For more information about our Chicago Park District Special Recreation Programs~ Contact us at 312.742.5798 or [email protected] m Winter 2018 Chicago Park District
Board of Commissioners Superintendent & CEO Jesse H. Ruiz, President Michael P. Kelly Avis LaVelle, Vice President Erika R. Allen Donald J. Edward David A. Helfand Tim King M. Laird Koldyke
City of Chicago Rahm Emanuel, Mayor
For more information about your Chicago Park District visit www.chicagoparkdistrict.com 312.742.PLAY or TTY 312.747.2001
Table of Contents Special Recreation Map & Locations 1 Mission Statement 2 General Information 3-5 Special Recreation Administrative Staff 6 Special Recreation Parks & Coordinators 7 Special Olympics 2018 Calendar 8 Programs by Park 9-19 Adaptive Recreation Programs 20-21 Deaf & Hard-of-Hearing Programs & Special Events 22-25 Veterans Programs 26 Winter Holiday Camps 27 New Program Columbus Park 28 Accessibility 29-33 Special Olympics Medical Application 34-36 English/Spanish Participation Forms 37-41 Annual Information Forms
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Mission & Vision Statement What is Chicago Park District Special Recreation? The Chicago Park District is a municipal pioneer in offering recreation programs for people with disabilities. Starting in 1965, the Chicago Park District began training park employees on ways to better serve people with disabilities. In 1968, the Chicago Park District became the birth place of the Special Olympics, an organization that now serves athletes with intellectual disabilities in over 170 countries worldwide. Since then, the park district has expanded its services for individuals with disabilities. With 21 specialty locations serving individuals with intellectual disabilities, 3 specialty locations serving individuals with a primary physical or visual impairment and 2 specialty locations serving individuals who are deaf or hard-of-hearing we strive to meet the recreational needs for all individuals with disabilities in the city of Chicago. The Chicago Park District Special Recreation Department currently offers specialty programs serving the following populations: Intellectual disabilities Deaf or Hard-of-Hearing Physical disabilities Veterans (Injured, able- bodied Blindness or Visual Impairment and active duty) **If your family member has special needs and is registered for a traditional program with the Chicago Park District and may need additional assistance, staffing or adaptive equipment, please contact the special recreation administrative staff
The Chicago Park District Special Recreation program welcomes all individuals with disabilities, come and join the fun!!
Chicago Park District Mission: Enhance the quality of life in Chicago by becoming the leading provider of recreation and leisure opportunities Provide safe, inviting and beautifully maintained parks and facilities Create a customer-focused and responsive park system that prioritizes the needs of children and families
Core values: Children First-Our most important task is to bring children and families into our parks and give them great reasons to stay and play for a lifetime. Best Deal in Town-We prioritize quality in our programs and accountability in our fiscal management to provide excellent and affordable recreation that invites everyone to come out and play. Built to Last-We use our capital to renew our aging infrastructure and leverage partnerships that produce new parks and facilities that are forward-thinking and world class. Extra Effort-We support innovation and welcome new ideas. We believe that professionalism, communication, technology, and team work serve as the foundation for great customer service and a productive workplace.
Special Recreation Department Mission: To enhance the quality of life for children and adults with disabilities through offering a diverse range of recreational opportunities. Vision: To promote, foster and encourage physical and mental health through athletic skill development, recreation and social interactions for youth and adults with disabilities.
General Information REGISTRATION All participants must register for each session and pay the assigned fee for that session before attending any program classes. Annual Information Forms need to be filled out at the beginning of each session, for all participants with intellectual disabilities (of all ages) and for minors with physical disabilities, visual impairment or deaf or hard-of-hearing. It is required that all first time participants meet with the Special Recreation Coordinator prior to registration. This is to ensure that the Special Recreation Program is the proper setting and can meet all specific needs of each individual. The Special Recreation staff may deem the program inappropriate for an individual based on safety concerns and/or lack of adherence to program policies. In-person registration is required in order to register for any Chicago Park District Special Recreation Program. For further information please call the specific park you are interested in. Online In-person Session/Year Session Begins Session Ends Registration Registration Begins Winter 2018 12/4/17 12/9/17 1/8/18 3/18/18 PAYMENT POLICY The Chicago Park District accepts the following forms of payment: Cash Checks (payable to “Chicago Park District”) Money Orders (payable to “Chicago Park District”) Credit Cards (Visa, MasterCard, Discover and American Express) REFUNDS A 15% service charge will be deducted from all refunds and payment cancellations. This includes duplicate and accidental registrations. All refund requests must be made in-person at the park where the program is being held, at least two weeks before the program’s scheduled start date. The Chicago Park District program receipt is required for a refund to be processed. No refund requests will be accepted after the two week point. Please allow up to six weeks for your refund to be processed.
RETURNED CHECK POLICY As a user fee payment, a check is an acceptable form of payment two weeks prior to the start of a class or the rental of a space or room. The two week prior limitation is to ensure sufficient time for the check to clear the issuer’s bank. If during the check clearing process the check fails, due to lack of funds, a closed account, etc. the check will be sent back to the Chicago Park District. It is important that the park or department responsible for the original receipt of the check take appropriate action to contact the individual or group to collect the amount of the check as well as a $25 returned check fee.
NON-RESIDENT POLICY Anyone can register for a Chicago Park District program; however, fees are doubled for non- Chicago residents.
LATE PICK-UP POLICY There will be a $5 late charge for every 15-minute a participant is picked up late. Each late pick-up will be documented, and if it happens more than 3 times, park staff reserves the right to dismiss a participant from the program without a refund. If a parent/guardian intends to pick-up a participant early, they must notify staff in advance
PARTICIPANT BEHAVIOR GUIDELINES The Chicago Park District promotes the concept of “equal fun for everyone.” Participants are expected to exhibit appropriate behavior at all times. The Special Recreation Behavior Guidelines have been developed to help make the program safe and enjoyable for all participants. 1. Participants must show respect to all other participants and staff. 2. Participants must refrain from using foul language or discussing inappropriate tropics 3. Participants must show respect for equipment, supplies, and facilities 4. Additional rules may be developed for specific programs and athletic leagues as deemed necessary by staff
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Upon infraction of one of these behavior guidelines, a Behavior Incident Report will be completed in detail by Special Recreation Staff. The following are next step options: 1. No further action at this time 2. Parent/Participant/Staff Meeting 3. Behavior Contract 4. Suspension from program for ____day(s) 5. One-on-one aide is assigned to participant 6. Expulsion from program for the remainder of the session
PARTICIPANT ILLINESS To prevent the spread of contagious illnesses, it is recommended that participants refrain from attending a class when any of the following conditions exist: 1. Fever of 100 degrees or higher 2. Vomiting within the past 24 hour 3. Persistent diarrhea in conjunction with other symptom 4. Contagious rash or a rash of unknown origin 5. Persistent cough and/or cold symptoms 6. “Pink eye” (conjunctivitis) or discharge from the eye 7. Symptoms of mumps, measles, chicken pox, strep throat, flu, impetigo, head lice, mites and ringworm 8. Runny nose with yellow or green discharge, which could indicate an infection 9. Fatigue due to illness, which will hinder participation and full enjoyment of the program
Please notify the Special Recreation staff if a participant contracts any contagious illness that will affect attendance. After one absence, a participant should return to the program at the recommendation of his/her doctor, or, if not under a doctor’s care, when symptoms have clearly passed.
DISPENSING OF MEDICATION 1. If the medication is to be given, staff is to be provided instruction by the physician or a registered nurse and approved, staff must also be willing and able to demonstrate or provide evidence of appropriate learning.
2. CPD staff and/or adult delivering medication shall document verification of the medication count by initialing the medication administration form.
SEVERE WEATHER In the event of severe weather, cancelling a program/class may be in the best interest of all our participants. The following guidelines will be used to determine cancellations:
SEVERE COLD Outdoor programs: 10 degrees Fahrenheit or in combinations with wind chill of 0 degree or lower. Programs with transportation: Temperature range of 10 degree or in combination with a wind chill of 0 degree or lower. All programs, including indoor: Snowstorm situations when driving restrictions (winter storm or blizzard warning in which authorities have advised not going out unless necessary) and emergency accident plans (State and local police) are in effect.
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SEVERE HEAT Outdoor programs or indoor sites without air-conditioning: Head index of 110 degrees or higher. Programs with transportation: o Routes for adults with physical disabilities-Heat index of 100degrees or higher. o All other routes-Heat index of 105 degrees or higher. All programs, including indoor: Weather conditions with a tornado warning in effect for Lake, Will, Cook and/or DuPage Counties
ADA COMPLIANCE In compliance with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act, the Chicago Park District does not discriminate on the basis of disability in employment or admission/access to programs and activities. Further questions or concerns about ADA compliance; please contact [email protected] or 312.742.4298
ACCESSIBLE FACILITIES The Chicago Park District is committed to making its facilities accessible to all patrons and visitors. Offering more than 150 accessible soft- surface playgrounds, 77 swimming pools (both indoor and outdoor) with either a portable lift, easy access stairs, a zero depth ramp or a combination of amenities; More than 40 parks offering accessible exercise equipment within their fitness centers and 16 beaches with accessible walkways allowing all patrons to walk down the edges of Lake Michigan. For more information on accessible facilities within the Chicago Park District please contact [email protected] or 312.742.4298
VOLUNTEER OPPORTUNITIES Interested in working with children and adults with disabilities? Come join our team! Volunteers add to the success of programs by assisting in weekly programs and special events. If you are interested in learning more about volunteering opportunities with the Chicago Park District’s Special Recreation Department, please contact 312.742.5798 or [email protected]
Per the Chicago Park District Policy, all volunteers MUST complete the volunteer application process (including successfully completeling a background check) prior to be being allowed to volunteer with any Chicago Park District program. This inlcudes family member of programs participants as well.
BROCHURE CHANGES/ERROR DISCLAIMER Due to the large amount of information offered in the Chicago Park District’s Special Recreation brochure, errors and changes may occur. We apologize for any errors. If you have any questions about possible program changes or errors please contact the specific park program you are interested in. Thank you for your patience and understanding.
