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C-U Special Recreation Summer 2013

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    Summer

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    CUSRGeneral InformationHays Recreation Center1311 W. Church St.Champaign, IL 61821Phone: 217-239-1152

    Fax: 217-373-7951711 RelayE-Mail: [email protected]: www.cuspecialrecreation.comOfce Hours: Mon-Fri, 8am-5pmOfce Closed: May 27, July 4, September 2

    Inclusive Programs

    Through 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 desiresCUSR 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 service

    at 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 recreationalopportunities for people with disabilities to

    focus 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 fullrange 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 toyour group about the Americans with Disabilities

    Act, Inclusion, and the future of special recreation.An overview of CUSRs mission, trends inrecreation and many other topics are availableto you with a simple phone call. Call the CUSRofce 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 enableparticipation 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...

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

    CUSR Staff

    Dawn Schaefer, MS, CTRS - DirectorHannah Sheets, MA, CTRS - Athletics CoordinatorJessica Brutti, CTRS - Adult CoordinatorLisa Morand, CTRS - Youth & Teen CoordinatorCindy McGrath - Receptionist

    Program Locations

    Champaign

    CUSR OfceHays Recreation Center / Eisner Park1311 W. Church St. 217-239-1152

    Dexter Field / Centennial ParkKenwood Rd.

    Jefferson Middle School1115 S. Crescent

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

    Leaders for Life Martial Arts2413 Village Green Pl.

    The Pottery Place

    1808 Round Barn Rd.

    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

    Urbana

    Brookens Gymnasium1776 E. Washington 217-344-9583

    Stone Creek Golf Course2600 S. Stone Creek Blvd.

    PesotumHealing Horses Stables378 County Road 700 E

    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 Hannah Sheets

    Early Childhood........................ 3Summer Camps ....................... 4Youth & Teen Programs ........... 5

    Adult Programs ........................ 6Special Events ....................... 12

    Adult Trips .............................. 15

    Special Olympics ................... 15Athletics ................................. 17Registration Form .................. 19Waiver and Release ............... 20Special Olympic Application ... 21CUSR Information .................. 23

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    2

    All residents of Champaign-Urbana are important to us! If you are new to the area, ChampaignUrbana Special Recreation invites you to come in and nd out what we have going on foryou and your family. Throughout the year, we provide a large variety of educational, social,

    recreational and sports activities for all ages and abilities. To learn more about what we haveto offer, give us a call at 217-239-1152 and we will be happy to explain any program or service.As a potential program participant, we would like to meet with you and your family!

    Welcome

    RegistrationA CUSR registration form must be used. Youmay register for CUSR programs at these locations:

    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, so

    does 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 who 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.

    MedicationAt times, participants may require assistance takingmedication during programs. If the participant is unato self-medicate or take the medication prior to or aftthe program, CUSR requires additional paperwork,and pre-packaged medication must be delivered to o

    ofce prior to the program.

    Certied Therapeutic

    Recreation Specialist (CTRS)The CUSR full-time program staff are all CertiedTherapeutic Recreation Specialists. This certicationdemonstrates that each of these individuals, througheducation, experience and passing a knowledge-basexamination, has met the minimum requirementsfor practice in therapeutic recreation. The national

    exam for Therapeutic Recreation Specialists isbased on knowledge from the National Job AnalysisStudy for Therapeutic Recreation which denes theimportant skills and knowledge necessary for minimucompetency in the therapeutic recreation practice.

    CUSR employs experienced professionals whounderstand the level of skill, both physical and mentaneeded to participate fully and safely in the programsthey plan. Therefore, CUSR reserves the right todetermine if a program is suitable for an individual.Staff may serve as a resource to suggest alternate

    programming.

    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.

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    www.cuspecialrecreation.com 3

    Early Childhood

    Strikes & SparesDerekAwtryKyleCasterGeorgeDeamontRyanGatzaEricLangenfeld

    JordanPfeifer

    Adult ProgramsAlexBolinJonCerquaChrisDeamontEricLangenfeldAndyLuckmanJohnKieferChrisMulreedMichaelRigbyNicoleYoon

    Thank You toOur Volunteers!

    ItiswithgreatappreciationtoProfessorLarryEckerandProfessorPaulYoungatParklandCollegeintheGraphicDesignDepartmentthatCUSRishappytosharethenewCUSRLogo.ThewinningdesignwascreatedbyAmberWalters.AmberandherclassmatesinDesign122allcreatednewlogosforCUSR.Eachlogowaspresentedtostaffandthenwasputtoavotewithinavarietyofprogramsandmeetings.AmbersdesignwonthepollingandisnowthenewlogoforCUSRasfeaturedonourfront

    cover.CUSRthanksallthoseinvolvedinthecreationofthenewlogo!AndcongratulationsAmber,forthewinningdesign!

