c-u special recreation fall 2011

28

Upload: champaign-park-district

Post on 07-Apr-2018

219 views

Category:

Documents


0 download

TRANSCRIPT

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 1/28

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 2/28

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 3/28

 What’s Inside...

 Youth & Teen Programs.............3Adult Day Programs..................6Adult Programs..........................7Trips.........................................10Special Events.........................11Athletics...................................13Special Olympics.....................13Registration Form....................17

Waiver and Release................18Special Olympic Application....19Annual Information..................21CUSR Information...................23

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

CUSR Staff Dawn 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

ChampaignCUSR OfficeHays Recreation Center Eisner Park1311 W. Church St. 217-239-1152

Arrowhead Lanes1401 N. McKinley 217-352-5288

Jupiter’s at the Crossing2511 Village Green Pl. 217-366-8300

Mettler Athletics1809 Neil St. 217-398-9800

Springer Cultural Center 301 N. Randolph 217-398-2376

Spalding Recreation Center 910 N. Harris 217-398-2577

Stratton Elementary School902 Randolph 217-373-7330

Western Bowl917 Francis Dr. 217-359-1678

UrbanaBrookens Gymnasium1776 E. Washington 217-344-9583

Anita Purves Nature Center 1505 N. Broadway 217-384-4062

Phillips Recreation Center 505 W. Stoughton 217-367-1544

Urbana Indoor Aquatic Center 102 E. Michigan 217-384-7665

Find us on Facebook and stay connectedChampaign Urbana Special Recreation

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 4/28

2

All residents of Champaign-Urbana are importantto us! If you are new to the area, Champaign-Urbana Special Recreation invites you to comein and nd out what we have going on for youand other members of your family. Throughoutthe year, we provide a large variety of social,

recreational, cultural and sports activities for allages and abilities. To learn more about what wehave to offer, give us a call at 217-239-1152. Wewill be happy to explain any program or servicethat is of interest to you. As a potential programparticipant, we would like to meet with you andyour family!

 Welcome

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

Hays Recreation Center 1311 West Church Street, Champaign

Bresnan Meeting Center 706 Kenwood Road, Champaign

Douglass Community Center 512 E. Grove Street, Champaign

Leonhard Recreation Center 2212 W. Sangamon Drive, Champaign

Springer Cultural Center 301 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 CUSR ofce, through mail, and byfax (217-373-7951). When faxing, please includecredit card information so we may process theregistration. Coordinators and program leadersMAY NOT receive payment or registration formsat programs. CUSR does not prorate for lateregistration. Exceptions may be made for peoplewho 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.

Thank you to our support staff!

Morgan Allison Sara AndersonShaniquia Anderson Simon AndersonTaylor Bates Chris BillingsJoel Blanco Kelsey BighamKasey Boeger Molly Cinker Brittany Davidson Anna Fairbairn

Lynnsey Fisher Alexi FlorianEric Garcia Amy GilbertChris Hayek Colleen Hester Justin Jenkins Terrenia KentChevella LeShoure Allie LindemannKarin Mathis Jessica McKinnonJeremy Menefee Mitch MrazCatherine Peuvion Joe Pryor Aimee Puls Stephaine ReissAshley Robertson Tara RobertsonMike Rumbaugh Kristin SchmidtAnne Shea Karen Shelton

Erika Spanhook Shruti SuryaShannon Van Antwerp Erica Volkmann

Ricky Waller Dominique Williams

CUSR Inclusion Staff 

  Desmond Allen Brooke Beck 

Lamar Brown Lyndsey Curry

Emma Gibbens Yesenia Gonzalez

Emma Hurley Kelsey Katz

Aramis Kent Kimberly Litchfield

Rhea Matar Tricia MaybaumGracie Mayer Claire McTaggart

Missy Melvin Lauren Oliger 

Ashley Robertson Arlin Sangster 

Katie Sapp Janet Slater 

Ashley Souk Marcie Lynn Stout

Catherine Street Brandon Summers

Margaret Walterhausen

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

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 5/28

www.cuspecialrecreation.com 3

After School ProgramAges 5-High School GraduateCome join your friends for an afternoon lled withgames, sports, arts and crafts, cooking, and eld trips.We will offer an amazing and safe atmosphere where

we will laugh, play, learn, and grow.GOALS: Improve verbal and social skills, build new friendships and gain self-confidence and independence. Increase knowledge of leisureactivities and encourage peer interaction.

Date Time Program IDSeptember 6, 2011- 2:30-5:30pm  232104-B1December 16 (resumes January 5)

Day: Monday-FridayLocation: Spalding Recreation Center Fee (R/NR): $190/$285 monthly

Min/Max: 8/15Deadline: One week prior to the month starting*There will be no program:October 10 & 28November 11, 24-25December 19-January 4, 2012January 16February 20March 16, 19-23April 6 & 27

Note: dependant on registration, the group may

be split by age with one group hosted at the HaysRecreation Center.

Fun ClubAges 12-19

During Fun Club participants will play activesports and games. Activities are planned toengage participants in physical activity and utilizetheir energy in a productive way. We will alsointeract with our peers while winding down fromour physical activity. We will explore variousactivities, arts, crafts, and cooking.

GOALS: Increase attention to activity and ability 

to follow direction, increase physical activity and fitness, increase participation in new leisureactivities, increase self confidence and ability toexpress creativity through projects.

Date Time Program IDSeptember 24 10am-12pm 232607-A1October 22 10am-12pm 232607-A2November 19 10am-12pm 232607-A3December 3  10am-12pm 232607-A4

Day: Saturday

Location: Hays Recreation Center Fee (R/NR): $26/$39Min/Max: 6/15Deadline: One week prior to program

 Youth & Teens

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 6/28

4

 Youth & TeenSpecial Events

New!