Disability Policy Office
Larry Labiak, Disability Policy Officer [email protected] 312.742.5097
Annette Dodaja, CPRP, Senior Program Specialist [email protected] 312.742.4298
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Special Recreation Administrative Staff
Gerry Henaghan, CPRP, Special Recreation Manager [email protected] 312.745.1298
Mike Benavente, CTRS, Special Olympics Administrator [email protected] 312.747.6274
Michelle LoCoco, CTRS, Special Recreation Assistant Manager [email protected] 312.745.1121
Kristi Miller, CPRP, Special Recreation Assistant Manager [email protected] 312.745.2063
Emily Verrilli, CTRS, Senior Program & Event Coordinator [email protected] 312.745.1122
Eileen Guinane, Senior Special Olympics Program & Event Facilitator [email protected] 312.745.1993
Tamika Jones, CPRP, Senior Program and Event Facilitator [email protected] 312.747.0796
Riley Bowlin, CPRP, Special Olympics Program & Event Facilitator [email protected] 312.745.3195
Adam Tirres, Special Olympics Program & Event Coordinator [email protected] 312.745.1958
Dan Ferreira, CPRP, Program & Event Facilitator- Adaptive Sports [email protected] 312.745.2055
Sarah B. Faber, Program Specialist - Deaf and Hard-of-Hearing Programs [email protected] Direct Video Phone & Voice 773.796.3525
Maribel Mejia, Program & Event Facilitator- Veterans Programs [email protected] 312.745.2062
Jennifer Lunz, CTRS, Program & Event Facilitator [email protected] 312.745.3188
Joel Gutierrez, Program & Event Coordinator [email protected] 312.745.2170
Dan Hermle, Program & Event Coordinator [email protected] 312.745.2064
Andrew Grose, Program & Event Facilitator [email protected] 312.745.2172
Sheena Hager, Special Recreation Instructor, Adaptive Sports [email protected] 859.779.1787
Allen West, Special Recreation Instructor [email protected] 312.745.2176 6
Special Recreation Coordinators
Bessemer Park Victor Winson Loyola Park Jose Herrera 8930 S. Muskegon Ave 312.747.6023 1230 W. Greenleaf 773.262.8605 [email protected] [email protected]
Columbus Park Renee Chimino Mann Park Luis Fuentes 500 S. Central 773.921.8903 2949 E. 131st St 773.646.0009 [email protected] [email protected]
Davis Square Park Christina Moy Marquette Park Colleen Fitzgibbon 4430 S. Marshfield 312.747.6107 6700 S. Kedzie Ave 312.747.6485 [email protected] [email protected]
Douglas Park Valonda Smith McGuane Park Kate McIntosh 1401 S. Sacramento Dr 773.762.2842 2901 S. Poplar 312.747.6497 [email protected] [email protected]
Eckhart Park Carmen Lopez Mt. Greenwood Park Lisa Mulcrone 1330 W. Chicago Ave 312.746.5085 3721 W. 111st St 312.747.6565 [email protected] [email protected]
Gage Park Katie Stachura-Hart Norwood Park Jennifer Holecek 2411 W. 55th St 312.747.7635 5801 N. Natoma 773.631.4893 [email protected] [email protected]
Harrison Park Sylvia Prieto-Herrera Piotrowski Park David Donohue 1824 S. Wood 312.746.9581 4247 W. 31st St 312.745.4804 [email protected] [email protected]
Horner Park Tim Owens Shabbona Park Lori Michalski Deaf & Hard-of-Hearing Programs 6935 W. Addison St 773.685.6388 [email protected] [email protected] 773.273.6617 Vittum Park Xochitl Rodriguez Independence Park Maureen Perez 5010 W. 50th St 773.284.6022 3945 N. Springfield Ave 773.478.0944 [email protected] [email protected] Washington Park Hiram DeJesus Jesse Owens Park David Bustos 5531 S. Martin Luther King Dr. 773.256.1248 8800 S. Clyde Ave 312.747.6709 [email protected] [email protected] Welles Park Chelsi Lemaster Kosciuszko Park Megan Romberg 2333 W. Sunnyside 312.742.9536 2732 N. Avers 312.742.9954 [email protected] [email protected] West Pullman Park Rosie St. George 401 W. 123rd St 312.747.5744 [email protected]
For any general questions or concerns please contact the Special Recreation Department at 312-742-5798 or [email protected] 7
CHICAGO PARK DISTRICT Special Recreation
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Chicago Park District 01.5 3 6 Dept. of Planning & Construction Miles December, 2016 - JAT I Special Olympics Chicago 2018 Calendar of Events
January 1/3-4/2018 Gymnastics Camp Harrison Park-1824 S. Wood St. 1/5/2018 Gymnastics Broadway Armory Park-5917 N. Broadway St. 1/9-11/2018 Alpine Ski Qualifier Chestnut Mountain, Galena, IL 1/19/2018 Basketball—Junior & High School Skills (South) Kroc Center-1250 W. 119th St. 1/20/2018 Basketball—Senior Male Teams Competition Quest Multisport-2641 W. Harrison St. 1/23/2018 Basketball—Junior Teams Competition U of C Henry Crown Fieldhouse-5550 S. University Ave. 1/24-25/2018 Basketball—High School Teams Competition IIT Keating Center-3040 S. Wabash Ave. 1/26/2018 Basketball—Junior & High School Skills (North) De Paul University-2235 N. Sheffield Ave. 1/27/2018 Basketball—Senior Skills & Senior Female Teams NEIU-5500 N. St. Louis Ave. 1/31/2018 Basketball—Junior & High School Skills (Central) Quest Multisport-2641 W. Harrison St. February 2/6-8/2018 STATE WINTER GAMES Chestnut Mountain, Galena, IL 2/13/2018 Developmental Swimming Welles Park-2333 W. Sunnyside St. (North) 2/13/2018 Developmental Swimming Eckhart Park-1330 W. Chicago Ave. (Central) 2/13/2018 Developmental Swimming South-Foster Park-1440 W. 84th St. (South) 2/15/2018 CPS Soccer Skills Chicago Indoor Sports-3900 S. Ashland Ave. (North) 2/16/2018 CPS Soccer Skills Chicago Indoor Sports-3900 S. Ashland Ave. (South) 2/21/2018 CPS Soccer Teams Competition Chicago Indoor Sports-3900 S. Ashland Ave. 2/24/2018 Powerlifting Quest Multi Sport—2641 W. Harrison St March 3/3/2018 Swimming Whitney Young High School-211 S. Laflin St. 3/4/2018 Chicago Polar Plunge North Avenue Beach-1600 N. Lake Shore Dr. 3/16-18/2018 STATE BASKETBALL Normal, IL 3/20-21/2018 Volleyball Northside Scrimmages (Parks & Agencies) Hamlin Park-3035 N. Hoyne Ave. (North) 3/20-21/2018 Volleyball Southside Scrimmages (Parks & Agencies) Gage Park-2411 W. 55th St. (South) April 4/3/2018 Volleyball Skills Quest Multi Sport—2641 W. Harrison St (South) 4/4/2018 Volleyball Skills Quest Multi Sport—2641 W. Harrison St (North) 4/5/2018 Motor Activity Training Program (MATP) De La Salle Institute-3434 S. Michigan Ave. 4/7/2018 Volleyball Teams Competition (Parks & Agencies) Mt. Carmel High School-6410 S. Dante Ave. May 5/3/2018 Spring Games Opening Ceremonies Soldier Field-1410 Museum Campus Dr. 5/7-11/2018 Spring Games (Athletics) Competition Dunbar Park-300 E. 31st St. 5/18/2018 Bowling—Junior & High School Waveland Bowl-3700 N Western Ave. (North) 5/18/2018 Bowling—Junior & High School Bluebird Lanes-3900 W. Columbus Ave. (South) 5/19/2018 Bowling—Senior Habetler Bowl-5250 N. Northwest Hwy. (North) 5/19/2018 Bowling—Senior Waveland Bowl-3700 N Western Ave. (Central) 5/19/2018 Bowling—Senior Arena Lanes-4700 W. 103rd St. (South) 5/30/2018 Young Athlete Culminating Event Horner Park-2741 W. Montrose Ave. (North) 5/31/2018 Young Athlete Culminating Event Armor Square Park-3309 S. Shields Ave. (Central) June 6/1/2018 Young Athlete Culminating Event (South) Kennedy Park-11320 S. Western Ave. (South) 6/6/2018 Softball Skills & Team Competition (Parks & Agencies) Grant Park, Upper & Lower Hutchenson-200 E. Balbo Dr. 6/6/2018 SCC Calendar & Art Reception Pompei-1531 W. Taylor St. 6/7/2018 Softball Skills & Team Competition-North (CPS Only) Horner Park-2741 W. Montrose Ave. (North) 6/8/2018 Softball Skills & Team Competition-South (CPS Only) Washington Park-5531 S. Martin Luther King Dr. (South) 6/15-17/2018 STATE SUMMER GAMES Normal, IL July 7/11/2018 Tennis Skills & Match Play Waveland Park Tennis Courts-3650 N. Recreation Dr. 7/13/2018 Golf Course Play & Skills Competition Jackson Park-6401 S. Richards Dr. 7/20-22/2018 Special Olympics 50th Anniversary Celebration Soldier Field-1410 Museum Campus Dr. August 8/18-19/2018 STATE TENNIS Bloomington, IL 8/28-30/2018 Soccer Scrimmages (Parks & Agencies) Marquette Park-6700 S. Kedize Ave. September 9/8-9/2018 STATE OUTDOOR SPORTS FESTIVAL Decatur, IL 9/22/2018 Bocce Ball McGuane Park-2901 S. Poplar St. 9/27/2018 Floor Hockey Skills Jesse White Community Center-410 W. Chicago Ave. (North) 9/28/2018 Floor Hockey Skills Gage Park-2411 W. 55th St. (South) October 10/13/2018 Soccer Skills & Team Competition (Parks & Agencies) Warren Park-6601 N. Western Ave. 10/14/2018 SECTIONAL BOWLING Addison, IL 10/16/2018 CPS Soccer Scrimmages Humboldt Park-1400 N. Sacramento Ave. (North) 10/16/2018 CPS Soccer Scrimmages Marquette Park-6700 S. Kedize Ave. (South) 10/18-20/2018 Flag Football Frenzy UIC Physical Education Building-901 W. Roosevelt Rd. 10/23/2018 CPS Soccer Scrimmages Humboldt Park-1400 N. Sacramento Ave. (North) 10/23/2018 CPS Soccer Scrimmages Marquette Park-6700 S. Kedize Ave. (South) 10/27-28/2018 STATE FALL GAMES Rockford, IL November TBA Annual Coaches Conference TBA TBA MEDFest United Center-1901 W. Madison St. 11/17/2018 STATE FLOOR HOCKEY NEIU-5500 N. St. Louis Ave. 11/20/2018 MATP—Bowling Waveland Bowl-3700 N Western Ave. December 12/1/2018 STATE BOWLING Peoria, IL 12/8/2018 Snowshoe Norwood Park-5801 N. Natoma Ave. (North) 12/8/2018 Snowshoe Mt. Greenwood Park-3724 W. 111th St. (South) 12/13-14/2018 CPS Basketball Scrimmages Horner Park-2741 W. Montrose Ave. (North) 12/13-14/2018 CPS Basketball Scrimmages Washington Park-5531 S. Martin Luther King Dr. (South) 12/13-14/2018 Basketball Scrimmages (Parks & Agencies) Horner Park-2741 W. Montrose Ave. (North) 12/13-14/2018 Basketball Scrimmages (Parks & Agencies) Washington Park-5531 S. Martin Luther King Dr. (South) 12/19/2018 Alpine Ski Rookie School (Tentative) Wilmot Mountain, Wilmot, WI
Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility T Learn to Swim 8+ 4pm-6pm FREE ID/DD/PD T-F Daily Living Skills 8+ 1pm-6pm $35 ID/DD/PD Bessemer Park Social Club 18+ 11am-1pm $15 ID/DD/PD 8930 S. Muskegon W Contact: W Bowling League 8+ 4pm-6pm varies ID/DD/PD Victor Winson 312.747.6023 Th Social Club 14+ 6pm-8pm $15 ID/DD/PD
F Social Club 14+ 6pm-7pm $15 ID/DD/PD Special Olympics Sa 8+ 10am-4pm $15 ID/DD/PD Seasonal Sports T Swimming 8+ 4:30pm-6:30pm FREE ID/DD
T Fun & Games 8+ 3:00pm-4:30pm FREE ID/DD Special Olympics T,Th 21+ 1:00pm-3:00pm FREE ID/DD Columbus Park Basketball Special Olympics 500 S. Central W 8+ 4:00pm-6:30pm varies ID/DD Bowling Contact: W,F Fitness 21+ 1:00pm-3:00pm FREE ID/DD Renee Chimino 773.921.8903 Th Dance 8+ 3:00pm-4:00pm FREE ID/DD Special Olympics Th,F 8+ 4:00pm-5:30pm $15 ID/DD Seasonal Sports F Yoga 8+ 3:00pm-4:00pm FREE ID/DD
F Arts & Craft 8+ 5:30pm-7:00pm FREE ID/DD
T-F Adult Social Club 18+ 10:00am-1:00pm $20 ID/DD Special Olympics Davis Square T-F 18+ 1:00pm-2:00pm FREE ID/DD Training Park 4430 S. Marshfield T-F Fun & Games 6 to 14 2:30pm-6:00pm $20 ID/DD Special Olympics Contact: W 8 to 14 3:00pm-4:00pm FREE ID/DD Christina Moy Training 312.747.6107 Sa Super Saturday 6 to 14 9:30am-11:30am FREE ID/DD
Sa Judo 8+ 12:30pm-2:00pm FREE VI Sa Social Club 14+ 2:00pm-3:30pm FREE VI
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Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility
M-F Park Kids 8 to 21 3pm-6pm $28 ID/DD/PD Special Olympics M-Th 22+ 1pm-3pm $5 ID/DD/PD Seasonal Sports Douglas Park M-Th Leisure Education 22+ 3pm-6pm $28 ID/DD/PD 1401 S. Sacramento T, F Drama 8+ 3pm-4pm FREE ID/DD/PD Contact: Valonda Smith W Swimming/Bowling 8+ 4pm-6pm FREE ID/DD/PD 773.762.2842 Th Arts & Crafts 8 to 21 4:30pm-5:30pm FREE ID/DD/PD
Th Arts & Crafts 22+ 3pm-4pm FREE ID/DD/PD
F Fitness & Nutrition 22+ 10am-2pm FREE ID/DD/PD T-F Daily Living Skills 18+ 11:00am-12pm $24 ID/DD Special Olympics T-F 18+ 12:00pm-1pm FREE ID/DD Powerlifting Special Olympics T-F 18+ 1:00pm-2pm $13 ID/DD Seasonal Sports T-Th Basketball 18+ 2:00pm-4pm $13 ID/DD
T-Th Fitness 18+ 4:00pm-5pm FREE ID/DD
F Fitness 18+ 3:00pm-4pm FREE ID/DD Eckhart Park 1330 W. Chicago T-Th Fun & Games 8 to 18 3:00pm-6pm $56 ID/DD Contact: Carmen Lopez F Fun & Games 8 to 18 3:00pm-4pm FREE ID/DD 312.746.5085 T-Th Social Club 18+ 5:00pm-6pm FREE ID/DD
F Bowling 8+ 4:00pm-6pm FREE ID/DD
Sa Powerlifting 18+ 10am-1pm FREE ID/DD
Sa Swimming 18+ 11am-12pm FREE ID/DD
Sa Fitness 18+ 12pm-1pm FREE ID/DD
Special Olympics Sa 18+ 1pm-3pm FREE ID/DD Seasonal Sports
Sa Social Club 18+ 3pm-4pm FREE ID/DD 10
Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility M, W- Fitness 22+ 1:00pm-2:00pm $11 ID/DD F M, W- Daily Living Skills 22+ 2:00pm-3:00pm $5 ID/DD F M-F Fun & Games 8+ 3:00pm-5:00pm $15 ID/DD Gage Park 2411 W. 55th St. M Aerobics 8+ 5:00pm-6:15pm FREE ID/DD Contact: T Bowling 22+ 1:00pm-3:00pm $5 ID/DD Katie Stachura-Hart 312.747.7635 T Drama 12+ 5:00pm-6:30pm FREE ID/DD
Special Olympics T 15+ 6:30pm-7:30pm FREE ID/DD Practice W Dance 12+ 5:00pm-6:30pm $4.00 ID/DD Th Swim 12+ 3:00pm-5:30pm $4.00 ID/DD Th Crafts 8+ 5:00pm-6:30pm $4 ID/DD
F Cooking 8+ 5:00pm-6:30pm $4 ID/DD Special Olympics M, F 18+ 2pm-3pm FREE ID/DD/PD Swimming M, F Learn to Swim 8 to 17 3pm-3:45pm FREE ID/DD/PD
M Young Athletes 2 ½ to 9 4:15pm-5pm FREE ID/DD/PD
M,T,Th, Harrison Park ID/DD/PD F Daily Living Skills 22+ 12pm-1pm $7 1824 S. Wood Contact: W Arts & Crafts 22+ 1pm-2pm $5 ID/DD/PD Sylvia Prieto- Special Olympic W 8+ 2pm-6pm $12 ID/DD/PD Herrera Bowling 312.746.9581 Special Olympics T,Th 22+ 1pm-5pm $12 ID/DD/PD Seasonal Sports
M,F Adult Leadership 22+ 3pm-6pm $10 ID/DD/PD
T,Th Fun & Games 8 to 21 3:30pm-6pm $11 ID/DD/PD
M,F Dance 22+ 1pm-2pm FREE ID/DD/PD 1/30, 2/27 & 3/27 T Social Club 22+ $18 ID/DD/PD 1pm-5pm
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Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility
T Bowling 8+ 2:30pm-5:30pm $10 ID/DD/PD
Special Olympics W 12+ 2:30pm-6:00pm FREE ID/DD/PD Seasonal Sports
W Social Club 18+ 11:00am-2:00pm FREE ID/DD/PD
Th Social Club 18+ 11:00am-2:00pm FREE ID/DD/PD Independence F Social Club 18+ 11:00am-2:00pm FREE ID/DD/PD Park Junior Special 3945 N Springfield Th 8+ 2:30pm-5:30pm FREE ID/DD/PD Contact: Olympic Sports Maureen Perez Th Gymnastics 8+ 2:30pm-5:30pm FREE ID/DD/PD 773.478.0944 F Basketball League 8+ 5:00pm-9:00pm FREE ID/DD/PD
Sa Young Athletes 3 to 7 9:00am-10:00am FREE ID/DD/PD
Special Olympics Sa 10+ 12:00pm-2:00pm FREE ID/DD/PD Seasonal Sports
Sa Science Saturdays 8+ 9:00am-10:00am FREE ID/DD/PD
Sa Judo 10+ 10:00am-11:30am FREE ID/DD/PD M-W 2-6pm M-F Park Kids 8 to 13 $60 ID/DD Th, F 2-4:30pm M-W 2-6pm M-F Daily Living Skills 13 to 21 $40 ID/DD/PD/VI Th, F 2-4:30pm M-W 12-4pm M-F Daily Living Skills 21+ $24 ID/DD/PD/VI Jesse Owens Park Th, F 1-4pm 8800 S. Clyde Ave Adult Leadership M-W 21+ 4-6:00pm FREE ID/DD/PD/VI Contact: Club David Bustos Special Olympics W 8+ 5-6:00pm FREE ID/DD/PD/VI 312.747.6709 Seasonal Sports
Th Learn to Swim 8+ 5-6:30pm $11 ID/DD/PD/VI
Special Olympics F 8+ 4:30pm-6:30pm FREE ID/DD Bowling
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Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility Special Olympics T 22+ 6:00pm-7:00pm FREE ID/DD Swimming Special Olympics T, F 6 to 22 6:00pm-7:00pm FREE ID/DD Swimming T-Th Social Club 22+ 2:30pm-3:00pm FREE ID/DD
T-F Nutrition 14 to 22 3:00pm-3:30pm FREE ID/DD
F Daily Living Skills 22+ 11:00am-3:00pm FREE ID/DD
T,Th, Special Olympics T/Th 3-5:00pm 22+ $28 ID/DD Sa Seasonal Sports Sa 8am-4pm Kosciuszko Park T, Th,F Special Olympics T/Th/F 3-5pm 2732 N. Avers 14 to 22 $22 ID/DD Sa Seasonal Sports Sa 8am-4pm Contact: Special Olympics Th 5-7-pm Megan Romberg T,Sa 6 to 14 $18 ID/DD 312.742.9954 Seasonal Sports Sa 8am-4pm Adaptive Sports T 14+ 5:00pm-6:00pm FREE ID/DD Fitness T Daily Living Skills 14+ 5:00pm-6:00pm FREE ID/DD
Special Olympics F 14+ 5:00pm-9:00pm FREE ID/DD Basketball Th Powerlifting 22+ 5:00pm-6:00pm FREE ID/DD
T Powerlifting 14 to 22 5:00pm-6:00pm FREE ID/DD
Th Arts & Crafts 14+ 5:00pm-6:00pm FREE ID/DD F Gymnastics 14 to 22 5:00pm-6:00pm FREE ID/DD
Th Fun & Games 22+ 6:00pm-7:00pm FREE ID/DD
W Bowling 14+ 3:30pm-6:30pm varies ID/DD
Sa Jr. Bowling 6 to 22 9:30am-11:00am varies ID/DD
F Arts & Crafts 6 to 14 5:00pm-6:00pm FREE ID/DD
T Fun & Games 6 to 14 6:00pm-7:00pm FREE ID/DD
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Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility
M-F Park Kids 8 to 19 3pm-6pm $84 ID/DD Special Olympics M 18+ 6:30pm-8pm $11 ID/DD Powerlifting Special Olympics T 18+ 6:30pm-8pm $12 ID/DD Loyola Park Basketball 1230 W. Greenleaf Special Olympics W 8+ 6:30pm-8pm $11 ID/DD Contact: Snowshoe Jose Herrera 773.262.8605 Th Social Club 18+ 6:30pm-8pm $11 ID/DD Special Olympics F 8+ 4pm-5pm FREE ID/DD Gymnastics Special Olympics F 18+ 6:30pm-9pm FREE ID/DD Basketball
M Arts & Crafts 8+ 6pm-7pm FREE ID/DD M Woodcraft 8+ 2pm-4pm $7 ID/DD Special Olympics M,T 8+ 5pm-6pm $7 ID/DD Seasonal Sports Special Olympics M,F 8+ 4pm-5pm FREE ID/DD Track & Field Special Olympics T 8+ 4pm-5pm FREE ID/DD Volleyball Mann Park T Learn to Swim 8+ 6pm-7pm $7 ID/DD st 2949 E. 131 St. T Fitness 8+ 2pm-3pm FREE ID/DD Contact: Luis Fuentes T Walking Club 8+ 2pm-3pm FREE ID/DD 773.646.0009 T, Th Basketball 8+ 3pm-4pm FREE ID/DD
W Bowling 8+ 3pm-6pm FREE ID/DD
Th Cooking 8+ 4pm-6pm $7 ID/DD Th Zumba 8+ 6pm-7pm $7 ID/DD
Special Olympics Th, F 17+ 2pm-3pm $7 ID/DD Powerlifting F Social Club 17+ 5pm-7pm $7 ID/DD
F Archery 18+ 12pm-1pm $9 ID/DD
F Swim Team 8+ 3pm-4pm FREE ID/DD
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Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility M SO Gymnastics 8+ 2:30-5:30pm $13 ID/DD/PD 12-12:45 or T Young Athletes 3 to 7 FREE ID/DD/PD 3:30-4:15pm T SO Powerlifting 16+ 4:30-5:30pm $13 ID/DD/PD T,F Bowling 8+ 6:15-8:15/4-6pm Weekly ID/DD/PD Marquette Park fees 6700 S. Kedzie W Arts & Crafts 8+ 4-4:45pm $13 ID/DD/PD Contact: W Cooking 8+ 4:45-6:30pm $13 ID/DD/PD Colleen Fitzgibbon 6:30-8pm/ W, Sa Seasonal Sports 8+ $8 ID/DD/PD 312.747.6485 12:30-2pm Th Swim 8+ 3:30-5pm $13 ID/DD/PD Th Music 8+ 6-7:30pm $13 ID/DD/PD F Social Club 8+ 6-8:00pm varies ID/DD/PD