    Mustang AquaticsMadelineBucheitDaniellePapeJessicaThaisNicoleYoon

    Mustang BasketballMattEisenmengerJimGadburyGregGarlandDickMeentsDebbyRehn

    Mustang Power LiftingMacHodges

    Music Therapy

    will be back in the Fall!

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    Summer Camps

    For Kids Only Summer CampAges 6-12 yearsDate Program ID6/3-6/7 Full day 122301-A16/3-6/7 Half day 122301-A2

    6/10-6/14 Full day 122301-A36/10-6/14 Half day 122301-A4

    6/17-6/21 Full day 122301-A56/17-6/21 Half day 122301-A6

    6/24-6/28 Full day 122301-A76/24-6/28 Half day 122301-A8

    7/1-7/5* Full day 122301-A97/1-7/5* Half day 122301-B1

    7/8-7/12 Full day 122301-B27/8-7/12 Half day 122301-B3

    7/15-7/19 Full day 122301-B47/15-7/19 Half day 122301-B5

    7/22-7/26 Full day 122301-B67/22-7/26 Half day 122301-B7

    7/29-8/2 Full day 122301-B87/29-8/2 Half day 122301-B9

    No camp: July 4*Day: Monday-FridayTime: 7:30am-5:30pm Full day

    11:30am-5:30pm Half dayLocation: Spalding Recreation Center, ChampaignFee (R/NR): Full day - $131/$196.50

    Half day - $101/$151.50Max: 25Deadline: 2 weeks prior to start of sessionNO TRANSPORTATION

    Camp SpiritAges 13-High School Graduate

    Date Program ID6/3-6/7 Full day 132301-A16/3-6/7 Half day 132301-A2

    6/10-6/14 Full day 132301-A36/10-6/14 Half day 132301-A4

    6/17-6/21 Full day 132301-A56/17-6/21 Half day 132301-A6

    6/24-6/28 Full day 132301-A76/24-6/28 Half day 132301-A8

    7/1-7/5* Full day 132301-A97/1-7/5* Half day 132301-B1

    7/8-7/12 Full day 132301-B27/8-7/12 Half day 132301-B3

    7/15-7/19 Full day 132301-B47/15-7/19 Half day 132301-B5

    7/22-7/26 Full day 132301-B67/22-7/26 Half day 132301-B7

    7/29-8/2 Full day 132301-B87/29-8/2 Half day 132301-B9

    No camp: July 4*Day: Monday-FridayTime: 7:30am-5:30pm Full day

    11:30am-5:30pm Half day

    Location: Jefferson Middle School, ChampaignFee (R/NR): Full day - $131/$196.50Half day - $101/$151.50

    Max: 25Deadline: 2 weeks prior to start of sessionNO TRANSPORTATION

    Come join the camp fun for 2013! Old friendsand new friends alike make for a great summer.

    At camp, there will be games, crafts, sports,cooking, swimming, eld trips and many more funtimes! CUSR camps offer a safe and structured

    environment to explore, expand and enjoy.Both camps are staffed with well-trained, outgoingindividuals waiting to make this summer the besttime ever. A 1:4 staff to camper ratio is maintainedas much as possible. CUSR camps are open toany individual who has an IEP.

    GOALS: Learn new skills, increaseindependence, increase peer interaction,socialization, motor functioning and development,and community awareness.

    Payment Information for Summer Camps

    We understand that it may be difcult to pay allcosts up front. Because of this, we require a

    $10 non-refundable deposit per child per sessionto hold a spot. The remainder will be due twoweeks before camp begins.

    Single day morning option will be availablebased on Summer School schedules.

    Please call the ofce for more information.

    NewLoocation

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    Youth & Teen

    Martial ArtsAges 16-35

    Come learn and experience theart of Taekwondo and also gainoverall exposure to the martial arts.CUSR has partnered with Tinaand Jeff Newberry of Leaders forLife/Newberrys Martial Arts in order to provide acomprehensive curriculum. This class will be taughtby instructors who have years of experience teachingmartial arts to individuals with and without disabilities.This program will offer a balanced physical andmental workout. NOTE:*A uniform is required toparticipate. The fee does not include a uniform. The

    cost for a uniform is $45.00 payable to Leaders forLife Martial Arts. Promotion tests are optional (thereis an additional cost), but recommended. Uniformsizes will be determined at the rst class.

    I am passionate about providing an atmospherewhere children and adults will never be made fun ofor criticized ... a place where everyone will be madeto feel like champions.

    Master Tina Newberry

    GOALS: Increase in concentration and balance andimproved coordination, gross motor skills, endurance

    and exibility. The program will also focus on self-condence and self-defense.