 Youth & Teens

New!

Snack AttackAges 7-18

Don’t miss out on this edible adventure! Join us aswe work together to create some fun and yummy

snacks. We will learn kitchen safety, the basics of measuring, and kitchen etiquette all while havingfun!

GOALS: Learn the basics of cooking, kitchensafety, create a recipe book of easy snacks tomake, and increase social interaction with peers.

Date Time Program IDSeptember 12 6-7pm 232608-A1October 10 6-7pm 232608-A2November 14 6-7pm 232608-A3December 12 6-7pm 232608-A4

Day: MondayLocation: Hays Recreation Center Fee (R/NR): $26/$39Min/Max: 4/10Deadline: One week prior to program

Spurlock MuseumAges 6-12

Come join us at WorldFest. This is an eventwhere performers will present a variety of culturalperformances from around the world. AfricanDrumming and Southeast Asian dancing are acouple that will be featured. There will also be acraft related to one of the cultures.

GOALS: Increase socialization, increaseknowledge of historical artifacts and information,and improve listening skills.

Date Time Program IDSeptember 10 1-3pm 222403-A1

Day: SaturdayLocation: Spurlock MuseumFee (R/NR): $10/$15Min/Max: 6/12Deadline: September 2

Drop off at Spurlock Museum at 1pm andPick-up at Spurlock Museum at 3pm.

There is no transportation to this event due toparking limitations with the bus.

Curtis Apple OrchardAges 6-12

Come join your friends as we get lost in the orchardand pick our own apples! There will be a variety of apples to choose from; Jonathan, Golden Delicious,Red Delicious, Red Fuji and more. Apples rangefrom very sweet to tart so there will sure be anapple for your taste bud! Please bring money if youwould like additional items from their Country Store.

GOALS: Increase independence and decisionmaking skills, increase socialization, and exploreour senses.

Date Time Program IDOctober 15 2-3:30pm 222404-A1

Day: SaturdayLocation: Curtis Apple OrchardFee (R/NR): $20/$30Min/Max: 6/12Deadline: October 7Transportation: 222404-T1Drop off at Hays Center at 1:30pm and Pick-up atHays Center at 4:00pm.

Tae Kwon DoAges 13-35

Come learn the non competitive art of Tae KwonDo! Tae Kwon Do offers a balanced physicalworkout as well as a mental workout. You willmaster new skills, increase your strength,flexibility, focus, discipline, and self esteem andof course have fun! Techniques will be adjustedto fit individual capabilities. These classes will betaught by Grand Master Han from Hans Tae KwonDo Academy. Registration is for all 15 sessions.

GOALS: Improve coordination, gross motor skills, and endurance, increase concentrationand balance, improve both physical and mental discipline, improve focus, increase self esteem

and improve goal setting abilities.

Date Time Program IDSeptember 7- 6-7pm 232806-A1December 21

Day: WednesdayLocation: Hays Recreation Center Fee (R/NR): $150/$225Min/Max: 6/12Deadline: August 22*There will be no program November 30.

New!

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 7/28

www.cuspecialrecreation.com 5

New!

Pottery PlaceAges 13-19

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 your creativity. Studio time is included in the fee as well as$10.00 for a piece to pick out. If you wish to spend

more than $10.00 please bring your own money.

GOALS: Increase independence, enhance creativity,and improve fine motor skills.

Date Time Program IDDecember 10 1:30-2:45pm 222405-A1

Day: SaturdayLocation: Pottery PlaceFee (R/NR): $31/$46.50Min/Max: 6/12Deadline: December 2

Transportation: 222405-T1Drop off at Hays Center at 1:15pm and Pick-up atHays Center at 3pm.

Winter Break Camp

Ages 7-22Looking for something fun to do over your Winter Break? Then your search is over, because thisprogram provides fun for all. Activities includeplaying games, cooking, making cool projects,and a field trip. Please bring a lunch daily.

GOALS: Enhance social skills, learn new leisureactivities, increase independence, and increasesocialization among peers.

Date Day Program IDDecember 19-22 Mon-Thurs 232603-A1

December 21-22 Wed-Thurs 232603-A2December 27-30 Tues-Fri 232603-A3

Time: 9am-3pmLocation: Spalding Recreation Center Fee (R/NR): December 19-22: $105/$157.50

December 21-22: $75/$112.50December 27-30: $105/$157.50

Min/Max: 6/12Deadline: December 9

Find us on Facebook and stay connectedChampaign Urbana Special Recreation

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 8/28

6

 AdultsDay ProgramsToo 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 classwe will be exploring yoga, stretching, strengthtraining, endurance and much more.

GOALS: Increase gross motor skills, gainknowledge of proper tness techniques, and improve overall physical tness.

Date Time Program IDSeptember 6- 10:30-11:30am 243401-A1December 15

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

Luncheon BunchAges High School Graduate – 35

What’s for lunch today? Join us as we head outinto the community and experience different

restaurants around town. CUSR will pick up your tab for lunch; you just have to join the club!

GOALS: Increase money management and dining etiquette skills, and increase socialization among 

 peers.

Date Location Program IDSeptember 7 Za’s (Neil St.) 243402-A1September 21 Pancheros 243402-A2October 5 Panera (Kirby Ave) 243402-A3October 19 Old Chicago 233402-A4November 2 O’Charleys 243402-A5November 16 El-Toro Bravo 243402-A6December 7 Monicals 243402-A7

December 14 Group’s Choice 243402-A8Day: 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 programTransportation ID: 243402-T1-T8Door-to-Door Transportation Fee: $20/month

Out and AboutAges High School Graduate - 35

Join CUSR as we take a one day trip once a month tplaces outside and around our area. Any admissionsand meals are included in the fee.

