NOT COMPLETELY FILLED OUT WILL BE RETURNED TO PARTICIPANT.

MAIL CUSR 1311 W. Church St., Champaign, IL 61821FAX 217-373-7951 QUESTIONS: (phone) 217-239-1152 711 Relay

PROGRAM NAME CODE PICK UP POINT TRANSPORT CODE FEE

1.

2.

3.

4.

5.

Would you like to make a donation to the CUSR scholarship fund? $5.00 $10.00 Other

Fee Waiver/Scholarship applied for? ________ NO ________ YES (If yes, please attach)

CUSR may use pictures and videos taken at programs for publicity purposes. Is this okay? __________ Yes __________ No

List Medications:

List Allergies:

List Dietary Restrictions:

List Special Needs/Assistance Necessary:

Please circle all that apply: Wheelchair: manual/electric Nonverbal Sign Lanuage Close Supervision

Seizures Cane/Walker Atlantoaxial Subluxation Condition

Participants name

Participants signature* Date* (18 YEARS/OLDER OR PARENT/GUARDIAN)* Participation can be denied if the signature of adult participant or parent/guardian and date are not on this waiver.Please call 239-1152, if you require special accommodations.

See back of form for credit card payment information


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PLEASE SEE FRONT SIDE FOR WAIVER. THE WAIVER MUST BE SIGNED BEFORE YOUR REGISTRATION MAY BE PROCESSED.Please make checks payable to CUSR. Complete below when using VISA/MasterCard

Account Number

3-4 Digit CCID# (on back of card) Expiration Date

Authorized Signature Charge Amount

Important information

CUSR is committed to conducting its recre-ation programs and activities in a safe mannerand holds the safety of participants in high re-gard. CUSR continually strives to reduce suchrisks and insists that all participants followsafety rules and instructions that are designedto protect the participants safety. However,

participants and parents/guardians of minorsregistering for the CUSR programs/activitiesmust recognize that there is an inherent riskof injury when choosing to participate in rec-reational activities/ programs. You are solelyresponsible for determining if you or your mi-nor child/ward are physically t and/or skilledfor the activities contemplated by this agree-ment. It is always advisable, especially if theparticipant is pregnant, disabled in any way, orrecently suffered illness, injury, or impairment,

to consult a physician before undertaking anyphysical activity.

Warning of riskRecreational activities/programs are intendedto challenge and engage the physical, mentaland emotional resources of each participant.Despite careful and proper preparation, in-struction, medical advice, conditioning andequipment, there is still a risk of serious injurywhen participating in any recreational activ-

ity/program. Understandably, not all hazardsand dangers can be foreseen. Depending onthe particular activity, participants must under-stand that certain risks, dangers and injuriesdue to inclement weather, slipping, falling,poor skill level or conditioning, carelessness,horseplay, unsportsmanlike conduct, premisesdefects, inadequate or defective equipment,inadequate supervision, instruction or ofci-ating, and all other circumstances inherent

to indoor and outdoor recreational activities/programs exist. In this regard, it must berecognized that it is impossible for CUSR toguarantee absolute safety.

Waiver and release of all claims and

assumption of riskPlease read this form carefully and be awarethat in signing up and participating in CUSRprograms/activities, you will be expressly as-suming the risk and legal liability and waivingand releasing all claims for injuries, damages orloss which you or your minor child/ward might

sustain as a result of participating in any and allactivities connected with and associated withsaid programs/activities (including transportatioservices/vehicle operation, when provided).

I recognize and acknowledge that there arecertain risks of physical injury to participants inthese programs/activities, and I voluntarily agreto assume the full risk of any and all injuries,damages or loss, regardless of severity, that myminor child/ward or I may sustain as a result of

said participation. I further agree to waive andrelinquish all claims I or my minor child/wardmay have (or accrue to me or my child/ward) asa result of participating in these program/activi-ties against CUSR and Champaign and UrbanaPark Districts, including their respected ofcialsofcers, employees, and volunteers (hereinaftecollectively referred as CUSR). I do herebyfully release and forever discharge CUSR fromany and all claims for injuries, damages, or loss

that my minor child/ward or I may have or whichmay accrue to me or my minor child/ward andarising out of, connected with, or in any way as-sociated with these programs/activities. I haveread and understand the above important infor-mation, warning of risk, assumption of risk andwaiver and release of all claims.