Sa Mom, Pop & Tots 18mo- 8 9:30am-10:15am FREE ID/DD/PD Sa Leisure Education 8+ 10:30-12:00pm $13 ID/DD/PD T Scrapbooking 21+ 10am-12pm $11 ID/DD/PD Special Olympics T-F 21+ 12pm-3pm $19 ID/DD/PD Seasonal Sports McGuane Park T Drama 8+ 3pm-6pm $11 ID/DD/PD 2901 S. Poplar W Fun & Games 8+ 3pm-6pm $11 ID/DD/PD Contact: Special Olympics Kate McIntosh Th 8+ 3pm-6:30pm $11 ID/DD/PD Bowling 312.747.6497 Special Olympics F 8+ 3pm-6pm $11 ID/DD/PD Seasonal Sports Sa Super Saturdays 8+ 10am-3pm $11 ID/DD/PD M Powerlifting 16+ 5:30pm-6:45pm $16 ID/DD/PD M Gymnastics 8+ 3:45pm-5:00pm $16 ID/DD/PD Mt. Greenwood M Zumba 8+ 7:00pm-7:45pm varies ID/DD/PD Park th Arts & Crafts/Fun & 3721 W. 111 St. T 8 to 15 3:30pm-5:30pm $16 ID/DD/PD Contact: Games Lisa Mulcrone T Gymnastics 8 to 15 6:15pm-6:45pm $16 ID/DD/PD 312.747.6565 T Gymnastics 8 to 15 6:50pm-7:20pm $16 ID/DD/PD
W Cooking 16+ 3:30pm-5:30pm $16 ID/DD/PD W Zumba/Dance 16+ 3:30pm-5:30pm $16 ID/DD/PD
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Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility
W Crafts/Fitness 16+ 3:30pm-5:30pm $16 ID/DD/PD
Special Olympics W 16+ 6:30pm-7:30pm $16 ID/DD/PD Floor Hockey Special Olympics Th 12+ 3:30pm-5:15pm $16 ID/DD/PD Seasonal Sports
Th Basketball 8+ 6:00pm-7:00pm $16 ID/DD/PD Mt. Greenwood Cont… Th Swim Team 12+ 7:00pm-7:45pm $16 ID/DD/PD F Bowling League 7+ 6:00pm-8:30pm $16 ID/DD/PD
F Social Club 18+ 6:00pm-8:30pm $16 ID/DD/PD M, W, Adult Leadership 22+ 11:30am-3:00pm FREE ID/DD/PD F M-F Teen Leadership 15+ 3:00pm-4:00pm FREE ID/DD M Basketball Skills 6 to 15 3:45pm-4:30pm $11 ID/DD
M Basketball Team 15+ 4:00pm-5:30pm $11 ID/DD Norwood Park Special Olympics 5801 N. Natoma M 8+ 6:00pm-7:00pm $11 ID/DD/PD/VI Volleyball Contact: Jennifer Holecek M Cooking 8+ 7:00pm-8:00pm FREE ID/DD/PD/VI 773.631.4893 Special Olympics T 8+ 4:00pm-5:00pm $11 ID/DD Track & Field Special Olympics T 8+ 5:00pm-6:30pm $11 ID/DD Floor Hockey Special Olympics T-Th 16+ 7:00pm-8:00pm $11 ID/DD Powerlifting W Drama 8+ 4:00pm-5:30pm $11 ID/DD/PD/VI W Boccia 8+ 5:30pm-6:30pm $11 PD
Special Olympics W 8+ 6:00pm-7:00pm $11 ID/DD Showshoe
Th Tumbling 4 to 7 3:45pm-4:30pm $11 ID/DD Th Art Club 8+ 4:30pm-5:30pm $11 ID/DD/PD/VI Special Olympics Th 8+ 5:30pm-6:30pm $11 ID/DD Gymnastics Special Olympics F 8+ 4:00pm-6:00pm FREE ID/DD/PD/VI Bowling F Social Club 8+ 6:30pm-8:00pm $11 ID/DD/PD/VI 16
Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility T Bowling 8+ 4:00pm-7:30pm varies ID/DD T,Th Fitness 8+ 2:00pm-3:00pm $7 ID/DD T,Th Aerobics 8+ 3:00pm-4:00pm $7 ID/DD W Learn to Swim 8+ 4:00pm-5:00pm FREE ID/DD W Adult Leadership 18+ 12:00pm-2:00pm FREE ID/DD Special Olympics W/F 8+ 6:00pm-7:00pm $13 ID/DD Seasonal Sports Piotrowski Park W/F Daily Living Skills 8+ 5:00pm-6:00pm FREE ID/DD 4247 W. 31st St. Th Arts & Crafts 8+ 4:00pm-5:00pm FREE ID/DD Contact: David Donohue Th Cooking 8+ 5:00pm-6:00pm FREE ID/DD 312.745.4804 Th Social Club 8+ 6:00pm-7:00pm $8 ID/DD F Music & Movement 8+ 12:00pm-1:00pm FREE ID/DD Sa Learn to Swim 8+ 9:00am-10:00am FREE ID/DD Sa Music & Movement 8+ 12:00pm-1:00pm FREE ID/DD Special Olympics Sa 8+ 1:30pm-3:00pm $8 ID/DD Seasonal Sports Sa Daily Living Skills 8+ 1:00pm-1:30pm FREE ID/DD Sa Super Saturdays 8+ 10:00am-12:00pm $7 ID/DD Special Olympics M 18+ 2:30pm-7:00pm $11 ID/DD Seasonal Sports M Swim 18+ 7:00pm-8:00pm $5 ID/DD M Gymnastics 18+ 3:00pm-4:00pm FREE ID/DD Special Olympics Shabbona Park T 18+ 2:30pm-7:00pm $11 ID/DD 6935 W. Addison Seasonal Sports Contact: T Swim 18+ 7:00pm-8:00pm $5 ID/DD Lori Michalski W Ice Skating 18+ 1:00pm-3:00pm $5 ID/DD 773.685.6388 W Tennis 18+ 3:00pm-4:00pm $5 ID/DD W Youth Seasonal Sports 8 to 12 6:00pm-7:30pm $11 ID/DD Th Bowling 18+ 3:00pm-6:00pm $11 ID/DD
F Basketball League 18+ 5:00pm-9:00pm $11 ID/DD Special Olympics Sa 18+ 8:00pm-3:00am FREE ID/DD Competition 17
Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility
M, T Arts & Crafts 18+ 3:30pm-4:30pm FREE ID/DD
M, T Daily Living Skills 18+ 4:30pm-5:30pm FREE ID/DD M, T Social Club 18+ 2:30pm-3:30pm FREE ID/DD
M, Th Adult Leadership 18+ 12:00pm-2:00pm FREE ID/DD Special Olympics T All 4-7pm varies ID/DD/PD Bowling Adult Leadership W-F 18+ 11am-3pm $10 ID/DD/PD Club Vittum Park T-F Daily Living Skills 8+ 3-4pm FREE ID/DD/PD 5010 W. 50th St. Special Olympics Contact: W, F 8+ 4-6:30pm $8 ID/DD/PD Volleyball Xochitl Rodriguez 773.284.6022 Th Aerobics 8+ 4-6pm $6 ID/DD/PD
Sa Super Saturday 8+ 12:30-3:30pm $14 ID/DD/PD
Special Olympics Sa 2 to 7 11-12:30pm $8 ID/DD/PD Young Athletes
Sa Arts & Crafts 4 to 7 12:30-2pm $8 ID/DD/PD
Special Recreation T 8+ 5:00pm-7:00pm FREE ID/DD Swim
T-F Walking Club 8+ 2:30pm-3:30pm FREE ID/DD
T-F Fun & Games 8+ 3:30pm-5:00pm FREE ID/DD Washington Park 5531 S. Martin W Gym Games 8+ 6:00pm-7:00pm FREE ID/DD Luther King Dr. Contact: W Fitness 8+ 5:00pm-6:00pm FREE ID/DD Hiram DeJesus Special Olympics Th 5pm-7pm 773.256.1248 Th, Sa 8+ FREE ID/DD Seasonal Sports Sa 9am-4pm
F Social Club 8+ 5:00pm-7:00pm FREE ID/DD
Sa Bowling 8+ 12:00pm-2:30pm $8 ID/DD
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Winter Programs-At-A-Glance January 8th- March 18th, 2018 Park Days Program Name Ages Time FEE Eligibility
T Daily Living Skills 18+ 11am-12pm FREE ID/DD/PD
W-F Aquatic Exercise 18+ 11am-12pm $8 ID/DD/PD
Special Olympics Welles Park T-F 18+ 12pm-3pm $11 ID/DD/PD 2333 W. Sunnyside Seasonal Sports Contact: Chelsi Hill-Lemaster T,Th Adult Leadership 14+ 3pm-5:30pm $9 ID/DD/PD 312.742.9536 Special Olympics W 14+ 3pm-5pm FREE ID/DD/PD Bowling
F Social Club 14+ 3pm-5:30pm $7 ID/DD/PD
Special Olympics Sa 14+ 11am- 3pm $11 ID/DD/PD Seasonal Sports Special Olympics M, T 20+ 10:30am-2:00pm $4 ID/DD/PD Seasonal Sports W, Th Learn to Swim 20+ 11:30am-12:45pm FREE ID/DD/PD Special Olympics W, Th 20+ 1pm-2pm $3 ID/DD/PD Seasonal Sports West Pullman M-F Daily Living Skills 8+ 2:30pm-6:30pm $28 ID/DD/PD Park 401 W. 123rd St. M Daily Living Skills 20+ 3:30pm-5:30pm FREE ID/DD/PD Contact: Special Olympics F 20+ 10:30am-1:30pm $6 ID/DD/PD Rosie St. George Bowling 312.747.5744 Special Olympics Sa 8+ 10:30am-2:00pm $4 ID/DD/PD Seasonal Sports Sa Learn to Swim 8+ 1:00pm-2:00pm $4 ID/DD/PD
Sa Fun & Games 8+ 2:00pm-3:00pm FREE ID/DD/PD W,Th, Special Olympics 13+ 10:30am-2:30pm FREE ID/DD/PD Sa Seasonal Sports F Social Outing 13+ 10:30am-2:30pm $6 ID/DD/PD
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Adaptive Recreation Programs Eligi ility: I di iduals ith a physi al disa ility or isual i pair e t. **Spring Programs may vary, contact Coordinators for more information**
Program Name Park Ages Days Time Price Eligibility
Adaptive Swimming Fosco Park All T 6pm-8pm Interested in improving your swimming
skills? This program will focus on proper FREE PD/VI
swimming form, techniques as well as Ellis Park All Th 6:30-7:30pm skills needed to train for a triathlon!
Swimmers of ALL levels are welcome. Contact: Sheena Hager [email protected] (312) 745-2064
Aquatic Exercise Grab your swim suit and get ready for a Ellis Park All M 1pm-2pm $10 PD/VI low intensity cardio and strengthening workout. No swimming experience Homan Square needed. This program is for individuals All F 11am-12pm $11 PD/VI who are blind or visually impaired. Park Contact: Allen West [email protected] (312) 745.2176 Boccia This Paralympic sport is for individuals with cerebral palsy or related neurological Loyola Park All T 1:30-3:00pm FREE PD disorder. Boccia is a test of muscle control and accuracy, requiring high focus and concentration. Contact: Sheena Hager [email protected] (312) 745-2064 Ceramics Adapted for individuals who are blind or Ridge Park All Th 2pm-4pm $14 VI visually impaired, in this class participants will learn the basics of Athletic Field working with clay, molding and glaze to All Th 2pm-4pm $14 VI Park make their own artistic creations. Contact: Allen West [email protected] (312) 745.2176
Gardening This activity gives participants a hands-on experience growing plants. Individuals Kilbourn Park All W 10-11:00am $11 VI will learn gardening skills and plant, take care of and harvest their edibles.
Contact: Allen West [email protected] (312) 745.2176
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Program Name Park Ages Days Time Price Eligibility
Judo This program helps to develop flexibility, Armour 8+ Sa 12:30-2pm FREE VI coordination and strength. Come learn Square and develop the skills of this Japanese martial art.
