Building Community through Recreation

REGISTRATION DATES
RESIDENT ONLY - PRIORITY • AUGUST 17 - AUGUST 21
RESIDENT/NON-RESIDENT/CO-OP • AUGUST 24 - AUGUST 28
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REGISTRATION DATES
RESIDENT ONLY - PRIORITY • AUGUST 17 - AUGUST 21
RESIDENT/NON-RESIDENT/CO-OP • AUGUST 24 - AUGUST 28

Dear Participants, Families, and Community Members,
It’s hard to believe that summer is over but as the air turns crisp and the colors of fall begin to appear, I am excited to welcome you to another incredible season with the South West Special Recreation Association (SWSRA).
Whether you are joining us for the first time or have been part of our SWSRA family for years, we are grateful for the opportunity to serve you and create programs that inspire friendships, build confidence, and encourage lifelong participation in recreation.
This fall, we are proud to offer a variety of programs and special events for all ages, including favorites like our Sensory-Friendly Pumpkin Patch and Santa's Workshop. For our early childhood and youth ages come join us for a fun Family Craft Night, Junior Athletes and Bumper Bowl Program. Teens and Adults come join us for a fun Family Paint Night as well as Special Olympics Basketball, Pickleball, Bowling, and Boards and Bags. Be sure to check out all the amazing programs that are available this fall.
September 8th begins another great year for our OASIS Adult Day Program. This program is offered Monday-Friday and designed to fit your schedule. Whether you are signing up for 2-days or joining us full-time this program continues to provide meaningful opportunities for recreation, socialization, and personal growth. If you are interested in learning more and joining our amazing group please contact our office about the admission process.
As we look ahead, I also encourage you to support our annual Tee Up Fore SWSRA Golf Outing-Friday, September 18th at The Meadows Golf Club of Blue Island. This event plays an important role in helping us provide scholarships and expand recreational opportunities so that financial barriers never stand in the way of participation. Every golfer, sponsor, volunteer, and donor helps make inclusive recreation possible for individuals and families throughout our member communities. Registration is now open and sponsorship spots are still available. Take a look in our brochure or online for more details on how to join. You won't want to miss it!
Thank you for choosing SWSRA—we look forward to another season of building memories, fostering friendships, and making a positive impact in the lives of those we serve.
Sincerely,
Nicolette D. Lahman-Morales, CPRP
or
South West Special Recreation Association (SWSRA) is comprised of member districts that include: Alsip Park District, Blue Island Park District, Hickory Hills Park District, Village of Merrionette Park, Midlothian Park District, Palos Heights Parks & Recreation Department, Posen Park District, and Worth Park District.
SWSRA was formed in 1981 to provide yearround quality therapeutic recreation programs and services for individuals with intellectual and/or physical disabilities. SWSRA offers a wide variety of programs for individuals in early childhood through adulthood. These programs are designed to increase independence and enhance the quality of life for each individual. SWSRA works to provide an inclusive environment which allows the participants to thrive in recreational settings with their peers.
This includes but is not limited to individuals who have varying degrees of physical or mental disabilities, learning disabilities, behavior disorders, and hearing or visual impairments.
Our mission is to serve individuals with disabilities in their need for recreation so that all persons in our member communities may experience and enjoy positive leisure opportunities.
SWSRA will be the leading community-based provider of quality therapeutic recreation programs for individuals with disabilities and consistently set new standards of value to meet the changing needs of our participants and our member communities.