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Instructions for Completing the Application for Participation

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

ter 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 emer-

gency 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 athletes signature is unrecognizable (for example, if the athletes 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.


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Late Pick-Up PolicyIn order to be fair to our participants and programleaders, CUSR has enacted a late pick-up policy.The rst time a participant is not picked up within a 5minute grace period, a written warning will be handedout. For each minute following the grace period, afee of $1/per minute will be charged to the parent orguardian. Registration for other programs will not

be accepted until all outstanding late fees are paid.Thank you for helping us to respect others throughpunctual pick-ups.

Satisfaction GuaranteedCUSR constantly strives to provide participantswith high quality recreation programs, activities,and events. To encourage rst-time participation,as well as repeat participation, CUSR has a refundpolicy highlighted by a satisfaction guarantee.This special refund policy provides us with timelyfeedback about dissatisfaction regarding our

services. If you are not completely satised, tell us,and we will either invite you to repeat the class atno charge, allow you a credit that can be applied toanother program, or issue you a refund. A refundwill be granted if you were dissatised with theexperience due to circumstances under CUSRscontrol. If you are not satised, we kindly ask youto give us your input or ideas for improvement.Requests for the above mentioned options must bemade before the midpoint of the program or withintwo weeks of a single meeting activity. All refundrequests must be submitted on the SatisfactionRefund Request form and turned into CUSR. A $5

service charge will be deducted from all refunds.Satisfaction Guarantee does not apply to trips andspecial events with prepaid admissions and tickets.

Program Cancellation PolicyAll registration cancellations must be made at leastone week prior to the start of the program in order toreceive a full refund. For programs with cancellationdates listed, registration must be cancelled no laterthan the specied date to receive a full refund. Anyprogram cancellations after the one week deadlinewill receive NO refund. A $5 service charge will bededucted from all refunds.

Program ScholarshipsBecause some residents are unable to participatein recreation programs due to economic hardship,CUSR provides a scholarship policy to reduce certainfees and charges. Scholarship applications arenot guaranteed and are based on available funds,program registration, or choice of program location.

Early applications are given priority. Please apply 3-4weeks before the program start date. Applicationsare available at the CUSR ofce and can be mailedupon request. Need is the primary criteria upon whichscholarship applicants are considered. Scholarshipsare not available for transportation and specicallyidentied programs. For more information, call 217-239-1152. Payment plans available to all. ALLmonies owed must be paid prior to next seasonregistration accepted.

Inclement Weather PolicyIf inclement weather occurs, CUSR may still decide tohold programs. If the weather turns dangerous, CUSRwill call participants prior to the start of the programto cancel the program. If you are unsure whethera program will meet due to inclement weather, call

CUSR. Missed programs due to weather may bemade up the week after the end of the programseason. Credit is given for additional cancellations.

CUSR Information

Extreme Temperature PolicyHot temperatures (for outdoor programs) atprogram time: 100oF actual temperature; heat indexof 110oF or more constitutes cancelling programdue to unsafe conditions.

Cold temperatures (for all programs) at programtime: 2oF actual temperature; -30oF or below wind

chill constitutes cancelling program due to unsafeconditions.

Participant Expectations1. Participants need to wear appropriate attire for

program participation (i.e. for athletic/tnessprograms comfortable clothing and tennis shoesmust be worn). If you have questions aboutthe type of attire participants should wear for aparticular program, please contact our ofce.

2. Participants need to have clean, dry clothing.

3. No bowel/bladder problems upon arrival at thetransportation location or program. (If this is aconcern, extra clean clothing, clean-up suppliesand Depend garments (or similar items) must besent with the participant).

4. Participants need to pay attention to bodyodor and overall appearance (clean hair, face,teeth, hands, etc.). CUSR staff will also beconsistent in stressing personal hygiene whileparticipants are in our programs and will notreturn participants at the end of a program in anunclean manner.