Contact: Christina Moy [email protected] (312) 747-6107
Indoor Racing Chair Jesse White Community All M 7:00pm-9pm FREE PD/VI Roller Training Center
Contact: Sheena Hager [email protected] 312-745-2064
Sled Hockey This Paralympic sport allows individuals McFetridge with a primary physical disability to 13+ W/ Su 9:00-11:00pm FREE PD participate in the game of ice hockey, Sports Center using specially designed sleds and sticks. The sport improves endurance, coordination, strength and more. Contact: Dan Hermle [email protected] (312) 747-6107 Wheelchair Basketball Jesse White Community 18+ W, F 6pm-9pm FREE PD Through drills and passing exercises, Center individuals will raise their level of play and understanding of the game. Rainbow 6 to 18 Sa 9am-12pm FREE PD Participants may be eligible for area Beach Park competitions. Contact: Dan Ferreira [email protected] (312) 745-2055
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Deaf & Hard-of-Hearing Programs Eligibility: Individuals with a primary diagnosis of deaf or hard-of-hearing **Fall Programs may vary, contact Coordinators for more information** Program Name Park Ages Day Times FEE Eligibility
ASL I – Learn a new language through American Sign Language. This is the best way to communicate Horner Park 18+ T 5:30pm-7:00pm $55 Anyone with those who are deaf or hard-of- hearing.
ASL II – American Sign Language – Learn a new language through American Sign Language. This is the best way to Horner Park 18+ T 7:15pm-8:45pm $55 Anyone communicate with those who are deaf or hard-of-hearing. Must have completed ASL I to join ASL II.
Pickleball- Pickleball is a racquet sport which combines elements of badminton, tennis and table Sauganash 40+ W 1:30pm-3:30pm $6 D/HOH tennis. Players will learn the basic skills, rules and fundamentals of the games.
ASL for TEENS- Learn a new language through American Sign Language. This is the best way to communicate with those who Horner Park 15 to 18 Th 5:30pm-6:30pm $21 Anyone are deaf or hard-of-hearing. Need A Basic Course in ASL book for class 0.932666.42.6
Ceramics For individuals with all types of hearing loss and visually Athletics Field impaired. Work with clay 18+ TH 2pm-4pm $14 DeafBlind Park without a wheel and build unique sculptures, functional art pieces and more.
Judo For individuals whose primary disability is deafness or hard-of- hearing. Learn and excel in this Japanese martial art. Judo is based on the ancient techniques Horner Park 15+ Th 7pm-8:30pm FREE D/HOH/VI of jujutsu. It promotes flexibility, develops speed and coordination, strengthens the cardiovascular system, and promotes balanced muscular development. Ceramics Introduce Deaf & Hard-of- Hearing individuals to work Athletics Field 18+ F 12pm-2pm $14 D/HOH with clay without a wheel and Park build unique sculptures, functional art pieces and more.
Teen Leadership Club For individuals who have all types of hearing loss. This club combines service to the park and community with fun Blackhawk 15 to 19 F 4pm-8pm $5 D/HOH activities for teens. Leadership Park skills, creative thinking and game play will be covered among other topics. Participate in City-Wide events for teens.
Play School An opportunity for socialization and interaction with peers who have all types of hearing loss through group activities. A variety of activities will help to develop motor and social skills in a playful setting – use of sign language will be incorporated into Horner Park 2 ½ to 5 Sa 9:30am-11:30am $12 D/HOH communication. Free play & activities like music, games & creative crafts to help to enhance a child’s experience away from parents. Children must be toilet trained and should be comfortable participating without a parent.
Fun & Games- This activity provides on opportunity for children and Horner Park 6 to 14 Sa 12:30pm-1:45pm $7 D/HOH parents/caregivers to play, interact, learn, and make new friends. Open Swim For individuals with a primary diagnosis of deaf or hard-of- hearing. Social fun swim. Some Welles 6 to 14 Sa 12:45pm-1:45pm FREE D/HOH may choose to work on their strokes, while others just float around.
Arts & Crafts- Introduce Deaf & Hard-of- Hearing individuals to various Horner 6 to 14 Sa 1:45pm-3pm $7 D/HOH art materials and techniques such as painting, clay, weaving and more.
Seasonal Sports Learn to play a variety of sports and brush up on athletic skills. Instructors teach and reinforce skills development through drills Horner 6 to 14 Sa 3pm-4:30pm $7 D/HOH and game play, with concentration on sportsmanship and friendly competition. Sports vary by Season. Men’s Basketball Enjoy the game of basketball and want to learn more? Learn the fundamental skills and concepts of basketball. Washington 18+ Sa 9:30am-11:30am $14 D/HOH Participants may be eligible to compete in local, regional and national tournaments.
Women’s Basketball Enjoy the game of basketball and want to learn more? Learn the fundamental skills and Gage Park 18+ Su TBD $14 D/HOH concepts of basketball. Participants may be eligible to compete in local, regional and national tournaments.
Special Events
Chicago KIDS & Parents Club Come join us! All deaf & hard-of-hearing youth ages 0-14 and their families will be in for a fun-filled program of events going on around the city of Chicago; held every third Saturday or Sunday of each month.
Open Swim For individuals with a primary diagnosis of deaf or hard-of-hearing. Social fun swim. Some may choose to work on their strokes, while others just float around. (Every other Saturday at Welles Park from 12:45pm – 2pm)
Dates: January 20th, February 3rd, February 17th, March 3rd, April 17th and April 31st
For more information please contact: Sarah B. Faber, Program Specialist Timothy Owens, SR Coordinator Deaf & Hard-of-Hearing Programs Deaf & Hard-of-Hearing Programs Direct Video Phone & Voice 773.796.3525 Direct Video Phone & Voice 773.273.6617 [email protected] [email protected]
VETERAN PROGRAMS “Serving Those Who Have Served” U.S. Vetera s ha e ear ed our respe t a d ad iratio ser i g our ou tr . The Chi ago Park Distri t e presses their gratitude to our ser i e e ers pro idi g a full ra ge of re reatio al progra s. B o tri uti g our ser i es e stri e to e ha e lifest les through ph si al a ti it , re reatio al progra i g a d so ial i tera tio s to ALL U.S. Vetera s.
Eligi ility: Must e an A tive Duty Personnel or US Military Veteran and e a le to present your DD 4 **Spring Programs may vary, contact Coordinators for more information**
Program Name Park Ages Days Time Price Eligibility Oriole Park 18+ M 10am-12pm FREE DD214 Archery Mann Park 18+ T 6pm-7:30pm FREE DD214 Basketball Horner Park 18+ Th 6:30pm-9:30pm $10 DD214 Contact: Maribel Mejia 312-745-2062 [email protected]
26
WINTER CAMPS
Columbus Park December 27- 29th & January 3-5th 7 to 18 years old $15 9:00am-3:00pm Contact: Renee Chimino 773.921.8903
Eckhart Park December 27- 29th & January 2-5th 8 years and older $25 10:00am-4:00pm Contact: Carmen Lopez 312.746.5085
Harrison Park December 11th-22nd 22 years and older $10 Contact: Sylvia Prieto-Herrera 312.746.9581 Jesse Owens Park December 26th-January 5th 8+ 8+ $15 $35 8:00am-9:00am and/or 9:00am-4:30pm Contact: David Bustos 312.747.6709
Loyola Park December 27th-January 5th 8 to 19 years old $28 W-F, 9:00am-5:00pm Contact: Jose Herrera 773.262.8605 27
Looking for programs for individuals with disabilities?
Is now offering…
Beginning Winter 2018 (Stay Tuned!)
For more information, please contact Renee Chimino at 773.921.8903 or [email protected]
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~FACILITY RESOURCES~
Chicago Park District - Accessible Pool Locations INDOOR OUTDOOR PARK ADDRESS PHONE ACCESSIBLE (ADA) POOL POOL ABBOTT 49 E. 95th St. 312-747-6001 X ADA Stairs ALTGELD 515 S. Washtenaw Ave. 32-746-5001 Lift ARMOUR SQUARE 3309 S. Shields Ave. 312-747-6012 X ADA Stairs & Lift AUSTIN 5610 W. Lake St. 773-287-7764 X Lift BESSEMER. 8930 S. Muskegon Ave. 312-747-6023 X X ADA Stairs & Lift BLACKHAWK. 2318 N. Lavergne Ave. 312-746-4150 X Lift (Stairs access only to pool) CALIFORNIA 3843 N. California Ave. 773-478-5408 X Lift CARVER 939 E. 132nd St. 312-747-6348 X Lift CHASE 4701 N. Ashland Ave. 312-742-7518 X ADA Stairs & Lift COLUMBUS 500 S. Central Ave. 773-287-7641 X Lift CORNELL SQUARE 1809 W. 50th St. 312-747-6097 X Lift DAVIS SQUARE 4430 S. Marshfield Ave. 312-747-6107 X Lift DOUGLAS 1401 S. Sacramento Dr. 773-767-6097 X Lift DVORAK 1119 W. Cullerton St. 312-746-5088 X ADA Stairs & Lift ECKHART 1330 W. Chicago Ave. 312-746-5553 X Lift ELLIS 3520 S. Cottage Grove Ave. 773-285-7099 X Zero Depth FERNWOOD. 10436 S. Wallace St. 312-747-6164 X Zero Depth & Lift FOSCO 1312 S. Racine Ave. 312-743-0135 X Zero Depth & Lift FOSTER 1440 W. 84th St. 312-747-7612 X ADA Stairs & Lift FULLER 331 W. 45TH St. 312-747-5997 X Lift GAGE 2411 W. 55th St. 312-747-2899 X Lift GILL 825 W. Sheridan Rd. 312-742-5807 X ADA Stairs & Lift GOMPERS 4222 W. Foster Ave. 773-685-3305 X Lift HALE 6258 W. 62nd St. 773-229-1032 X Lift HAMLIN 3035 N. Hoyne Ave. 312-742-7785 X Lift HARRIS 6200 S. Drexel Blvd. 312-747-2795 X Zero Depth & Lift HARRISON. 1824 S. Wood St. 312-746-9490 X ADA Stairs & Lift HAYES 2936 W. 85th St. 312-745-2200 X Zero Depth & Lift HOLSTEIN 2200 N. Oakley Ave. 312-742-7554 X Lift HOMAN SQUARE 3559 W. Arthington St. 312-746-6656 X Zero Depth & Lift HUMBOLDT 958 N. Sacramento Ave. 312-746-5281 X Lift INDEPENDENCE 3945 N. Springfield Ave. 773-478-3538 X ADA Stairs & Lift JEFFERSON 4822 N. Long Ave. 773-685-3347 X Lift KENNEDY 11320 S. Western Ave. 773-534-2425 X ADA Stairs & Lift KOSCIUSZKO 2732 N. Avers Ave. 312-742-7556 X ADA Stairs & Lift MANN 3035 E. 131st St. 773-646-0265 X ADA Stairs & Lift McGUANE 2901 S. Poplar Ave. 312-747-7463 X ADA Stairs & Lift McKINLEY 2210 W. Pershing Rd. 312-747-6527 X Lift MT. GREENWOOD 3721 W. 111th St. 312-747-6564 X Lift NASH 1833 E. 71st St. 773-256-0906 X ADA Stairs & Lift NORWOOD 5801 N. Natoma Ave. 773-631-5359 X ADA Stairs & Lift OAKDALE 965 W. 95th St. 312-745-4834 X Lift
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~FACILITY RESOURCES~