    Date Time Program IDMay 8- August 28 5:45-6:30pm 122809-A1

    No program: May 29Day: WednesdayLocation: Leaders for Life Martial ArtsFee (R/NR): $161/$241.50Min/Max: 4/20Deadline: May 3NO TRANSPORTATION

    Scholarships & PaymentPlans Available

    Therapeutic

    Horseback RidingAges 5-35

    Have you ever dreamed ofor been interested in ridinghorses past a mere pony ride?If you answered yes, then thisprogram is for you! At HealingHorses Stables you will learn riding skills throughan hour long lesson including various exercisesand activities from a P.A.T.H. (Professional

    Association of Therapeutic Horsemanship)certied instructor. You will also have a groundlesson where you will learn how to groom andsaddle a horse.NOTE: Closed-toed gym shoes are required andno high heels. Due to safety concerns you will

    not be able to participate in improper footwear.Cowboy boots are welcome! Long pants arehighly recommended to avoid rubbing on the legsfrom the saddle and horse. **There is a weightlimit of 250 lbs.

    GOALS: Increase in concentration and balance,improved coordination, gross motor skills,improve overall orientation and body awareness,muscle tone, posture, exibility, increase ofknowledge about horses and riding, improvedemotional well-being and forming a connectionwith a non-judgmental being.

    Date Program ID Transportation ID

    July 13-Aug. 17 132511-A1 132511-T1

    Day: SaturdayTime: 10am-12pmLocation: Healing Horses Stables, PesotumFee (R/NR): $181/$271.50Min/Max: 4/8Deadline: July 8Transportation: Meet at the Hays RecreationCenter at 9:15am and pick-up at the Hays

    Recreation Center at 12:40pm or meet at thestables by 9:45am and be picked up from stablesat 12pmDoor-to-Door Transportation Fee: $60

    New!

    Find us on Facebook and stay connectedChampaign-Urbana Special Recreation

    Please share your email with us.Find the line on the registration form.

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    Youth & TeenSpecial Events

    Back to School BashAges 10-18

    No one likes when summer comes to an end.Come kick off your school year at this backto school bash where you will enjoy karaoke,dancing, music and snacks.

    GOALS: Increase socialization and peerinteraction in a fun and safe atmosphere.

    Date Time Program ID

    August 27 2-4pm 122402-A1Day: TuesdayLocation: Hays Recreation CenterFee (R/NR): $6/$9Min/Max: 6/20Deadline:August 22NO TRANSPORTATION

    Pottery PlaceAges 12-16

    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 useyour creativity. CUSR will pay for your paint,studio time, and a limit of $12 for a piece ofpottery.

    GOALS: Increase independence, enhancecreativity, improve ne motor skills.

    Date Time Program IDAugust 15 1:30-2:45pm 132512-A1

    Day: ThursdayLocation: Pottery PlaceFee (R/NR): $32/$48Min/Max: 6/12Deadline:August 9Transportation: Drop off at 1:30pm at PotteryPlace and pick-up at 2:45pm at Pottery Place

    Adults ~ Monday

    Jumpin at JupitersAges 18+

    Have you and your friends been looking for a night

    where you can play some pool, enjoy arcade games,and win some prizes? If you have, meet us at Jupiterat the Crossing for a night of that and much more.CUSR will pay for one game of pool. Please bringmoney for food and arcade games.

    GOALS: Increase money management skills andenhance social skills with peers and communitymembers.

    Date Program ID Transportation IDMay 13 143501-A1 143501-T1June 10 143501-A2 143501-T2

    July 8 143501-A3 143501-T3August 12 143501-A4 143501-T4

    Day: MondayTime: 7-9pmLocation: Meet at Jupiters at the CrossingFee (R/NR): $17/$25.50Min/Max: 4/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

    Pin-ItAges 18+

    Join the latest Pinterest craze as CUSR brings someof the creations on the website to real life. Someprojects that we will be making are picture frames,

    jewelry racks, crayon art on an easel, and much morWe will do the pinning you just have to bring yourcreativity!

    Date Program ID Transportation IDMay 20 143505-A1 143505-T1

    June 24 143505-A2 143505-T2July 29 143505-A3 143505-T3

    August 26 143505-A4 143505-T4

    Day: MondayTime: 6-7:30pmLocation: Hays Recreation CenterFee (R/NR): $13/$19.50Min/Max: 4/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

    New!

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    Computers 101Ages 16+

    Microsoft Word, Access, Excel, emaildoesthis all sound confusing to you? Would youlike to learn more? Then come on over andlearn how its done. Please register for onesession per date. New learners take priority in

    registration.

    GOALS: Enhance fne motor skills and

    increase computer knowledge.