GOALS: Increase socialization among peers, increasmoney management skills, enhance community awareness.

Date Location Program IDSeptember 9 Decatur Zoo/Lunch 243403-A1October 14 Abraham Lincoln 243403-A2

Presidential Museumand Library/Lunch

November 4 Spurlock Museum/Lunch 243403-A3December 2 Give Back Day 243403-A4

Session 1

Day: FridayTime: 9am-2pmLocation: Meet at the Hays Recreation Center Fee (R/NR): $32/$48Min/Max: 6/12Transportation ID: 243403-T1Deadline: 2 weeks prior to programDoor-to-Door Transportation Fee: $10

Session 2 Day: FridayTime: 9am-3:30pmLocation: Meet at the Hays Recreation Center 

Fee (R/NR): $44/$66Min/Max: 6/12Transportation ID: 243403-T2Deadline: 2 weeks prior to programDoor-to-Door Transportation Fee: $10

Session 3Day: FridayTime: 11am-1pmLocation: Meet at the Hays Recreation Center Fee (R/NR): $18/$27Min/Max: 6/12Transportation ID: 243403-T3

Deadline: 2 week prior to programDoor-to-Door Transportation Fee: $10

Session 4Day: FridayTime: TBALocation: Meet at the Hays Recreation Center Fee (R/NR): $9/$13.50Min/Max: 6/12Transportation ID: 243403-T4Deadline: 2 week prior to programDoor-to-Door Transportation Fee: $10

New!

New!

New!

  I n t r o d 

 u c i n g  !

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 9/28

www.cuspecialrecreation.com 7

Hays HangoutAges 18+

Fill the evening up with a night of cards, Wii,board games 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 and turn-taking skills.

Date Program ID Transportation IDSeptember 26 222505-A1 222505-T1October 24 222505-A2 222505-T2November 28 222505-A3 222505-T3

Day: MondayTime: 6:30-8pm

Location: Hays Recreation Center Fee (R/NR): $6/$9Min/ Max: 4/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

 Adults

Cookin’ CrewAges 18+

Measure, chop, stir and cook! Join us as weprepare recipes from across the world. We willhave themed dinners where we will be learningabout different cultures and how they preparetheir meals. Some themes will be Italian, Mexican,and Chinese. You will receive a recipe book of the meals that we prepared that evening to try athome.

GOALS: Enhance cultural awareness, developappropriate dining etiquette, and improve cooking skills.

Date Program ID Transportation ID

October 3 242512-A1 242512-T1November 7 242512-A2 242512-T2December 5 242512-A3 242512-T3

Time: 5:30-8:30pmDay: MondayLocation: Hays Recreation Center Fee (R/NR): $21/$31.50Min/Max: 4/10Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

BilliardsAges 18+

Have you and your friends been looking for anight where you can play some pool, enjoy arcadegames, and win some prizes? If you have, meet

us at Jupiter’s at the Crossing for a night of thatand much more. CUSR will pay for one game of pool. Please bring money for food and arcadegames.

GOALS: Increase money management skills,enhance social skills with peers and community members.

Date Program ID Transportation IDSeptember 12 242524-A1 242524-T1October 10 242524-A2 242524-T2November 14 242524-A3 242524-T3December 12 242524-A4 242524-T4

Day: MondayTime: 7-9pmLocation: Meet at Jupiter’s at the CrossingFee (R/NR): $16/$24Min/Max: 4/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Bake the Night Away

Ages 18+Has your sweet tooth been getting to you? If it has, CUSR has the perfect remedy. At Bakethe Night Away we will prepare and bake threetasty recipes. You will receive a recipe book totake home with the delicious sweets baked thatevening.

GOALS: Increase baking skills, socialization skills,and dining etiquette.

Date Program ID Transportation IDSeptember 19 242513-A1 242513-T1

October 17 242513-A2 242513-T2November 21 242513-A3 242513-T3December 19 242513-A4 242513-T4

Day: MondayTime: 6:30-8:30pmLocation: Hays Recreation Center Fee (R/NR): $14/$21Min/Max: 4/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 10/28

8

Dancing in Decatur Ages 21+

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

GOALS: Enhance socialization with peers, meet new people.

Date Program ID Transportation IDSeptember 7 243003-A1 243003-T1October 5 243003-A2 243003-T2November 2 243003-A3 243003-T3December 7 243003-A4 243003-T4

Day: WednesdayTime: 5:15-9:15pmLocation: Meet at Hays Recreation Center Fee (R/NR): $15/$22.50Min/Max: 6/24Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Computers 101

Ages 16+Microsoft Word, Access, Excel, email…does thisall sound confusing to you? Would you like to learnmore? Then come on over and learn how it’s done.Please register for one session per date. Newlearners take priority in registration.

GOALS: Enhance fine motor skills and increasecomputer knowledge.

Date Program ID Sess 1 Sess 2 Sess September 12 232606 A1 A2 A3October 10 232606 A4 A5 A6

November 14 232606 A7 A8 A9December 12 232606 B1 B2 B3

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

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

Location: Hays Recreation Center Fee (R/NR): $6/$9Min/Max: 1/3Deadline: 1 week prior to program

Scrapbooking ClubAges 18+

Do you have pictures piling up, but nowhere to

keep them? If so, then come on out to the HaysRecreation Center and store them the right way.In this club we will learn ways to cut pictures,design pages, and treasure our memoriesforever. We will supply the scrapbook andsupplies, you bring your memories. Must providea minimum of 40 pictures.

GOALS: Increase fine motor skills and creativity.