ADMINISTRATION & RECREATION TEAM
Nicolette D. LahmanMorales, CPRP Executive Director nlahman@swsra.com 708-389-9423 ext. 204
Patti Swiney Business Manager pswiney@swsra.com 708-389-9423 ext. 203
Marina Uher, CTRS, CPRP Superintendent of Recreation muher@swsra.com 708-389-9423 ext. 208
Alsip Park District
Jeannette Huber
Blue Island Park District
Ted Ruthenberg
Hickory Hills Park District
Renee Chavez
Merrionette Park
Jairo Gutierrez
Ami Ill, CTRS Program Manager
aill@swsra.com
708-389-9423 ext. 210
Brittany Izzo, CTRS Program Manager bizzo@swsra.com
708-389-9423 ext. 207
Tina Izzo-Delbovo Recreation Specialist tizzo-delbovo@swsra.com 708-389-9423 ext. 212
Ana Hepp Office Clerk ahepp@swsra.com
708-389-9423 ext. 201
Midlothian Park District
Ed Jung
Palos Heights Parks & Recreation Department
Matt Fairbanks
Posen Park District T.J. Whitcomb
Worth Park District
Robert O’Shaughnessy
SWSRA Main Office 12521 South Kostner Avenue, Alsip, IL 60803
Phone: 708-389-9423
Fax: 708-389-6458
Website: www.swsra.org
Facebook: South West Special Recreation Association (SWSRA)
Instagram: @we_are_swsra
Twitter: @SWSRA
September 14 - November 7
November 16 - December 12, Post Season
Residents Only - Priority Registration*
August 17 - August 21
Resident/Non-Resident/Co-Op Registration
August 24 - August 28
*Please keep in mind our space is limited and in high demand.We encourage residents to enroll during this priority period. Registration will be processed on a first-come, firstserve basis.
Any registration that is received prior to your specific registration week will be processed on the second business day of your designated registration week.
Complete your registration form and submit the form with payment one of the following ways:
Email: info@swsra.com
Mail: 12521 S. Kostner Ave., Alsip, IL 60803
Fax: 708-389-6458
Drop Off: During regular business hours: Monday - Friday, 10:00am-4:00pm.
To help select the appropriate program for yourself/ child, please use this guide to assist you. Please note that some of these may overlap due to cognitive level variations. SWSRA staff may determine appropriate placement if necessary.
Early Childhood (EC): Ages 3-7
Youth: Ages 8-12
Teen: Ages 13-17
Adult: Ages 18 & Up
SWSRA is subject to and will comply with the Americans with Disabilities Act (ADA), which prohibits discrimination on the bases of disability against persons who meet essential eligibility requirements for services. If you have any questions about our services in regard to the ADA, please call us at 708-389-9423.
SWSRA offers a variety of programming and special events. We have included icons within the brochure to help differentiate the types of programs and special events. The icons are located next to the program and special events titles.