    Date Program ID Sess 1 Sess 2May 13 132604 A1 A2June 10 132604 A3 A4July 8 132604 A5 A6

    August 12 132604 A7 A8

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

    Session 2: 4:30-5pmLocation: Hays Recreation CenterFee (R/NR): $7/$10.50Min/Max: 1/3Deadline: 1 week prior to programNO TRANSPORTATION

    Cookin Across the WorldAges 18+

    Measure, chop, stir and cook! Join us as we preparerecipes from across the world. We will have themeddinners where we will be learning about differentcultures and how they prepare their meals. Somethemes will be Italian, Mexican, and Chinese.

    You will receive a recipe book of the meals weprepared to try at home.

    GOALS: Enhance cultural awareness, develop

    appropriate dining etiquette, and improve cooking skills.

    Date Program ID Transportation IDMay 6 142533-A1 142533-T1June 3 142533-A2 142533-T2July 1 142533-A3 142533-T3

    August 5 142533-A4 142533-T4

    Day: Monday

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

    ChampaignMusic Festival

    Grab your friends and family and be

    sure to come out to Champaign Park

    Districts Music Festival on July 20th

    from 7pm to midnight in Downtown

    Champaign.Be sure to check it out!

    MARK YOUR CALENDAR!

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    Adults ~ Wednesday

    Martial ArtsAges 16-35

    Come learn and experiencethe art of Taekwondo andalso gain overall exposureto the martial arts. CUSRhas partnered with Tinaand 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 $45.00 payable to Leaders forLife Martial Arts. Promotion tests are optional(there is an additional cost), but recommended.Uniform sizes will be determined at the rstclass.

    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: Increase in concentration and balanceand improved coordination, gross motor skills,endurance and exibility. The program will alsofocus on self-condence and self-defense.

    Date Time Program IDMay 8- August 28 5:45-6:30pm 122809-A1

    No program: May 29Day: WednesdayLocation: Leaders for Life Martial ArtsFee (R/NR): $161/$241.50

    Min/Max: 4/20Deadline: May 3NO TRANSPORTATION

    Scholarships & PaymentPlans Available

    Dancing in DecaturAges 21+

    CUSR will be venturing out to enjoy an evening ofdancing and snacks at the Knights of Columbusin Decatur, Illinois. Join us as we dance the nightaway and of course meet new friends. Admission isincluded; you just need to bring your dancing shoes!

    GOALS: Enhance socialization with peers, meet newpeople.

    Date Program ID Transportation IDMay 1 143001-A1 143001-T1

    June 5 143001-A2 143001-T2August 7 143001-A3 143001-T3

    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

    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.

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    Adults ~ Thursday

    Diners ClubAges 18+

    Join us as we go out to different restaurants for dinner.

    CUSR will be picking up your dinner tab! At DinersClub you will be able to socialize with your friends andenjoy a GREAT dinner.

    GOALS: Enhance socialization with peers, increasemoney management skills, and dining etiquette.

    Date Restaurant Program IDMay 9 Monicals (Mattis) 142505-A1June 13 Ruby Tuesdays 142505-A2July 11 Dos Reales (Prospect) 142505-A3

    August 8 Houlihans 142505-A4

    Day: ThursdayTime: 6:30-8pmLocation: 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 programTransportation ID:142505-T1; T2; T3; T4Door-to-Door Transportation Fee: $10 each; $40 allfour

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

    Come one, come all for a night of Bingo! Youwill enjoy hanging out and socializing with your

    friends and may even win some prizes!

    GOALS: Enhance socialization with peers,turn-taking skills.

    Date Program ID Transportation IDJune 27 132509-A1 132509-T1

    August 15 132509-A2 132509-T2

    Day: ThursdayTime: 6:30-7:30pmLocation: Hays Recreation CenterFee (R/NR): $11/$16.50Min/Max: 6/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

    Hays HangoutAges 18+

    Fill the evening with a night of cards, Wii, boardgames and more. At Hays Hangout you will do

    just that and socialize with all of your friendsfrom CUSR. Snacks are included.

    GOALS: Enhance socialization with peers andturn taking skills.

    Date Program ID Transportation IDMay 23 122510-A1 122510-T1July 25 122510-A2 122510-T2

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

    Please share your email with us.Find the line on the registration form.

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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. Lots of musicto choose fromits sure going to be a goodtime.

    GOALS: Increase socialization skills and turn-taking skills.