Date Program ID Transportation IDSeptember 8 242536-A1 242536-T1October 13 242536-A2 242536-T2

November 10 242536-A3 242536-T3December 15 242536-A4 242536-T4

Day: ThursdayTime: 4:30-5:30pmLocation: Hays Recreation Center Fee (R/NR): $57/$85.50 for all four datesMin/Max: 3/6Deadline: 1 week prior to rst classDoor-to-Door Transportation Fee: $40

New!

Tae Kwon DoAges 13-35

Come and learn the non competitive art of TaeKwon Do! Tae Kwon Do offers a balanced physicalworkout as well as a mental workout. You will masternew skills, increase your strength, flexibility, focus,

discipline, and self esteem and of course havefun! Techniques will be adjusted to t individualcapabilities. These classes will be taught by GrandMaster Han from Hans Tae Kwon Do Academy.Registration is for all 15 sessions.

GOALS: Improve coordination, gross motor skills,and endurance, increase concentration and balance,improve both physical and mental discipline, improvefocus, increase self esteem, and improve goal settingabilities.

Date Time Program IDSeptember 7- 6-7pm 232806-A1

December 21*

Day: WednesdayLocation: Hays Recreation Center Fee (R/NR): $150/$225Min/Max: 6/12Deadline: August 22*There will be no program November 30.NO TRANSPORTATION

 AdultsNew!

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 11/28

www.cuspecialrecreation.com 9

Adults

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

Come one, come all for a night of bingo! You will enjoyhanging out and socializing with your friends. You mayeven win some prizes!

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

Date Program ID Transportation IDSeptember 15 232501-A1 232501-T1October 20 232501-A2 232501-T2November 17 232501-A3 232501-T3December 15 232501-A4 232501-T4

Day: ThursdayTime: 7-8pmLocation: Hays Recreation Center Fee (R/NR): $10/$15Min/Max: 6/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee:

Diner’s ClubAges 18+

Join us as we go out in the community to differentrestaurants for dinner. CUSR will be picking up your 

dinner tab! At Diner’s Club you will be able to socializewith your friends and enjoy a GREAT dinner.

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

Date Restaurant Program IDSeptember 1 McAllister’s Deli 242504-A1October 6 Olive Garden 242504-A2November 3 Dos Reales (Prospect) 242504-A3December 1 Texas Road House 242504-A4 Day: ThursdayTime: 6-7:30pm

Location: 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: 242504-T1Door-to-Door Transportation Fee: $10 each; $40 allfour 

Karaoke and Dancing

Ages 18+

ATTENTION all singers and dancers. Come onover as CUSR brings out the karaoke machine for a night of dancing and singing. Lots of music tochoose from…it’s sure going to be a good time.

GOALS: Increase socialization skills and turn-taking skills.

Date Program ID Transportation IDOctober 14 242518-A1 242518-T1December 16 242518-A2 242518-T2

Day: FridayTime: 6:30-8pmLocation: Hays Recreation Center Fee (R/NR): $6/$9Min/Max: 4/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Movie NightAges 18+

Bring out your inner critic! Join us as we choosemovies to watch at the Hays Recreation Center,or feel free to bring your own movies from home

to share with us! CUSR will provide snacks, you just need to be ready for some entertainment!

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

Date Program ID Transportation IDSeptember 9 242503-A1 242503-T1October 21 242503-A2 242503-T2November 18 242503-A3 242503-T3December 2 242503-A4 242503-T4

Time: 6:30-9pmDay: FridayLocation: Hays Recreation Center Deadline: 1 week prior to programFee (R/NR): $6/$9Min/Max: 4/25Door-to-Door Transportation Fee: $10

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 12/28

10

 AdultsSports ClubAges 18+

ATTENTION SPORT FANS! CUSR has the

perfect club for you! We will be attending onesporting event a month. Cost of your ticket isincluded. You will need to bring money for snacks.

GOALS: Increase socialization and money management skills.

Date Location and ProgramSeptember 17 Eastern Illinois University FootballOctober 2 University of Illinois Women’s Soccer November 16 Parkland Men’s Basketball

Session 1: Eastern Illinois University FootballDay: Saturday

Time: 5-10:30pmLocation: Meet at Hays Recreation Center Fee (R/NR): $33/$44.50Min/Max: 6/12Program ID: 242807-A1Transportation ID: 242807-T1Deadline: 3 weeks prior to programDoor to Door Transportation Fee: $10

Session 2: University of Illinois Women’s Soccer Day: SundayTime: 12-3:30pm

Location: Meet at Hays Recreation Center Fee (R/NR): $13/$19.50Min/Max: 4/12Program ID: 242807-A2Transportation ID: 242807-T2Deadline: 2 weeks prior to programDoor to Door Transportation Fee: $10

Session 3: Parkland Men’s BasketballDay: WednesdayTime: 6:15-9:30pmLocation: Meet at Hays Recreation Center 

Fee (N/NR): $19/$28.50Min/Max: 6/12Program ID: 242807-A3Transportation ID: 242807-A3Deadline: 2 weeks prior to programDoor to Door Transportation Fee: $10

Timber Pointe OvernightAges 16-35

Back by popular demand! We’re headed back toTimber Pointe Outdoor Center with S.O.A.R.! Thisfall’s trip will be a one night cabin camping trip withnature activities, arts, crafts, cooking, a campre, andmore!

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

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

Date Time Program IDNovember 5-6 Sat 9:30am – 243021-A1

Sun 11:30am

Day: Saturday-SundayLocation: Meet at Hays Center Fee (R/NR): $69/$103.50Min/Max: 4/8Deadline: October 21NO TRANSPORTATION

Trips

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 13/28

www.cuspecialrecreation.com 11

SeptemberSpecial Events

OctoberSpecial Events

Halloween Party

Ages 18+Ghosts, goblins, and more! Come on out toCUSR’s annual Halloween Party. We will beplaying games, enjoying a tasty snack, dancing,and having a costume contest, so wear your bestcostumes!