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TransportationPolicy/Safety Procedures1. Transportation must be requested at least

48 hours prior to the program date. Iftransportation is requested with less than 48

hours from program date, there is no guaranteetransportation will be available.NO transportation request at the time of theprogram will be accepted.

2. A minimum of two participants must register fortransportation in order for it to run.

3. Transportation is provided from YOUR homeback to YOUR home. We will not pick up or drooff at any other sites.

4. CUSR staff will wait a maximum of5 minutespast your pickup time due to a demanding van

schedule. If you miss your pickup time, we willnot return to pick you up. It is your responsibilityto nd transportation to the program if you missyour pickup time.

5. CUSR transports in-district participants only.

6. Transportation will only be provided for thosewho sign up and pay for the service at thebeginning of the program. We will not providetransportation for anyone mid-season that is noton the transportation roster at the beginning ofthe program.

7. Persons unable to be in a house alone shouldhave someone meet the van at the designatedtime of return.

8. If needed, the CUSR driver will assistparticipants to and from their homes, butdriveways and walkways must be clear of debrisand obstacles.

9. All passengers must be sitting in seats orwheelchairs with belts securely fastened in thecorrect manner or the driver will not move thevehicle.

10. CUSR staff is responsible for determiningwhether or not a participant can be transportedsafely.

11. Persons riding in Amigo-type wheelchairs orstrollers must transfer into a vehicle seat and usa seat belt.

CUSR reserves the right to refuse to transportindividuals. These policies have been developed toensure safety of everyone riding in CUSR vehicles.

Behavior CodeCUSR promotes the concept of Equal Fun ForEveryone and strives to accomplish this beliefthrough our program goals. However, certain rulesare necessary to ensure everyones safety andenjoyment.

CUSR participants are expected to exhibitappropriate behavior at all times. The CUSRbehavior code states that participants shall showrespect to all participants and staff, refrain fromusing foul language, refrain from causing bodilyharm, and show respect to equipment, supplies,and facilities. Additional policies may be developedfor specic programs and camps.

DisciplineA caring, positive approach will be used regardingdiscipline. CUSR reserves the right to dismissparticipants. Each situation will be evaluated onits own merit.

InsuranceIndividual accident liability insurance is notprovided by CUSR.

Dishonored ChecksA $25 service charge will be assessed on allchecks returned by the bank for any reason.

CUSR Information

Emergency ContactsEmergency phone numbers may be used forreasons other than an actual emergency situation.If staff needs to communicate any unforeseenchange(s) of plans, transportation scheduleadjustments, etc., and neither parent/guarding canbe reached, the emergency contact is our onlysource to call. Please help us reduce any anxietycreated with these calls by letting your designatedemergency contact know that they may be calledfor other situations. Your assistance with this isappreciated.

Atlanto-Axial SubluxationIndividuals with Downs Syndrome are at risk ofhaving a condition known as Atlanto-Axial Sublux-ation. CUSR must have a doctors written note onle stating a participant is free of the instability ifhe/she wishes to participate in programs that maycause undue stress upon the neck. Please takethis into consideration when registering and informstaff if the condition is present.


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CUSR Picture RequestDo you have some great pictures of programs orevents? Please email them [email protected] or bring a CD to HaysRecreation Center.

Follow us on FacebookTo stay connected to all the happenings, nd us onFacebook and see whats going on.

Program IdeasDo you want to try out a new food place? Have youwanted to see a play at Krannert? Let us know!


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Champaign-Urbana

Special Recreation

Hays Recreation Center1311 W. Church St.Champaign, IL 61821

PRSTD. STD.U.S. Postage

PAID

Permit No. 287Champaign, IL

www.cuspecialrecreation.com

[email protected]

Design-A-Program

CUSR is always looking for new ideas for programs. Perhaps you have an interest in something specialand would like to see if we can offer it. Please fill in this form and return it to: Champaign-Urbana SpecialRecreation, 1311 W. Church Street, Champaign, IL 61820. As a bonus, if a program you suggest becomes areality, you will be given the opportunity to attend that program FREE OF CHARGE for one season!

In the case of duplicate suggestions, names will be drawn to determine who receives the free program.

NameAddressCity Zip Phone

I would like to see the following program(s) offered:

1500

Documents

C-U Special Recreation Fall 2012