Virtual Program
In-Person Program
Transportation Available
Alsip Park District - Apollo 12521 S. Kostner Avenue Alsip, IL 60803
Burr Oak Bowl 3030 W. 127th Street Blue Island, IL 60406
Dorothy Menker TheaterMoraine Valley CC 9000 College Parkway Palos Hills, IL 60465
Goy Building
10707 S. Oak Park Avenue Worth, IL 60482
Lincolnway Special Recreation Center 1900 Heatherglen Drive New Lenox, IL 60451
Oak Lawn Park DistrictOak View Center & Museum 4625 W 110th Street Oak Lawn, IL 60453
Oak Lawn Park DistrictPavilion 9401 Oak Park Avenue Oak Lawn, IL 60453
Orland Park Civic Center
14750 S. Ravinia Avenue Orland Park, IL 60462
Palos Heights Parks & Recreation Center 6601 W. 127th Street Palos Heights, IL 60463
The Promenade Bolingbrook 631 E Boughton Road Bolingbrook, IL 60440
Romeoville Recreation Center
900 W. Romeo Road Romeoville, IL 60446
Worth Park DistrictTerrace Centre 11500 S Beloit Avenue Worth, IL 60482
SWSRA requires all participants to complete a Master Registration Form annually. The form provides staff with valuable information, which allows SWSRA to conduct its activities in the safest possible manner and to meet the basic needs of participants. If you are new to SWSRA or do not have a current form on file, please contact the office and one will be sent to you. Additionally, if the agency receives a registration form and does not have a Master Registration Form on file, one will be sent to you to complete and return. If at any time the form needs to be updated (change in medication, behavior, address, house manager, etc.) please call the SWSRA office. All information is kept strictly confidential and enhances successful participation.
We assess each of our “new” participants for all our programs to best fulfill their needs and goals. Once you enroll in a SWSRA program, someone from the recreation staff will contact you within 2 weeks to complete an over-the-phone assessment. The goal of this interview is to get to know your participant and be able to train our Team to work with them.
SWSRA currently staffs most programs with one staff to every four participants. If a participant will need more assistance or won't be able to participate within this structure, please let staff know at registration so appropriate staffing may be secured (if possible). Please note in brochure write ups any exceptions to this 1:4 ratio.
SWSRA is committed to providing new and challenging leisure and recreation activities for all our participants. We recognize that a park district or recreation department program may better serve an individual’s needs. SWSRA works with our partner agencies to assist individuals with making the transition from special recreation to these programs. Our professional staff can help you choose an appropriate program, provide referral services, conduct any necessary staff training, secure support staff, or supply adaptive equipment or communication devices. If you or a family member wish to participate in a park district or recreation department program, please contact our office.
LINCOLNWAY SPECIAL RECREATION ASSOCIATION COOPERATIVE AGREEMENT
A cooperative agreement with the Lincolnway Special Recreation Association (LWSRA). Each association offers programs to the other association’s residents at indistrict rates with the following exceptions:
1. Special Services - scholarships & door to door transportation are not included. First Time Participant Discount does not apply to LWSRA residents.
2. Participants who wish to register for TITANS, summer camp, vacation trips, away camps and weekend trips may do so at non-resident rates.
3. Early bird discounts or any other discounts do not apply under this agreement.
4. When programs are offered free to either association’s own residents because of grant funds or sponsorships, the program or event will be offered to residents of the other association at the regular fee for residents.
All other agency policies and guidelines apply to residents who register for programs under this Agreement. LWSRA serves the residents of: Crete, Frankfort, Frankfort Square, Mokena, Manhattan, New Lenox, Peotone, and Wilmington.
SOUTH SUBURBAN SPECIAL RECREATION ASSOCIATION COOPERATIVE AGREEMENT
A cooperative agreement with South Suburban Special Recreation Association (SSSRA). Each association offers programs to the other association's residents at indistrict rates with the following exceptions:
1. Special Services such as scholarships, door to door transportation, and “First Time Participant Discounts” are not included in this agreement.
2. Participants who wish to register for day camps, vacation trips, away camps and weekend trips may do so at non-resident rates.
3. Early bird discounts or any other discounts do not apply under this agreement. Registration for programs will take place after the deadline is reached for “regular” agency residents. Registrations will then be taken on a first-come, first-serve basis.
4. When programs are offered free to either association’s own residents because of grant funds or sponsorships, the program or event will be offered to residents of the other association at the regular fee for residents.
All other agency policies and guidelines apply to residents who register for programs under this agreement. The intent is not to duplicate services. Therefore, if an agency offers similar programs as the home agency the participant can participate but at the non-resident rate. SSSRA serves the residents of: Country Club Hills, Hazel Crest, HomewoodFlossmoor, Lan-Oak, Matteson, Oak Forest, Olympia Fields, Park Forest, Richton Park, Tinley Park.

Virtual Recreation will bring programs right to you and your family in order for you to stay inspired, connected and creative. You will receive an email with the links the Friday prior to the season starting.
SWSRA uses Zoom Video Communications as the platform to run virtual programs. You will need to make sure you have a stable connection to the internet, a good headset for either your computer or phone, minimal background noise and minimal distractions in order to have a successful program(s).
Group: Teens & Adults
Dates:September 14-November 6
No Program September 18
Fee: $45
Weekly Schedule
PROGRAM DAY TIME
Coffee Talk Monday 9:00am-9:30am
BINGO Monday 3:00pm-3:30pm
Lunch with Friends Wednesday 11:30am-12:00pm
Hangman Wednesday 3:00pm-3:30pm
Coffee Talk Friday 9:00am-9:30am
BINGO Friday 3:00pm-3:30pm
Group: Teens & Adults
Dates: November 16-December 11
No Program November 25 & November 27
Fee: $25
Weekly Schedule
PROGRAM DAY TIME
Coffee Talk Monday 9:00am-9:30am
BINGO Monday 3:00pm-3:30pm
Lunch with Friends Wednesday 11:30am-12:00pm
Intro to Drawing Wednesday 3:00pm-3:30pm
Coffee Talk Friday 9:00am-9:30am
BINGO Friday 3:00pm-3:30pm
BINGO: Who doesn't like a good game of BINGO? Each BINGO game winner will have their name entered into a drawing at month end. The more times you win, the greater chance you have for winning the overall seasonal prize.
Coffee Talk: Grab your favorite morning beverage (water, tea, coffee, juice, etc.) and begin your morning talking with your peers.
Hangman: Put your word skills to the test by playing Hangman. Guess letters to reveal the hidden word before the stick figure is drawn.
Intro into Drawing: Please bring a pencil and paper to this program. We'll learn how to draw a variety of subjects through easy, step-by-step instruction.
Lunch with Friends: Bring your lunch and socialize with your friends. We will discuss current events, video games, movies and much more!
You will receive an email with the links the Friday prior to the season starting.