    Date Program ID Transportation IDMay 10 142535-A1 142535-T1July 12 142535-A2 142535-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

    AdultsDay Programs

    Luncheon BunchAges High School Graduate-35

    Whats for lunch today? Join us as we head out andexperience different restaurants around town. CUSRwill pick up your tab for lunch, you just have to join

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

    Date Location Program ID

    May 8 Zas (Springfeld) 143402-A1June 12 Rainbow Garden (Urbana) 143402-A2July 10 Monicals (Mattis) 143402-A3August 21 El Toro (Springfeld) 143402-A4

    Day: WednesdayTime: 11:30am-1pmLocation: Meet at the restaurantFee (R/NR): $16/ $24 per session$51/ $76.50 all 4 sessionsMin/Max: 6/12Deadline: One week prior to programNO TRANSPORTATION

    Movie NightAges 18+

    Bring your inner critic out! Join us as we

    choose movies to watch at the Hays Center,or feel free to bring your own movies fromhome to share with us! CUSR will providesnacks, you just need to be ready for someentertainment!

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

    Date Program ID Transportation IDMay 17 142534-A1 142534-T1June 21 142534-A2 142534-T2July 26 142534-A3 142534-T3

    August 16 142534-A4 142534-T4

    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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    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: Increase socialization among peers, increasemoney management skills and enhance community

    awareness.Date Location Program IDMay 10 Miniature Golf & Lunch 143403-A1June 7 Caterpillar Tour & Lunch 143403-A2July 12 Scrapbooking at Hays 143403-A3

    August 9 Illinois State Museum & 143403-A4Lunch

    Session 1: Miniature Golf & Lunch in Bloomington, ILDay: FridayTime: 10am-4pmLocation: Hays Recreation Center

    Fee (R/NR): $32/$48Min/Max: 6/12Transportation ID: 143403-T1Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

    Session 2: Caterpillar Tour & Lunch in Peoria, ILDay: FridayTime: 10am-5pmLocation: Hays Recreation CenterFee (R/NR): $39/$51.50Min/Max: 6/12

    Transportation ID: 143403-T2Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

    Session 3: Scrapbooking at the Hays CenterDay: FridayTime: 2-4pmLocation: Hays Recreation CenterFee (R/NR): $9/$13.50Min/Max: 6/12Deadline: 2 weeks prior to programNO TRANSPORTATION

    Session 4: Illinois State Museum & Lunch inSpringeld, ILDay: FridayTime: 10am-5pmLocation: Meet at the Hays Recreation CenterFee (R/NR): $22/$33Min/Max: 6/12Transportation ID: 143403-T4Deadline: 2 weeks prior to programDoor-to-Door Transportation Fee: $10

    Therapeutic

    Horseback RidingAges 5-35

    Have you ever dreamedof or been interested inriding horses past a mere

    pony ride? If you answeredyes, then this programis for you! At HealingHorses Stables you willlearn riding skills through an hour long lessonincluding various exercises and activities from aP.A.T.H. (Professional Association of TherapeuticHorsemanship) certied instructor. You will alsohave a ground lesson where you will learn how togroom and saddle a horse.NOTE: Closed-toed gym shoes are required andno high heels. Due to safety concerns you willnot be able to participate in improper footwear.Cowboy boots are welcome! Long pants arehighly recommended to avoid rubbing on the legsfrom the saddle and horse. **There is a weightlimit of 250 lbs.

    GOALS: Increase in concentration and balance,improved coordination, gross motor skills,improve overall orientation and body awareness,muscle tone, posture, exibility, increase ofknowledge about horses and riding, improvedemotional well-being and forming a connection

    with a non-judgmental being.

    Date Program ID Transportation ID

    July 13-Aug. 17 132511-A1 132511-T1

    Day: SaturdayTime: 10am-12pmLocation: Healing Horses Stables, PesotumFee (R/NR): $181/$271.50Min/Max: 4/8Deadline: July 8Transportation: Meet at the Hays RecreationCenter at 9:15am and pick-up at the Hays

    Recreation Center at 12:40pm or meet at thestables by 9:45am and be picked up from stablesat 12pmDoor-to-Door Transportation Fee: $60

    New!

    Find us on Facebook and stay connectedChampaign-Urbana Special Recreation

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    Dinner and

    Cosmic Bowling

    Ages 18+Looking for ways to ll your Saturday nights?CUSR staff will be picking the restaurant1-week prior to the program and then headingto Arrowhead Lanes for Cosmic Bowling.CUSR will be paying for your dinner and twogames of bowling. *NOTE: STROBE LIGHTSMAY CAUSE SEIZURE ACTIVITY.

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

    Date Program ID Transportation ID

    May 18 142510-A1 142510-T1

    Day: SaturdayTime: 7-10:30pmLocation: Meet at Hays Recreation CenterFee (R/NR): $39/$58.50Min/Max: 4/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

    Pottery Place

    Ages 18+Paint the evening away with your friends fromCUSR as we head out to Pottery Place. CUSRwill pay for your paint, studio time and one pieceof pottery. Just bring your creativity!

    GOALS: Increase artistic expression and socialskills.