GOALS: Enhance socialization skills with peers.

Date Program ID Transportation IDOctober 27 272504-A1 272504-T1

Day: Thursday

Time: 6:30-8:30pmLocation: Hays Recreation Center Fee (R/NR): $16/$24Min/Max: 6/25Deadline: 1 week prior to programDoor-to-Door Transportation Fee:$10

Curtis Orchard and Dinner Ages 18+Join us as we spend the evening at Curtis Orchardto pick apples and shop. We will then go to BillyBarooz for dinner. CUSR will be picking up your tabfor dinner. Please bring money for Curtis Orchard.

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

Date Program ID Transportation IDSeptember 30 242530-A1 242530-T1

Day: Friday

Time: 4:30-8pmLocation: Meet at the Hays Recreation Center Fee (R/NR): $30/$45Min/ Max: 6/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

Apple and Pork FestivalAges 18+

Join us as we venture out to Clinton, IL for their annual Apple and Pork Festival. There we will lookaround at what all of the booths and vendors haveto offer. Please bring money for your lunch andsouvenirs.

GOALS: Increase money management skills and social skills within the community.

Date Program ID Transportation IDSeptember 24 243017-A1 243017-T1

Day: SaturdayTime: 9am-3pmLocation: Hays Recreation Center Fee (R/NR): $15/$22.50Min/Max: 6/12Deadline: One week prior to programDoor-to-Door Transportation Fee: $10

Conklin’s Barn II Dinner Theatre

Ages 21+“Exit the Body” is the play we will be headingto see in Goodeld, IL. There you will enjoy awonderful buffet dinner followed by the play. Costof meal and play included.

GOALS: Enhance socialization with peers and cultural experience.

Date Program ID Transportation IDOctober 9 243013-A1 243013-T1

Day: SundayTime: 10:30am-5pmLocation: Meet at Hays Recreation Center Fee (R/NR): $56/$84Min/Max: 4/12Deadline: 2 weeks prior to programDoor-to-Door Transportation Fee: $10

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 14/28

12

Holiday Shopping

in Orland ParkAges 18+

Too much holiday shopping but not enough timeto get it all in? Put your worries aside and spendthe afternoon shopping with your friends fromCUSR. We will be heading out to Orland Mall toshop and look at all of the holiday decorations.CUSR will pick up your tab for lunch; you justhave to bring your list, and money for shopping.

GOALS: Enhance decision making skills. Improvebudgetary and money management skills.

Date Program ID Transportation IDNovember 19 242901-A1 242901-T1

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

 NovemberSpecial Events

Dinner and Cosmic BowlingAges 18+

Looking for ways to fill your Saturday nights?CUSR staff will be picking the restaurant1-week prior to the program and then headingto Arrowhead Lanes for Cosmic Bowling. CUSRwill be paying for your dinner and two games of 

bowling. *NOTE: STROBE LIGHTS MAY CAUSESEIZURE ACTIVITY.

GOALS: Improve gross motor coordination, turntaking skills, and socialization with peers.

Date Program ID Transportation IDOctober 22 242527-A1 242527-T1

Day: SaturdayTime: 7-11pmLocation: Meet at Hays Recreation Center Fee (R/NR): $38/$57

Min/Max: 4/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

DecemberSpecial Events

Winter Wonderland Ball

Ages 18+Walking in a Winter Wonderland…Join us as wecelebrate the holidays at our Winter WonderlandBall. Dinner will be served and the dance floor willbe open.

GOALS: Enhance socialization with peers.

Date Program ID Transportation IDDecember 3 242902-A1 242902-T1

Day: SaturdayTime: 6-9pmLocation: Meet at the Hays Recreation Center 

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

Pottery PlaceAges 18+

Paint the evening away with your friends fromCUSR as we head out to Pottery Place. CUSR willpay for your paint, studio time, and one piece of pottery. Just bring your creativity

GOALS: Increase artistic expression and social interactions.

Date Program ID Transportation IDDecember 9 242525-A1 242525-T1

Day: FridayTime: 6:30-8pmLocation: Meet at Pottery PlaceFee (R/NR): $31/$46.50Min/Max: 6/12Deadline: 1 week prior to programDoor-to-Door Transportation Fee: $10

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 15/28

www.cuspecialrecreation.com 13

 Athletics

Important DatesSpecial Olympics

September 10: State Softball, Decatur 

September 25: District Volleyball, Effingham

October 15: Sectional Bowling, Peoria

October 28-30: State Volleyball, Rockford

December 3: State Bowling, Peoria

December 29: State Farm Holiday Classic,Bloomington

Criteria for ParticipationAll Special Olympics athletes must have a current,completed Application for Participation in IllinoisSpecial Olympics form on file with the AthleticsCoordinator at CUSR. This form has four sections:

1. Athlete Information

2. Parent / Guardian Authorization & MedicalAuthorization

3. Health Insurance and Emergency Information

4. Medical Clearance *(Must be completed byPhysician)

Applications for Participation in Illinois SpecialOlympics are valid for 2 years based on the earliestsigned date on the medical application form.Anyone interested in participating, starting a newsport, or volunteering, please contact:Hannah Sheets, CUSR Athletics Coordinator at217-239-1152.

Special Olympics Illinois provides year-round 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 of Special Olympics Illinois through participation in thefollowing sports:

* Volleyball

* Basketball

* Aquatics

* Power Lifting

* Bocce

* Track & Field

* Softball

* Bowling

Special Olympics

Lady Mustang BasketballAges 12+

Lady Mustang team basketball practice will beginin December. Registration and a valid SpecialOlympics Medical Application must be on file atthe CUSR office by December 6 for all femalebasketball athletes. All teams will play a minimumof three games before district competition.