Chicago Park District - Accessible Pool Locations INDOOR OUTDOOR POOL ADDRESS PHONE ACCESSIBLE (ADA) POOL POOL PALMER 201 E. 111th St. 312-747-6577 X ADA Stairs & Lift PING TOM 1700 S. Wentworth Ave. 312-225-0955 X Zero Depth PIOTROWSKI 4247 W. 31st St. 312-747-3868 X X Lift PORTAGE 4100 N. Long Ave. 773-685-7189 X ADA Stairs & Lift PULASKI 1419 W. Blackhawk St. 312-742-9918 X Lift RIDGE 9625 S. Longwood Dr. 312-747-0402 X ADA Stairs & Lift RIIS 6100 W. Fullerton Ave. 312-746-5918 X Lift RIVER 5100 N. Francisco Ave. 312-742-4466 X ADA Stairs & Lift SHABBONA 6935 W. Addison St. 773-685-6205 X ADA Stairs & Lift SHERIDAN 910 S. Aberdeen St. 312-746-5370 X ADA Stairs & Lift SHERMAN 1301 W. 52nd St. 312-745-2940 X ADA Stairs & Lift SMITH 2526 W. Grand Ave. 312-742-5711 X Lift STANTON 618 W. Scott St. 312-742-9553 X Lift TRUMBULL 2400 E. 105th St. 312-747-6759 X Lift TULEY 501 E. 90th Pl. 312-747-8416 X Lift UNION 1501 W. Randolph St. 312-746-5466 X Lift WASHINGTON 5531 S. Russell Dr. 773-256-1897 X Zero Depth & Lift WELLES 2333 W. Sunnyside Ave. 312-742-7515 X ADA Stairs & Lift WEST PULLMAN 401 W. 123rd St. 312-747-7340 X ADA Stairs & Lift
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~FACILITY RESOURCES~
Chicago Park District – Fitness Centers PARK ADDRESS PHONE REGION ACCESSIBLE (ADA) ADA 11250 S. Ada St. 312-747-6002 South ADA ALTGELD 515 S. Washtenaw Ave. 312.746.5001 Central AMUNDSEN 6200 W. Bloomingdale Ave. 312.746.5003 North ADA* ARCHER 4901 S. Kilbourn Ave. 773.284.7029 Central ADA ARMOUR SQUARE 3309 S. Shields Ave. 312.747.6012 Central ADA AVALON 1215 E. 83rd St. 312.747.6015 South ADA BROADWAY ARMORY 5917 N. Broadway St. 312.742.7502 North ADA CALUMET 9801 S. Ave. G 312.747.6039 South CARVER 939 E. 132nd St. 312.747.6047 South CHASE 4701 N. Ashland Ave. 312-472-7518 North ADA CLARENDON COMMUNITY CENTER 4501 N. Clarendon Ave. 312.742.7512 North ADA COLUMBUS 500 S. Central Ave. 773.287.7641 Central ADA DAVIS SQUARE 4430 S. Marshfield Ave. 312.747.6107 Central ADA DON NASH COMMUNITY CENTER 1833 E. 71st St. 773.256.0904 South ADA DOUGLAS 1401 S. Sacramento Dr. 773.762.2842 Central ADA* DUNHAM 4638 N. Melvina Ave. 773-685-3257 North EXKHART 1330 W. Chicago Ave. 312.746.5490 Central ADA FERNWOOD 10436 S. Wallace St. 312.747.6132 South FOSCO 1312 S. Racine St. 312.746.5086 Central FOSTER 1440 W. 84th St. 312.747.6135 South FULLER 331 W. 45th St. 312.747.6144 Central ADA GAGE 2411 W. 55th St. 312.747.6147 South ADA GARFIELD 100 N. Central Park Ave. 312.746.5092 Central ADA GILL 825 W. Sheridan Rd. 312.742.7802 North ADA GRAND CROSSING 7655 S. Ingleside Ave. 312.747.6158 South HAAS 2402 N. Washtenaw Ave. 312-742-7552 North ADA HAMLIN 3035 N. Hoyne Ave. 312.742.7785 North HARRIS 6200 S. Drexel Blvd. 312.747.2706 South HARRISON 1824 S. Wood St. 312.746.5491 Central ADA HAYES 2936 W. 85th St. 312.747.6177 South ADA HIAWATHA 8029 W. Forest Preserve Dr. 312.746.5559 North ADA HOMAN SQUARE 3517 W Arthington St. 312.746.6650 Central ADA HORNER 2741 W. Montrose Ave. 773.478.3499 North ADA HUMBOLDT 1400 N. Sacramento Ave. 312.742.7549 Central ADA INDEPENDENCE 3945 N. Springfield Ave. 773.478.3538 North ADA JACKSON 6401 S. Stony Island Ave. 773.256.0903 South ADA JESSE OWENS 2032 E. 88th St. 312.747.6709 South ADA KELVYN 4438 W. Wrightwood Ave. 312.742.7547 North KENNICOTT 4434 S. Lake Park Ave. 773.287.0541 Central ADA LAFOLLETTE 1333 N. Laramie Ave. 312.746.5316 Central LAKE SHORE 808 N. Lake Shore Dr. 312.742.7891 Central ADA LINDBLOM 6054 S. Damen Ave. 312.747.6443 South MARGATE 4921 N. Marine Dr. 312.742.7522 North ADA MCFTRIDGE 3843 N. California Ave. 773.478.2609 North ADA MCGUANE 2901 S. Poplar Ave. 312.747.6497 Central MOZART 2036 N. Avers St. 312.742.7535 North NORWOOD 5801 N. Natoma Ave. 773.631.4893 North ADA OGDEN 6500 S. Racine Ave. 312.747.6572 South 31
~FACILITY RESOURCES~
*Features wheelchair accessible equipment throughout the facility Chicago Park District – Fitness Centers PARK ADDRESS PHONE REGION ACCESSIBLE (ADA) PALMER 201 E. 111th St. 312.747.6577 South ADA PETERSON 5801 N. Pulaski Rd 312.742.7584 North PING TOM 1700 S. Wentworth Ave. 312.225.3121 Central ADA PIOTROWSKI 4247 W. 31st St. 312.745.4801 Central ADA* POTTAWATOMIE 7340 N. Rogers Ave. 773.262.5835 North RAINBOW BEACH 3111 E. 77th St. 312.745.1479 South ADA RIDGE 9625 S. Longwood Dr. 312.747.6640 South ADA RUSSELL SQUARE 3045 E. 83rd St. 312.747.6651 South RUTHERFORD SAYRE 6871 W. Belden Ave. 312.746.5368 North ADA SCOTTSDALE 4637 W. 83rd St. 773.284.1826 South SHABBONA 6935 W. Addison St. 773.685.6205 North SHERMAN 1301 W. 52nd St. 312.747.6672 South ADA TAYLOR PARK 39 W. 47th St. 312.747.6728 Central ADA TAYLOR-LAURIDSEN 704 W. 42nd St. 312.747.6729 South ADA TRUMBULL 2400 E. 105th St. 312.747.6759 South UNION 1501 W. Randolph St. 312.746.5494 Central ADA VALLEY FORGE 7001 W. 59th St. 773-229-0812 South ADA WASHINGTON 5531 S. Martin Luther King Dr. 773.256.1248 South ADA WELLES 2333 W Sunnyside Ave. 312.742.7511 North ADA WEST LAWN 4233 W. 65th St. 773.284.2803 South ADA WILLY WHITE 1610 W. Howard St. 773.262.5051 North
*Features wheelchair accessible equipment throughout the facility
32
CHICAGO PARK DISTRICT SPECIAL RECREATION ANNUAL INFORMATION FORM (A.I.F.) THE A.I.F. CONTAINS EXTREMELY IMPORTANT PARTICIPANT INFORMATION WHICH IS NECESSARY FOR THE CHICAGO PARK DISTRICT SPECIAL RECREATION STAFF TO PLAN AND EXECUTE SAFE AND ENJOYABLE PROGRAMS. THIS FORM IS MANDATORY AND WILL HELP THE STAFF SERVE THE PARTICIPANT BETTER AND SAFER.
THIS FORM MUST BE COMPLETED AT THE BEGINNING OF A SESSION, SIGNED, DATED & UPDATED PER SESSION –COMPLETING A NEW FORM ANNUALLY. PLEASE ANSWER ALL THE QUESTIONS IN THEIR ENTIRETY (PLEASE PRINT). DATE: ______PAGE 1 OF 3
PARTICIPANT INFORMATION (PLEASE PROVIDE CURRENT PHOTOGRAPH) SEC. A FIRST NAME ______MIDDLE NAME ______LAST NAME ______IS PARTICIPANT HIS/HER OWN GUARDIAN? □ YES □ NO NICKNAME ______AGE ______
STREET ADDRESS______CITY ______STATE ______ZIP ______PHONE ______EMAIL ______PRIMARY LANGUAGE USED AT HOME______DATE OF BIRTH ____/____/____ GENDER □M OR □F HEIGHT ______WEIGHT ______HAIR COLOR ______EYE COLOR______
PRIMARY DIAGNOSIS ______SECONDARY DIAGNOSIS ______CURRENT MEDICATIONS (DOSE& FREQUENCY) ______ALLERGIES ______DIETARY RESTRICTIONS ______
IS PARTICIPANT SUBJECT TO SEIZURES? □ YES □ NO TYPE & FREQUENCY ______DATE OF LAST SEIZURE ____/____/____ DOES PARTICIPANT REQUIRE REST AFTER SEIZURE? □ YES □ NO ANY SEIZURE CONTROLLED MEDICATION? □ YES □ NO IF YES, NAME:______
DOES PARTICIPANT HAVE ANY DOCTOR RESTRICTIONS? □ YES □ NO IF YES, PLEASE EXPLAIN ______IF PARTICIPANT HAS DOWN SYNDROME, HAS HE/SHE BEEN TESTED FOR ATLANTOAXIAL INSTABILITY? □ YES □ NO IF YES, WERE THE RESULTS POSITIVE? □ YES □ NO
MOBILITY □ WALKS INDEPENDENTLY □ USES MANUAL WHEELCHAIR □ USES MOTORIZED WHEELCHAIR □USES OTHER DEVICES CHECK ALL THAT APPLY: □ CANE □ BRACES □ WALKER □ CRUTCHES □ CONTACT LENSES □ ORTHOPEDIC DEVICES □ DENTURES □ GLASSES □ PROSTHESIS □ OTHER ______EXPLAIN______
CONTACT INFORMATION SEC. B PRIMARY CONTACT FIRST, MIDDLE & LAST NAME ______RELATIONSHIP ______ADDRESS STREET______CITY ______STATE ______ZIP ______EMAIL ______PHONE # □ HOME ______□ CELL ______□ WORK ______**PLACE A CHECKMARK BESIDE THE PHONE NUMBER YOU WOULD LIKE US TO USE FIRST**
SECONDARY CONTACT FIRST, MIDDLE & LAST NAME ______RELATIONSHIP ______ADDRESS STREET______CITY ______STATE ______ZIP ______EMAIL ______PHONE # □ HOME ______□ CELL ______□ WORK ______**PLACE A CHECKMARK BESIDE THE PHONE NUMBER YOU WOULD LIKE US TO USE FIRST**
DOCTOR’S NAME ______PHONE ______MEDICAL INSURANCE______POLICY NUMBER ______
SCHOOL/PLACE OF EMPLOYMENT ______TEACHER/SUPERVISOR ______GROUP HOME/RESIDENTIAL FACILITY______MANAGER/CASE WORKER ______
CHICAGO PARK DISTRICT SPECIAL RECREATION ANNUAL INFORMATION FORM (A.I.F.) PAGE 2 OF 3
DAILY LIVING SKILLS SEC. C EATING □ EATS INDEPENDENTLY □ NEEDS TO BE MONITORED □ NEEDS ASSISTANCE EXPLAIN ______BATHROOM □ TOILETS INDEPENDENTLY □ NEEDS TO BE MONITORED □ NEEDS ASSISTANCE EXPLAIN ______DRESSING □ DRESSES INDEPENDENTLY □ NEEDS SOME ASSISTANCE □ CANNOT DRESS INDEPENDENTLY EXP. ______
COMMUNICATION □ VERBAL: SPEAKS CLEARLY □ VERBAL: DIFFICULT TO UNDERSTAND □ HAS DIFFICULTY EXPRESSING NEEDS □ GESTURES/POINTS □ USES SIGN LANGUAGE □ USES HEARING DEVICES/HEARING AIDS □ USES A COMMUNICATION BOARD/SCHEDULE/PICTURES EXPLAIN: ______
TRANSPORTATION □ SCHOOL BUS □ PARENTS/GUARDIANS DROP-OFF □ CDT/PACE ALLOWED TO SELF-TRANSPORT? □ YES □ NO OTHER______EXPLAIN ______**CHECK ALL THAT APPLY**
INTERACTION/SOCIALIZATION SKILLS SEC. D SWIMMING □ SWIMS INDEPENDENTLY □ CAN SWIM A LITTLE □ CANNOT SWIM AT ALL □ EXTREME FEAR OF WATER EXPLAIN ______
SOCIAL INTERACTION □ INITIATES SOCIAL INTERACTION ON OWN □ SOCIALIZES WITH VERBAL PROMPTING □ AVOIDS SOCIAL INTERACTIONS EXPLAIN ______
PREFERS BEING □ ALONE □ WITH PEERS □ WITH ADULTS EXPLAIN ______IS MOST SUCCESSFUL IN □ LARGE GROUPS □ SMALL GROUPS □ OTHER EXPLAIN ______RESPONDS BETTER TO □ MALES □ FEMALES □ EITHER EXPLAIN ______PLEASE LIST ANY SENSORY ISSUES THE PARTICIPANT MAY HAVE: ______
BEHAVIOR/ CONDUCT SEC. E FOLLOWING DIRECTIONS □ CAN FOLLOW DIRECTIONS INDEPENDENTLY □ NEEDS VERBAL PROMPTING □ NEEDS STEP-BY-STEP ASSISTANCE – EXP. BELOW EXPLAIN: ______
CHECK ALL THAT □ SHORT ATTENTION SPAN □ EASILY DISTRACTED □ HYPERACTIVITY □ TENDENCY TO WANDER OFF APPLY: □ MANIPULATIVE □ VERBAL OUTBURST □ INSTIGATES BEHAVIOR □ SELF-ABUSIVE BEHAVIORS □ TAKES OTHER PEOPLES □ TANTRUMS/MELTDOWNS □ OPPOSITIONAL/DEFIANT □ PHYSICAL AGGRESSION TO OTHERS BELONGINGS □ PUSHING □ HITTING □ SPITTING □ BITING □ KICKING □ HAIR PULLING □ THROWING □ SCRATCHING □ TAPPING/STEMMING □ REPETITIVE BEHAVIORS □ LIST OTHER INAPPROPRIATE BEHAVIORS HERE: ______
IF YOU CHECKED YES TO ANY BEHAVIORS ABOVE, PLEASE PROVIDE A DETAILED EXPLANATION:______
WHAT ARE KNOWN TRIGGERS TO THE BEHAVIORS ABOVE:______
DOES THE PARTICIPANT RESPOND TO SPECIFIC BEHAVIOR MANAGEMENT TECHNIQUES USED AT HOME, SCHOOL, OR WORK? □ YES □ NO EXPLAIN: ______
DOES THE PARTICIPANT HAVE UNUSUAL FEARS OR CONCERNS? □ YES □ NO EXPLAIN: ______
CHICAGO PARK DISTRICT SPECIAL RECREATION ANNUAL INFORMATION FORM (A.I.F.) PAGE 3 OF 3