    Date Program ID Transportation IDMay 31 142536-A1 142536-T1

    Day: Friday

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

    MaySpecial Events

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    CUSRs Got Talent!Ages 5+

    Have you been waiting for a chance to show offyour skills? Well now is the time. CUSR will be

    hosting their 3rd annual talent show! Whetheryou like to sing, dance, or show off anothertalent, CUSR wants to see it! From 1-1:45pm weask that all participants come and demonstrateto staff what they would like to do in the show.We will start the actual talent show at 2pm. Anyparents and guests of the performer are welcometo attend the show to cheer on the performers.

    GOALS: Express creativity and imagination,increase socialization.

    Date Program ID Transportation ID

    July 14 172506-A1 172506-T1

    Day: SundayTime: 1-3pmLocation: Hays Recreation CenterFee (R/NR): $10/$15Min/Max: 6/24Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

    JulySpecial Events

    Conklins Barn II Dinner TheatreAges 21+

    Out of Orderis the play we will be heading to see inGoodeld, IL. Before the play starts you will enjoya wonderful buffet dinner. Cost of meal and playincluded.

    GOALS: Enhance socialization with peers, culturalexperience.

    Date Program ID Transportation IDJune 2 143502-A1 143502-T1

    Day: SundayTime: 10:30am-5pmLocation: Meet at Hays Recreation CenterFee (R/NR): $57/$85.50Min/Max: 4/12Deadline: 2 weeks prior to programDoor-to-Door Transportation Fee: $10

    JuneSpecial Events

    ChampaignMusic Festival

    Grab your friends and family and be sure tocome out to Champaign Park Districts Music

    Festival on July 20th from7pm to midnight in Downtown Champaign.

    Be sure to check it out!

    MARK YOUR CALENDAR!

    Drive-In Movie

    in Gibson CityAges 18+Come out and enjoy a night with your friendsas we head to Gibson City to see a movie attheir local drive-in. There we will watch a movie,socialize with our friends and eat snacks. CUSRwill pay for the movie, please bring money forsnacks. Dont forget a chair or a blanket to sit onfor the movie.

    GOALS: Increase money management skills,increase socialization with peers.

    Date Program ID Transportation IDJune 20 133001-A1 133001-T1

    Day: ThursdayLocation: Meet at Hays Recreation CenterTime: 7:30-11:30pmDeadline: One week prior to programFee (R/NR): $20/$30Min/Max: 6/12Door-to-Door Transportation Fee: $10

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    Please share your email with us.Find the line on the registration form.

    Illinois State FairAges 18+

    Have you been looking for a little escape duringthe week? Join CUSR as we venture to Springeld,Illinois for an afternoon at the Illinois State Fair. Enjoyrides, eat snacks, and visit the attractions. CUSR will

    pay for your admission. Please bring money for foodrides and souvenirs. *Must be able to walk longdistances.

    GOALS: Increase money management skills,enhance socialization.

    Date Program ID Transportation IDAugust 14 143018-A1 143018-T1

    Day: WednesdayTime: 10am-4pmLocation: Meet at the Hays Recreation Center

    Fee (R/NR): $26/$39Min/Max: 6/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

    AugustSpecial Events

    End of Summer DanceAges 18+

    ATTENTION EVERYONE! Hollywood is coming

    to CUSR! This years theme for our End ofSummer Dance is Hollywood. Come dressed asyour favorite Hollywood stars, like the ones yousee on the red carpet. At this dance we will havedancing, music and snacks. CUSR will providethe snacks and music; you just have to bring yourdancing shoes!

    GOAL: Enhance socialization skills.

    Date Program ID Transportation IDAugust 23 132513-A1 132513-T1

    Day: Friday

    Time: 6-8pmLocation: Hays Recreation CenterFee (R/NR): $17/$25.50Min/Max: 6/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

    Ice Cream Social

    & GamesAges 16+

    Looking for ways to beat the summer heat? Joinus at the Hays Center for our Ice Cream Social.We will provide the ice cream, toppings andgames! Tell your friends about it!

    Date Program ID Transportation IDAugust 3 172505-A1 172505-T1

    Day: SaturdayTime: 6-8pm

    Location: Hays Recreation CenterFee (R/NR): $12/$18Min/ Max: 6/22Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

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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 Information2. Parent/Guardian Authorization & Medical

    Authorization3. Health Insurance and Emergency Information4. 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 OlympicsSpecial Olympics Illinois provides year-roundsports training in a variety of Olympic-type sportsfor youth, teens and adults with intellectualdisabilities who are 8 years of age or older.CUSR supports the mission of Special OlympicsIllinois through participation in the followingsports:

    Volleyball Basketball Basketball Skills Power Lifting Aquatics

    Bocce Track & Field Softball Bowling

    Important

    Special Olympic DatesMay 4 District Track Meet, ChampaignJune 14-16 State Summer Games,

    Bloomington-Normal

    July 27 District Softball, SpringeldAugust 25 Area Bowling, Champaign

    September 7 Area Volleyball, LaSalle

    Adult Trips

    Rockford OvernightAges 18+

    Come one, come all to Rockford, Illinois as weventure out to Magic Waters Water Park. There,we will be visiting their water park and doing a littleshopping. Admission, lodging and meals are includedin the fee, please bring money for souvenirs.*There is limited accessibility within this park.