Athletes wishing to participate in practice, but notin games or competition must make CUSR awareof this by the second week of practice.

GOALS: Increase overall physical fitness, gainknowledge of individual basketball skills and teamstrategy, and improve team cooperation skills.

Date Time Program IDDecember 6 – 7:15-8:45pm 232808-A1March 13

Day: TuesdaysLocation: Brookens GymFee (R/NR): $58/$87Min/Max: 7/20Deadline: December 20Transportation ID: 232808-T1Door-to-Door Transportation Fee: $130

Mustang BasketballAges 12+

Mustang team basketball practice will begin inNovember. Registration and a valid SpecialOlympics Medical Application must be on file at theCUSR office by November 1 for all male basketballathletes. All teams will play a minimum of threegames before district competition. Mustang teamsthat qualify for the state tournament will continuepracticing after January 17.

GOALS: Increase overall physical fitness, gainknowledge of individual basketball skills and team

strategy, and improve team cooperation skills.

Date Time Program IDNovember 1 – 7:15-8:45pm 222815-A1January 17

Day: TuesdaysLocation: Brookens GymFee (R/NR): $58/$87Min/Max: 7/20Deadline: November 15Transportation ID: 222815-T1Door-to-Door Transportation Fee: $130

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 16/28

14

 Athletics

Wheelchair AthleticsOpen GymAges 8+

Come to wheelchair athletics open gym onThursdays to shoot hoops, practice skills or learn new ones. For Champaign-Urbanaresidents the cost is $2 at the door.

GOAL: Develop athletic ability, encouragevarious athletic interests and improve peer 

interaction.Date TimeNovember 3 - March 15* 6:30-8:30pm

Day: ThursdayLocation: Stratton ElementaryFee (R/NR): $2/$3*No open gym on Nov. 24, Dec. 22 and Dec. 29

Strikes & SparesAges 21+

Bring your friends to the bowling alley for some fun.Perfect your skills while socializing with your friendsand meeting new ones. Participants will be assignedto lanes and can bowl up to two games. Note:Participants arriving late will bowl 2 games or as longas time allows.

GOALS: Improve social skills and ability to interact with others, learn and practice bowling etiquette, andincrease gross motor coordination.

Date Day Program IDSeptember 12- Monday 222802-A1December 5

September 14- Wednesday 222802-A2December 7

Time: 4-5pm

Location: Western BowlFee (R/NR): $75/$112.50Min/Max: 3/20Deadline: September 28Transportation ID: 222802-T1, T2Home Only Transportation Fee: $65

Tae Kwon DoAges 13-35

Come and learn the non competitive art of Tae Kwon Do! Tae Kwon Do offers a balanced

physical workout as well as a mental workout.You will master new skills, increase your strength,flexibility, focus, discipline, and self esteem andof course have fun! Techniques will be adjustedto fit individual capabilities. These classes will betaught by Grand Master Han from Hans Tae KwonDo Academy. Registration is for all 15 sessions.

GOALS: Improve coordination, gross motor skills, and endurance, increase concentrationand balance, improve both physical and mental discipline, improve focus, increase self esteemand improve goal setting abilities.

Date Time Program IDSeptember 7- 6-7pm 232806-A1December 21*

Day: WednesdayLocation: Hays Recreation Center Fee (R/NR): $150/$225Min/Max: 6/12Deadline: August 22*There will be no program November 30.NO TRANSPORTATION

New!

Teen PinsAges 13-21

Bring your friends to the bowling alley for some fun.

Learn how to bowl while socializing with your friendsand meeting new ones. articipants will be assignedto lanes and can bowl up to two games. Note:Participants arriving late will bowl 2 games or as longas time allows.

GOALS: Improve ability to interact with others,improve bowling skills, increase gross motor coordination.

Date Day Program IDSeptember 12- Monday 232605-A1December 5

September 14- Wednesday 232605-A2December 7

Time: 4-5pmLocation: Western BowlFee (R/NR): $75/$112.50Min/Max: 3/20Deadline: September 28Transportation ID: 232605-T1, T2Home Only Transportation Fee: $65

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 17/28

www.cuspecialrecreation.com 15

 AthleticsSaturday Soccer Ages 16+

Want to try a new sport this fall? Try SaturdaySoccer! Players will learn and practice basic skills

such as trapping, dribbling, and various kicks – allwhile getting a great cardio workout with friends!

GOALS: Increase overall physical fitness, gainknowledge of individual soccer skills and teamstrategy, and improve gross motor coordination.

Date Program ID Fee (R/NR)September 17– 242808-A1 $20/$30October 8

Day: SaturdayTime: 11:30am-12:30pmLocation: Dodds Soccer Complex

Min/Max: 6/12Deadline: September 13*NO TRANSPORTATION

Pump Up Your Fitness!Ages 15+

You’ll never be bored at this fitness class! ach weekwe’ll try a new type of exercise. You’ll get a chanceto practice everything from kick boxing, yoga, stepaerobics – and more. Try the first session and thencome back for the second!

GOALS: Improve overall physical fitness and grossmotor coordination and increase fitness programawareness.

Date Program ID DeadlineSeptember 15-October 20 232807-A1 September 12October 27-December 8* 232807-A2 October 24

Day: ThursdayTime: 6-7pm

Location: Phillips Recreation Center Fee (R/NR): $36/$54Min/Max: 4/10*No program November 24NO TRANSPORTATION Swim Lessons in Urbana

Ages 5+

Learn to swim with lessons from UPD instructorsand help from CUSR staff! This program is for beginning swimmers of any age! Swimmers’ skilllevels will be assessed during the first lessonand swimmers will be placed in small groups

according to skill and age for the followinglessons.