SAFETY- REGARDING THE PARTICIPANT SEC. F WILLING TO STAY WITH THE GROUP? □ YES □ NO CAN RECOGNIZE DANGER? □ YES □ NO MAY WANDER OR RUN? □ YES □ NO CAN MANAGE OWN MONEY? □ YES □ NO CAN BE RESPONSIBLE FOR OWN BELONGINGS? □ YES □ NO
ADD ANY ADDITIONAL INFORMATION NOT ALREADY NOTED IN THE ANNUAL INFORMATION FORM IN THIS SECTION: CUT/PASTE CURRENT PHOTO HERE
DATE PHOTO INSERTED: ______
THIS FORM MUST BE COMPLETED AT THE BEGINNING OF A SESSION, SIGNED, DATED & UPDATED PER SESSION WINTER SESSION – YEAR ______□ CHECK/SKIP IF NOT REGISTERED ______SIGNATURE OF PARTICIPANT/GUARDIAN/PARENT DATE ______□ PRINT NAME SR STAFF INITIALS
SPRING SESSION – YEAR ______□ CHECK/SKIP IF NOT REGISTERED ______SIGNATURE OF PARTICIPANT/GUARDIAN/PARENT DATE ______□ PRINT NAME SR STAFF INITIALS
SUMMER SESSION – YEAR ______□ CHECK/SKIP IF NOT REGISTERED ______SIGNATURE OF PARTICIPANT/GUARDIAN/PARENT DATE ______□ PRINT NAME SR STAFF INITIALS
FALL SESSION – YEAR ______□ CHECK/SKIP IF NOT REGISTERED ______SIGNATURE OF PARTICIPANT/GUARDIAN/PARENT DATE ______□ PRINT NAME SR STAFF INITIALS
A NEW A.I.F. SHOULD BE COMPLETED ANNUALLY
**NOTE: THE ANNUAL INFORMATION FORM MUST BE COMPLETED AT THE BEGINNING OF THE FIRST SESSION. PLEASE LET US KNOW IF ANY INFORMATION CHANGES DURING THE YEAR. ALL APPLICABLE MEDICAL FORMS MUST BE COMPLETED/UPDATED EACH SEASON. PLEASE NOTIFY US OF CHANGES IN MEDICATION THAT OCCUR DURING THE YEAR** APPLICATION FOR PARTICIPATION IN SPECIAL OLYMPICS ILLINOIS Valid Application for Participation is mandatory for all competitors SO ILL Rev. 8-1-10 SO ILL OFFICE ONLY 605 E. Willow St. Normal, IL 61761-2682 309-888-2551
ATHLETE INFORMATION Birthdate MEDICAL CLEARANCE Athlete Name (last name, space, first name) M M D D Y Y PLEASE CHECK MEDICAL INFORMATION
Agency Name Sex (M or F) Does athlete have Down Syndrome? Yes No If yes, have x-rays of the C1-C2 vertebrae Athlete’s Mailing Address Parent’s/Guardian’s (Please Circle One) Home Address been taken and examined? Yes No Date of x-ray Athlete’s City Parent’s/Guardian’s City Is the athlete clear of Atlantoaxial Instability? Yes No
State Zip Code State Zip Code Does the athlete have or is the athlete: - - Heart Problems Yes No Diabetic Yes No Parent’s/Guardian’s Epileptic/Seizures Yes No White Black/African American Asian Ethnicity Home Telephone -- Blind Yes No Hispanic/Latino Other Deaf Yes No Hepatitis Yes No HEALTH INSURANCE & EMERGENCY INFORMATION (Required for Processing) Other Person to be contacted Emergency in case of emergency Contact Phone ( ) Current Medication Dosage Medical Insurance Company Policy Number
PARENT AND/OR GUARDIAN AUTHORIZATION AND MEDIA RELEASE I, on my own behalf or as the undersigned parent and/or legal guardian of the above named applicant (hereafter referred to as the “Entrant”), hereby request permission for the Allergies to medication, if any: Entrant to participate in Special Olympics programs. I acknowledge that Special Olympics will screen all entrants using the Sex Offender Public Registry and the Child Murder and Violent Offender Against Youth Registry and understand that entrants listed on either Registry will be denied participation. I affirm that this Entrant has never been on said Registries or, if Entrant was listed on either Registry but has since been removed, I will contact Special Olympics Illinois for instructions before submitting this application. Date of last Tetanus shot: I represent and warrant to you that the Entrant is physically and mentally able to participate in Special Olympics, and I submit herewith a subscribed medical certificate. I understand that if the athlete has Down Syndrome, he/she cannot participate in sports or events which, by their nature result in hyper-extension, radical flexion or direct pressure on the neck or upper I have examined the above-named Entrant spine unless a full radiological examination establishes the absence of Atlantoaxial Instability. I am aware that the sports and events for which this radiological examination is required are equestrian sports, artistic gymnastics, diving, pentathlon, high jump, alpine skiing, soccer, soccer skills, powerlifting squat and butterfly stroke and diving starts in swimming. and, in my opinion, there is no mental or physical reason why he or she should not On behalf of the Entrant and myself, I acknowledge that the Entrant will be using facilities at his/her own risk and I, on my own behalf, herby release, discharge and indemnify Special Olympics from all liability for injury to person or damage to property of myself and Entrant. participate in the Special Olympics sports training and competition program. Further In permitting the Entrant to participate, I am specifically granting permission to Special Olympics Illinois to use the likeness, voice and words of the Entrant in television, radio, films, newspapers, magazines and other media, and in any form not heretofore described, for the purpose of advertising or communicating the purposes and activities of Special information will be forwarded if required. Olympics and in appealing for funds to support such activities. I understand that by signing below I consent for the Entrant to participate in the Special Olympics Healthy Athletes Current medication, if any, is specified with Program that provides individual screening assessments of health status and health care needs. The Entrant has no obligation to participate and I understand the Entrant should dosage on this application. seek his/her own medical advice and assistance and Special Olympics is not responsible for the Entrant’s health. If I am not personally present at Special Olympics activities in which the Entrant is to compete, so as to be consulted in case of necessity, you are authorized on my behalf and at Examination Date my account to take such measures and arrange for such medical and hospital treatment as you may deem advisable for the health and well-being of the Entrant. I, THE UNDERSIGNED ADULT ENTRANT, have read and fully understand the I, THE UNDERSIGNED PARENT AND/OR GUARDIAN of the above specified Doctor’s Signature provisions of the above release and/or have had them explained. I hereby agree that I Entrant, have read and fully understand the provisions of the above release and have will be bound thereby and I shall defend Special Olympics Illinois and hold it harmless explained them to said Entrant. I hereby agree that I and said minor will be bound Print Name from disaffirmation thereof. thereby, and I shall defend Special Olympics Illinois and hold it harmless from any disaffirmation thereof by said minor. Address Entrant Signature of Parent and/or Legal Guardian Witness Date (Check appropriate box) City State Zip Print Name Date Athlete’s Email Address Parent’s Email Address Phone ( ) Original parent/guardian and doctor signatures are required by the office of Special Olympics Illinois. Faxed signatures will not be accepted. 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 athlete’s signature is unrecognizable (for example, if the athlete’s signature is an “X.”) MEDICAL CLEARANCE 3. The Medical Clearance section must be completed, signed and dated by a medical practitioner licensed to administer physical examinations by the state in which he/she practices. As of September 1, 1990, the Special Olympics Illinois Application for Participation is the only Medical Clearance form which will be accepted as valid by Special Olympics Illinois. This person, by signing the Medical Clearance, is stating that the athlete is in good health and can safely participate in Special Olympics sports training and competition. It is strongly suggested that the person administering the physical examination possess the following: Background and preparation in giving sports physical examinations. Qualifications to administer examinations that would not compromise his/her area of specialty. AFTER COMPLETING THE APPLICATION ... 4. Send the original copy of the Application for Participation to the Area Director who will send the App to the Special Olympics Illinois Chapter office. The Chapter office will validate the Application for Participation and send a copy of the App with an approved stamp back to the SOAD (Special Olympics Athletic Director). An Application for Participation will not be validated until all information is correct and completed on the approved form. 5. Special Olympics Illinois requires that all Applications for Participation be presented prior to and no later than the established Medical App deadline of a Chapter championship level event (Winter Games, State Basketball Tournament, Summer Games, Outdoor Sports Festival, Fall Games, Floor Hockey or State Bowling Tournament). All Apps for the event in question must be valid throughout the completion of that Chapter competition. Applications for Participation for athletes participating in District Tournaments and Sectional Tournaments must be received before the entry deadline or with registration materials. Applications not on file or in receipt by the specified deadline will not be accepted. SOLICITUD DE PARTICIPACIÓN EN OLIMPÍADAS ESPECIALES DE ILLINOIS Es obligatoria para todos los participantes una Solicitud de Participación válida SO ILL Rev. 8-1-10 SÓLO PARA USO DE LA OFICINA (SO ILL OFFICE) 605 E. Willow St. Normal, IL 61761 309-888-2551 APROBACIÓN MÉDICA INFORMACIÓN DEL ATLETA Fecha de nacimiento (MEDICAL CLEARANCE) Nombre del atleta (apellido espacio nombre) M M D D Y Y FAVOR DE CHEQUEAR LA INFORMACIÓN MÉDICA (PLEASE CHECK MEDICAL INFORMATION) Nombre de la agencia Sí No Sexo (M o F) Síndrome de Down (Down Syndrome) Si el atleta padece el Síndrome de Down, Domicilio Postal del Atleta Domicilio de la casa de los padres o guardián (Por Favor Círculo Uno) ¿se ha tomado y hecho radiografías, o rayos X de las vértebras C1-C2? (If athlete is Down Syndrome, have x-rays of the C1-C2 Ciudad del atleta Ciudad de los padres o guardián vertebrae been taken and examined?) Fecha de los rayos X (Date of x-ray) ¿Tiene el atleta la aprobación de la Estado Código Postal Estado Código Postal Inestabilidad Atlanto-Axial? (Is the athlete clear - - of Atlantoaxial Instability?)