    Date Program IDJune 29-30 143020-A1

    Day: Saturday-SundayTime: 8am Saturday-1pm SundayLocation: Meet at the Hays Recreation CenterFee (R/NR): $191/$286.50Min/ Max: 6/10Deadline: 6/3NO TRANSPORTATION to and from HaysRecreation Center

    Louisville, Kentucky3 nights/ 4 days

    Do you like baseball, horses, and adventure? If sostart saving now for our trip to Louisville, Kentucky forFall of 2013. There we will be visiting the KentuckyDerby Museum, Louisville Slugger Museum, theLouisville Mega Cavern and also their local ScienceCenter. Lodging, transportation, and meals areincluded in the fee. Please bring money for souvenirs.

    Dates Days Program IDOctober 6-9 Sunday-Wednesday 143021-A1

    Time: Leaving Hays Recreation Center at 9am onSunday. Returning at 2:30pm on Wednesday.Location: Must meet at the Hays Recreation CenterMin/Max: 6/10Fee (Res/NR): $750/$1125Deadline: rst payment of $375 must be paid byJuly 19NO TRANSPORTATION to and from HaysRecreation Center

    No Scholarships Available for Trips

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    Mustang Softball

    Ages 13+We want you to join our Mustang softballteam! Practices focus on the basic skills ofhitting, elding, throwing and sportsmanship.Participants need to have a valid SpecialOlympics Medical Application on le withCUSR. If more than 20 players register, askills assessment will take place at the rstpractice. Players will be placed on the Mustangcompetition team or Mustang recreational teambased on their skill assessment. Both teams willplay games against other area teams, howeverthe competition team will also compete at theSpecial Olympics district softball tournament inJuly.

    GOALS: Increase gross motor coordination andimprove team building and sportsmanship skills.

    Date Program ID Transportation IDMay 8-July 27 132802-A1 132802-T1

    Day: WednesdayTime: 5:30-7pm

    Location: Dexter FieldFee (R/NR): $46/$69Min/Max: 12/30Deadline: May 15Door-to-Door Transportation Fee: $120

    Please share your email with us.Find the line on the registration form.

    Special Olympics

    Mustang BowlingAges 21+

    Practice your bowling skills this summer and showthem off at competition. This session of Strikes andSpares will lead up to the Special Olympics Area

    Bowling competition in August. Bowlers need to bowa minimum of 15 games at CUSR practice by July 31to be eligible for competition. All participants need tohave a current Special Olympics Medical Applicationon le with CUSR.

    GOALS: Learn and practice bowling rules andetiquette, increase gross motor coordination, improvbowling and sportsmanship skills.

    Date Day Program IDMay 13-August 5* Monday 132702-A1May 15-August 7* Wednesday 132702-A2

    *No program May 27 & July 3

    Time: 4-5pmLocation: Western BowlFee (R/NR): $76/$114Min/Max: 4/25Deadline: May 8Transportation ID: 132702-T1, 132702-T2Home Only Transportation Fee: $65

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    Mustang VolleyballAges 13+

    Learn the basics of the game and improve your skillsby participating on CUSRs volleyball teams. Playerswill work on serving, bumping, setting, hitting andshowing off their sportsmanship skills at practice andat games against area teams. Participants need tohave a valid Special Olympics Medical Application onle with CUSR.

    GOALS: Increase gross motor coordination, improveteam cooperation skills and gain knowledge of rulesof the game and individual volleyball skills.

    Date Time Program IDJune 25-Sept 7 5:30-7pm 132811-A1

    Day: TuesdayLocation: Brookens GymFee (R/NR): $46/$69Min/Max: 8/24Deadline: June 18Transportation ID: 132811-T1Door-to-Door Transportation Fee: $120

    Mustang Teen BowlingAges 13-21

    Practice your bowling skills this summer and showthem off at competition. This session of Teen Pinswill lead up to the Special Olympics Area Bowlingcompetition in August. Bowlers need to complete a

    minimum of 15 games at CUSR practice by July 31to be eligible for competition. All participants need tohave a current Special Olympics Medical Applicationon le with CUSR.

    GOALS: Learn and practice bowling rules andetiquette, increase gross motor coordination, improvebowling and sportsmanship skills.