* If you are too skilled for these lessons, pleasecheck out UPD’s more advanced swim lessonsor join us in January for our Special Olympicsaquatics program.

GOALS: Develop beginner-intermediateswimming skills, improve ability to listen and follow directions, and increase gross motor coordination.

Date Fee (R/NR) Program ID

September 18- $78/$117 222814-A1October 23

November 6- $78/$117 222814-A2December 18*

Day: SundayTime: 7-8pmLocation: Urbana Indoor Aquatic Center Min/Max: 5/12*No Lessons on November 20*NO TRANSPORTATION

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 18/28

16

 Athletics

Fitness FrenzyAges 15+

Need some extra motivation to get fit? Try exercisingwith a friend! At Fitness Frenzy, participants will bepaired with a CUSR staff who will exercise with themfor an hour, twice a week, for 8 weeks. Workoutswill be planned to meet participant’s individualfitness goals, and can be scheduled when it isconvenient for both partners. For more informationon registration, please contact Hannah Sheets.

GOALS: Increase gross motor coordination and  physical tness, gain knowledge of proper tnesstechniques.

Date Program ID Fee (R/NR)October 17 - 232809-A1 $212/$318December 18*

Location: Mettler AthleticDeadline: September 20*No program week of November 20-26NO TRANSPORTATION

Payment PlansAvailable

Frunner ClubAges 15+

Returning and new runners are welcome for our fall session of Frunner Club. Runners of allpaces are welcome and training partners willwork with you at your pace. Enjoy the fall weather and get some exercise by training for a 5K racein November. Please wear shoes with proper support and weather appropriate clothing.

GOALS: Improve cardiovascular tness and ability to interact with others, and increase self condence.

Date Day Time Program IDSeptember 21- Sun 4:30-5:30pm 242805-A1

November 16 Wed 5:30-6:30pmLocation: Sunday: Dexter Field parking lot

Wednesday: Pavilion at Hessel Park

Fee (R/NR): $50/$75Min/Max: 3/10Deadline: September 19NO TRANSPORTATION

Find us on Facebook and stay connectedChampaign Urbana Special Recreation

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 19/28

PARTICIPANT NAME

ADDRESS PHONE (H)

PHONE (W)

CITY ZIP EMAIL

BIRTHDATE AGE SEX SHIRT SIZE

PRIMARY DISABILITY

PARENT/GUARDIAN PHONE (H) PHONE (C)

EMERGENCY NAME PHONE (H) PHONE (C)

DOCTOR’S 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)

PLEASE SEE BACK SIDE FOR WAIVER. THE WAIVER MUST BE SIGNED BEFORE YOUR REGISTRATION MAY BE PROCESSED.

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

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

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 20/28

Important information

CUSR is committed to conducting its recre-ation programs and activities in a safe manner and 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 fit and/or skilledfor the activities contemplated by this agree-ment. It is always advisable, especially if theparticipant is pregnant, disabled in any way, or recently suffered illness, injury, or impairment,

to consult a physician before undertaking anyphysical activity.

Warning of risk Recreational 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 offici-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 risk Please 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 officialsofficers, 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.

Participant’s name

Participant’s 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. Pleascall 239-1152, if you require special accommodations.

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 21/28

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 22/28

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 23/28

CUSR Annual Information Form (AIF)

The AIF contains extremely important participant information which is necessary for CUSR staff to plan andexecute safe and enjoyable programs. This form will be updated at beginning of each calendar year.

Date: _______________ 

Participant Name: ____________________________________ 

Sex: M ____ F ____ Date of Birth: ____/____/____ Height: _____ Weight: _____ Address: _______________________ City: __________________ Zip: ________ 

Phone Number: H ( ) _____-_______C ( ) _____-______ W ( ) _____-______ Primary Disability/Diagnosis: _____________________________________________________ 

Parent/Guardian Name: __________________________________________________________ 

Parent/Guardian Address: ________________________ City: ____________ Zip: ________ 

Parent/Guardian Phone Number: C ( ) _____-______ W ( ) _____-______ 

Emergency Contact Name: ________________________ Cell Number: ( ) _____-______ 

Case Worker’s Name: ____________________________ Phone Number: ( ) _____-______ 

Authorization for Emergency Medical Treatment

I authorize CUSR to arrange for emergency medical treatment, in the event of an injury to my child, or me, and

in the event that I or my designated emergency contact cannot be reached by CUSR.

  _____________________________________ _____________________

Signature of Participant, Parent, or Guardian Date

Medical Information

Preferred Hospital: _____________________________ 

Doctor’s Name: _______________________________ Phone Number: ( ) _____-______ 

Please list all medications the participant is taking, even if it will not be dispensed during program. Amedication dispensing form must be obtained, signed, and returned to CUSR in order for staff to assist withdispensing.

MEDICATION DOSAGE FREQUENCY  ______________________ ________________ __________________ 

  ______________________ ________________ __________________ 

  ______________________ ________________ __________________ 

  ______________________ ________________ __________________ 

  ______________________ ________________ __________________ 

  ______________________ ________________ __________________ 

  ______________________ ________________ __________________ 

  ______________________ ________________ __________________ 

Does the participant self-medicate? YES _____ NO _____ 

Does participant need a reminder to take medication? YES _____ NO _____ 

Does the participant have any allergies? YES _____ NO _____ 

If yes, please explain:______________________________________________________ __________  ___________________________________________________________________ 

Is participant subject to seizures? YES _____ NO _____ 

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 24/28

If yes, please list the duration, frequency, and date of last seizure:_________________________ 

 ______________________________________________________________________________ 

Are seizures controlled by medication? YES _____ NO _____ 

Are there any doctor’s restrictions? YES _____ NO _____ 

If yes, please explain:______________________________________________________ ____________ _________________________________________________________________ 