Telefono de casa de ¿Es o tiene el atleta?: (Does the athlete have or Blanco Negro/Afroamericano Asiático -- Ethnicity los padres o guardián is the athlete:) Sí No Etnicidad Hispano/Latino Other Problemas del corazón (Heart Problems) INFORMACIÓN SOBRE EL SEGURO DE SALUD Y EMERGENCIAS (Requerido para Procesamiento) Diabético (Diabetic) En caso de emergencia Teléfono Epilépsia/Ataques epilepticos avisar a de emergencia ( ) (Epileptic/Seizures) Invidente (Blind) Número de póliza Compañía de seguro médico Sordo (Deaf) AUTORIZACIÓN PATERNAL O DEL GUARDIÁN Y EL PERMISO PARA LA PRENSA Hepatitis (Hepatitis) Yo, en mi propio nombre o como el suscrito padre/guardián legal del solicitante mencionado arríba (desde aquí en adelante referido como el “Participante”) por el Otros (Other) presente, pido permiso para la participación del entrante o Participante para que tome parte en los programas de Olimpíadas Especiales. Yo reconozco que Medicina que toma actuamente Dosis Olimpíadas Especiales investigará a todos participantes utilizando el Registro Público de Infractores Sexuales o el Registro de Asesinatos a Menores y Delincuentes Violetos Contra Jóvenes y yo entiendo que todos participantes que aparecen en alguno de estos registros serán negados de participar. Yo afirmo que el presente (Current Medication) (Dosage) particpante nunca ha aparecido en los mencionados registros o, si el participante estuvo inscrito en cualquier de estos registros, entiende que a los participantes inscritos en cualquier de estos registros se les negará participación. Afirmo que el presente participante nunca ha aparecido inscrito en los mencionados registros. Yo represento y garantizo a ustedes que el Participante está física y mentalmente apto para participar en Olimpíadas Especiales, y entrego con esto un certificado médico del Participante. Entiendo que si el atleta tiene el Síndrome de “Down,” él o ella no podrá tomar parte en los deportes o juegos que, por su propia naturaleza podrían resultar en hipertensión, flexión radical o presión directa en el cuello o la parte alta de la columna vertebral a menos que una Alergias a medicinas (si tiene alguna): radiografía establezca la ausencia de la Inestabilidad Atlanto-Axial. Estoy consciente de que los deportes o juegos para los cuales esta radiografía es necesaria son los deportes ecuestres, los ejercicios gimnásticos sin aparatos, los clavados, el pentatlón, la “mariposa” y los clavados básicos de la natación, (Allergies to medication, if any:) el salto alto, la esquíe de montaña, futbol soccer, habilidades de futbol soccer y halterofilia. En nombre del Participante y del mio propio, reconozco que el Participante va a estar usando instalaciones por su propia riesgo y yo, por mi propia parte, doy per- miso, descargo o exonero, y no cobraré ninguna indemnización a Olimpíadas Especiales por ninguna lesión a la persona o daño mi propiedad y del Participante. Fecha de la última inyección para el Tetano Al permitir la participación del Participante, estoy específicamente dando permiso a ustedes para usar la apariencia, la voz y las palabras del Participante en la tele- (Date of last Tetanus shot:) visión, radio, cine, periódicos, revistas y otros medios de información y en cualquier forma hasta ahora no descrita, para los propósitos de la publicidad o de comuni- I have examined the above-named Entrant cación de los propósitos y actividades de Olimpíadas Especiales y al pedir fondos para apoyar tales actividades. Tengo amplio conocimiento de que al firmar en el and, in my opinion, there is no mental or espacio provisto estoy dando mi consentimiento para que el principiante participe en el Programa de Atletas Sanos de Olimpiadas Especiales, mismo que propor- physical reason why he or she should not ciona pruebas individuales de estatus de salud y asesoría en cuanto a cuidados de salud. El Participante no tiene la obligación de participar y tengo amplio participate in the Special Olympics sports conocimiento de que yo debo consultar mi propia opinión y asistencia médica y de que Olimpiadas Especiales no se hace responsable por la salud del Participante. training and competition program. Further Si yo no estoy presente personalmente en las actividades de Olimpíadas Especiales en las cuales el Participante va a competir, como para consultárseme information will be forwarded if required. en caso de necesario, ustedes están autorizados en mi nombre y por mi cuenta a fin de tomar tales medidas y arreglar el tratamiento médico y hospital- Current medication, if any, is specified with ización que ustedes juzguen aconsejable para la salud y el bienestar del Participante. dosage on this application. YO, EL PARTICIPANTE ADULTO Y FIRMANTE he leído y entiendo comple- YO, EL FIRMANTE PADRE Y/O GUARDIÁN LEGAL DEL PARTICIPANTE, he tamente las provisiones del permiso arriba mencionado y/o que me ha sido leído y totalmente entendido las provisiones del permiso arriba mencionado y se las Examination Date explicado. Yo, de esta manero estoy de acuerdo que yo y el Participante he explicado al Participante. Yo, de esta forma estoy de acuerdo que yo y el menor Signature estaremos limitados y condicionados por este acuerdo y yo les defenderé a estaremos limitados por este acuerdo y yo les defenderé a ustedes y no haré ustedes y no haré ningún cargo de cualquier desafirmación que yo haga. ningún cargo de cualquier desafirmación o afirmación contraría que el menor haga. Print Name Firma del padre Address Entrante o guardián (Márque con una cruza las cassilla apropiada) City State Zip Testigo Fecha Nombre (letra de molde) Fecha Phone ( ) La dirección electrónica del participante La dirección electrónica de los padres Las firmas originales de los padres/tutores y doctores son requeridas por la oficina de las Olimpíadas Especiales de Illinois. Aquellas firmas que sean enviadas por fax no serán aceptadas. Instructiones Para Completar La Solicitud De Participación
La Solicitud de Participación (SP) tiene que ser llenada completamente; no se aceptarán los formularios con secciones o documentos en blanco (excepción: la carta de la Oficina de Guardianía del Estado, 2A abajo). Esta solicitud es válida durante dos años, a partir e incluyendo la fecha de la examinación física, sin importar la fecha de la firma del padre, guardián o del participante o entrante.
Las firmas del Padre/Tutor y Doctor deben ser originales y ambas firmas originales deben aparecer en el mismo documento de aplicación. Aquellas firmas que sean enviadas por fax no serán aceptadas.
Yo afirmo que este participante nunca ha aparecido inscrito en los mencionados registros o, si el participante fue listado en el Registro Público de Infractores Sexuales o el Registro de Asesinatos a Menores y Delincuentes Violetos Contra Jóvenes pero ha estado tachado de la lista, yo contactaré a Olimpíadas Especiales de Illinois para más instrucciones antes de entregar esta solicitud. INFORMACIÓN DEL ATLETA E INFORMACIÓN SOBRE EL SEGURO DE SALUD Y DE EMERGENCIA 1. La primera sección tiene que llenarse completamente. La información optativa sobre la etnicidad es solicitada para ayudar en los esfuerzos organizativos de divulgación.
AUTORIZACIÓN PATERNAL Y/O DEL GUARDIÁN Y LA PUBLICACIÓN EN LOS MEDIOS 2. El padre o el guardián legal tiene que leer, firmar y fechar la Autorización Paternal o del Guardián y la Publicación en los Medios. a. Esta sección debe firmarse y fecharse. Las omisiones o alteraciones en esta sección invalidarán la SP. (Excepción: Omisión del último párrafo sobre el tratamiento médico y la adhesión de un carta explicativa, el número de teléfono de emergencia durante las 24 horsas de la Oficina de Guardianía del Estado. La carta explicatoria debe adjuntarse en la solicitud, a partir del 1o. de enero de 1987). b. De los dos bloques de firma, solo debe completarse uno. Olimpíadas Especiales de Illinois trabajan bajo el entendido de que esta sección puede firmarse, ya sea por: El padre (biológico o adoptivo) a menos de que el atleta se la haya designado un guardián por parte del estado; O POR El guardián legal; esta persona debe ser asignada legalmente para el individuo; O POR El atleta, si él o ella es mayor de 18 años y no ha sido designado como que necesita de ello y que no tuvo que habérsele asignado un guardián legal. Es necesaria la firma de un testigo, si la firma del atleta es ilegible (por ejemplo, si la firma del atleta es una “X”).
APROBACIÓN MÉDICA 3. Debe completarse, firmarse y fecharse la sección de la Aprobación Médica por un profesional médico con licencía para adminis- trar exámenes físicos por el estado donde él o ella ejerce. A partir del 1o. de septiembre de 1990, e incluyéndolo, la Solicitud de Participación en Olimpíadas Especiales será la única forma de consentimiento médico que se aceptará como válida por Olimpíadas Especiales de Illinois. Esta persona, al firmar la Aprobación Médica, está declarando que el atleta está en buena salud y que puede participar de manera segura en los entrenamientos y competenciones de Olimpíadas Especiales. Se aconseja de manera muy especial que la persona que administra el examen físico posea lo siguiente: Formación y conocimientos en dispensar chequeos o exámenes físicos. Credenciales para administrar chequeos o exámenes que no comprometan su área de especialidad.
DESPUÉS DE COMPLETAR LA SOLICITUD ... 4. Envíe la copia original de la Solicitud de Participación al Director de Área, quien mandará la solicitud a la oficina de Olimpíadas Especiales, Capítulo de Illinois. La oficina del Capítulo validará la Solicitud de Participación y mandará de regreso una copia de ésta con el sello de aprobado a SOAD (Director Deportivo de Olimpíadas Especiales). Una Solicitud de Participación no será validada sino hasta que toda la información sea correcta y completada en el formulario aprobado. 5. Olimpíadas Especiales de Illinois exige que todas las Solicitudes de Participación se presenten antes de y no después de la fecha límite establecida para la Solicitud Médica en un evento a nivel de campeonato del Capítulos (las Olimpíadas de Invierno, el Torneo Estatal de Baloncesto, las Olimpíadas de Verano, el Festival Deportivo en Exteriores, las Olimpíadas de Otoño, las Olimpiadas de Hockey Sobre Césped y las Olimpiadas de Bowling). Todas las solicitudes para el evento en cuestión deben ser validas una vez cumplida la competición del Capítulo. Las Solicitudes de Participación para los atletas que toman parte en los Torneos de Distrito y en los Torneos Seccionales deben recibirse antes de la fecha límite de entrada o con los materiales de inscripción. No se aceptarán las solicitudes archivadas o que se reciban por la fecha límite especificada.
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