    Date Day Program IDMay 13-August 5* Monday 132603-A1May 15-August 7* Wednesday 132603-A2

    *No program May 27 & July 3

    Time: 4-5pmLocation: Western BowlFee (R/NR): $76/$114Min/Max: 4/12Deadline: May 8Transportation ID: 132603-T1, 132603-T2Home Only Transportation Fee: $60

    Athletics

    FitnessFrenzyAges 15+

    Need some extra motivation to get t? Tryexercising with a friend! Participants will bepaired with a CUSR staff who will exercisewith them for an hour, twice a week, for 8weeks. Workouts will be planned to meetparticipants individual tness goals, and canbe scheduled when it is convenient for bothpartners. For more information on registration,please contact Hannah Sheets.

    GOALS: Increase gross motor coordinationand physical tness, gain knowledge of proper

    tness techniques.Date Program IDJune 17-August 11 132812-A1

    Location: Savoy Recreation CenterFee (R/NR): $213/$319.50Deadline: June 1NO TRANSPORTATION

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    Athletics

    Fore! Sunshine Through GolfAges 12+Whether youre a regular on the course or have nevgolfed before, join us for driving practice! We will beworking with Tom Szymoniak, golf pro at Stone CreGolf Course. With his instruction youll be looking lika pro in no time!

    GOALS: Learn and practice proper technique forbasic golf skills and safety, increase gross motorcoordination.

    Date Time Program ID

    June 18-July 23* 4-5pm 122806-A1*No program July 2

    Day: TuesdayLocation: Stone Creek Golf Course, UrbanaFee (R/NR): $25/$37.50Min/Max: 4/12NO TRANSPORTATION

    Aqua Fun

    CUSR is taking the summer off from AquaFun. Please be sure to check it out again inthe Fall starting in September.

    WELL BE BACK!

    Martial ArtsAges 16-35

    Come learn and experiencethe art of Taekwondo andalso gain overall exposureto the martial arts. CUSRhas partnered with Tinaand 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 $45.00 payable to Leaders forLife Martial Arts. Promotion tests are optional(there is an additional cost), but recommended.Uniform sizes will be determined at the rstclass.

    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: Increase in concentration and balanceand improved coordination, gross motor skills,endurance and exibility. The program will alsofocus on self-condence and self-defense.

    Date Time Program IDMay 8- August 28 5:45-6:30pm 122809-A1

    No program: May 29Day: WednesdayLocation: Leaders for Life Martial ArtsFee (R/NR): $161/$241.50

    Min/Max: 4/20Deadline: May 3NO TRANSPORTATION

    Scholarships & PaymentPlans Available

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    PARTICIPANT NAME

    ADDRESS PHONE (H)

    PHONE (W)

    CITY ZIP

    BIRTHDATE AGE SEX SHIRT SIZE EMAIL

    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 notbe 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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    Transportation

    Policy/Safety Procedures1. Transportation must be requested at least

    48 hours prior to the program date. Iftransportation is requested with less than 48hours 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, certainrules are necessary to ensure everyones safetyand enjoyment.

    CUSR participants are expected to exhibitappropriate behavior at all times. The CUSRbehavior code states that participants shallshow respect to all participants and staff, refrainfrom using foul language, refrain from causing

    bodily harm, and show respect to equipment,supplies, and facilities. Additional policies maybe developed for specic programs and camps.

    DisciplineA caring, positive approach will be usedregarding discipline. CUSR reserves the rightto dismiss participants. Each situation will beevaluated on its 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 usedfor reasons other than an actual emergencysituation. If staff needs to communicate anyunforeseen change(s) of plans, transportationschedule adjustments, etc., and neither parent/guarding can be reached, the emergency contactis our only source to call. Please help us reduceany anxiety created with these calls by lettingyour designated emergency contact know thatthey may be called for other situations. Yourassistance with this is appreciated.

    Atlanto-Axial SubluxationIndividuals with Downs Syndrome are at risk ofhaving a condition known as Atlanto-Axial Sub-luxation. CUSR must have a doctors written noteon le stating a participant is free of the instabilityif he/she wishes to participate in programs thatmay cause undue stress upon the neck. Pleasetake this into consideration when registering andinform staff 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!

    Congratulations to

    for winning the

    ITRS Outstanding Program Award.

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    PRSTD. STD.

    U.S. Postage

    PAID

    Permit No. 287

    Champaign, IL

    www.cuspecialrecreation.com

    [email protected]

    600

    CUSR is always looking for new ideas for programs. Perhaps you have an interest in

    something special and would like to see if we can offer it. Please ll in this form and return it to:

    Champaign-Urbana Special Recreation, 1311 W. Church Street, Champaign, IL 61820.

    As a bonus, if a program you suggest becomes a reality, 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.

    NameAddress

    City Zip Phone

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

    Design-a-Program

    Hays Recreation Center1311 W. Church St.

    Champaign, IL 61821