If participant has Down’s Syndrome, have x-rays of the C-1 and C-2 vertebrae been taken and examined?YES _____ NO _____ 

Is participant clear of Atlanto Axial Subluxation? YES _____ NO _____ 

Does participant use any of the following:

Hearing Aid(s) YES _____ NO _____ 

Corrective Eyewear YES _____ NO _____ 

Orthopedic or Prosthetic Devices YES _____ NO _____ 

Manual Wheelchair YES _____ NO _____ 

Electric Wheelchair YES _____ NO _____ 

Walker YES _____ NO _____ 

Cane YES _____ NO _____ 

Recreation Information

Can participant swim independently? YES _____ NO _____ 

Does participant use a floating device while in water? YES _____ NO _____ 

Does participant need 1:1 supervision in water? YES _____ NO _____ 

Is participant able to stay with a group? YES _____ NO _____ 

Can participant be left alone after a program has ended to wait for a ride?

YES _____ NO _____ 

Can participant get home without supervision (walk, public transportation, etc)?

YES _____ NO _____ 

Daily Living Skills/Communication/Behavior Information

Does the participant require assistance with any of the following?

Eating/Drinking YES _____ NO _____ 

Toileting YES _____ NO _____ 

Dressing/Undressing/Tying Shoes YES _____ NO _____ 

Money Handling YES _____ NO _____ 

Following Directions YES _____ NO _____ 

Orientation to people, place, time YES _____ NO _____ 

Anticipation of safety needs YES _____ NO _____ 

Reading YES _____ NO _____ 

Writing YES _____ NO _____ 

Communication YES _____ NO _____ 

Circle any communication tools that the participant uses:

American Sign Language Communication Board/Book Personal Signs/Gestures

Are there any additional comments or concerns we should know about this participant? ____________________ _________________________________________________________________________________________ ____________________________________________________ 

CUSR may use pictures taken at programs for publicity use. Is this okay? YES ___ NO ___ 

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 25/28

www.cuspecialrecreation.com 23

Late Pick-Up PolicyIn order to be fair to our participants and programleaders, CUSR has enacted a late pick-up policy.The first time a participant is not picked up within a 5

minute 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 or guardian. 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 first-time participation,as well as repeat participation, CUSR hasa refund policy highlighted by a satisfactionguarantee. This special refund policy providesus with timely feedback about dissatisfactionregarding our services. If you are not completelysatisfied, tell us, and we will either invite youto repeat the class at no charge, allow you a

credit that can be applied to another program,or issue you a refund. A refund will be grantedif you were dissatisfied with the experience dueto circumstances under CUSR’s control. If youare not satisfied, we kindly ask you to give usyour input or ideas for improvement. Requestsfor the above mentioned options must be madebefore the midpoint of the program or within twoweeks of a single meeting activity. All refundrequests must be submitted on the SatisfactionRefund Request form and turned into CUSR. A $5service charge will be deducted from all refunds.

Satisfaction Guarantee does not apply to tripsand special events with prepaid admissions andtickets.

Program ScholarshipsBecause some residents are unable to participatein recreation programs due to economichardship, CUSR provides a scholarship policyto reduce certain fees and charges. Scholarshipapplications are not guaranteed and are based

on available funds, program registration, or choice of program location. Early applicationsare given priority. Please apply 3-4 weeksbefore the program start date. Applications areavailable at the CUSR office and can be mailedupon request. Need is the primary criteria uponwhich scholarship applicants are considered.Scholarships are not available for transportationand specifically identified programs. For moreinformation, call 217-239-1152.

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 later than the specified 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.

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 whether a program will meet due to inclement weather, callCUSR. Missed programs due to weather may bemade up the week after the end of the programseason. Credit is given for additional cancellations.

CUSRInformation

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 26/28

24

Transportation Policy/SafetyProcedures1. Transportation must be requested at least

48 hours prior to the program date. If transportation is requested with less than48 hours from program date, there is noguarantee transportation will be available.

NO transportation request at the time of theprogram will be accepted.

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

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

4. CUSR staff will wait a maximum of 5 minutespast your pickup time due to a demandingvan schedule. If you miss your pickup time,we will not return to pick you up. It is your 

responsibility to find transportation to theprogram if you miss your 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 thatis not on the transportation roster at thebeginning of the program.

7. Persons unable to be in a house alone

should have someone meet the van at thedesignated time of return.

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

9. All passengers must be sitting in seats or wheelchairs with belts securely fastened inthe correct manner or the driver will not movethe vehicle.

10. CUSR staff is responsible for determiningwhether or not a participant can betransported safely.

11. Persons riding in Amigo-type wheelchairs or strollers must transfer into a vehicle seat anduse a seat belt.

CUSR reserves the right to refuse to transportindividuals. These policies have been developedto ensure safety of everyone riding in CUSRvehicles.

Behavior CodeCUSR promotes the concept of “Equal Fun For Everyone” and strives to accomplish this belief through our program goals. However, certain rulesare necessary to ensure everyone’s safety andenjoyment.

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 causingbodily harm, and show respect to equipment,supplies, and facilities. Additional policies maybe developed for specific programs, camps, andintegrated programs.

DisciplineA caring, positive approach will be used regarding

discipline. CUSR reserves the right to dismissparticipants. Each situation will be evaluated onits own merit.

InsuranceIndividual accident liability insurance is not

provided by CUSR.

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

CUSRInformation

Find us on Facebook and stay connectedChampaign Urbana Special Recreation

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 27/28

8/6/2019 C-U Special Recreation Fall 2011

http://slidepdf.com/reader/full/c-u-special-recreation-fall-2011 28/28