Have a sweet tooth and are interested in learning a new recipe each week? During this program, bakers will learn a new recipe step by step to share with others! Recipes will be cut in half to make a smaller treat at home.
Group: Teens & Adults
Day: Saturday
Dates: September 19, October 10, November 7, December 5
Time: 10:00am-11:00am
Fee: $55 (R), $65 (NR)


Do you want to have a “striking” good time with your friends at the alley? Bowling with SWSRA gives you that opportunity to have fun and be with your friends at the same time! Our bowling program provides a chance for all ability levels to participate in this fantastic sport. Please note the numbers next to each option. This is how you will sign up on the registration page.
Fee includes: one or two game(s) of bowling, shoe rental, one t-shirt per year, and staff supervision
As soon as bowlers are finished with all of their games, they are free to go home with a designated guardian. Occasionally, games move quickly and may cause some bowlers to be done before 6:00pm.
Group: Youth, Teens & Adults
Day: Monday
Dates: September 14-November 2
Time: 5:00pm-6:00pm
Location: Burr Oak Bowl, Blue Island
Min/Max: 3/6
Fee: $130 (R), $255 (NR)
Bowling I
Min/Max: 4/8
Fee: $130 (R), $255 (NR)
Bowling II *
Min/Max: 4/8
Fee: $165 (R), $325 (NR)
*Participants in Bowling II get two (2) games of bowling and must be able to bowl at a pace which would allow the lane of four (4) bowlers to complete both games in the allotted hour time frame.


Join us in a pre-season program, where the athletes will be able to work on their dribbling, shooting and passing skills before the big season begins!
Fee includes: equipment and staff supervision
Group: Teens & Adults
Day: Tuesday
Dates: September 15-September 29
Time: 6:00pm-7:00pm
Location: Alsip Park District-Apollo, Alsip
Min/Max: 4/8
Fee: $40 (R), $60 (NR)


Get ready SWSRA Coyotes! Basketball season is right around the corner, and we are looking for athletes like YOU to join our team! We will be competing at weekly games as well as two tournaments. So grab your sneakers and a ball, and let’s go shoot some hoops! All players must have a SWSRA Coyotes uniform, see Uniform Fee on the next page. Additional fees will be required if team qualifies for State Competition.
Fee includes: equipment, TR Section tournament fee and staff supervision
Group: Teens & Adults
Day: Tuesday
Dates: October 6-February 9
Region E Tournament Date: January 24, 2027
Time: 6:30pm-8:00pm
Location: Alsip Park District-Apollo, Alsip
Min/Max: 8/10
Fee: $260 (R), $390 (NR)
A $50 uniform deposit, which is fully refundable, providing you turn in your uniform clean, on-time and in similar condition it was received. If the uniform is not returned on-time and in good, clean condition, the $50 charge will then become non-refundable. Thank you for your cooperation!
Fee: $50 (R), $50 (NR)

Let's get ready to have fun and get active. Come along for an introduction to different sport skills. This is designed for youth looking to explore and develop basic techniques in a variety of sports. Each session will focus on the fundamentals such as hand-eye coordination, footwork, strategy, and teamwork.
Fee includes: equipment and staff supervision
Group: EC & Youth
Day: Tuesday
Dates: September 15-November 3
EC Time: 4:00pm-4:45pm
Youth Time: 4:45pm-5:30pm
Location: Alsip Park District-Apollo
Min/Max: 4/8
Fee: $80 (R), $100 (NR)


Step up to the boards and join the fun! Boards & Bags is a relaxed and social program where participants can learn the basics of cornhole, practice their aim, and enjoy friendly competition. Whether you’re new to the game or looking to sharpen your skills, this program offers a welcoming environment for all ability levels.
Fee includes: staff supervision
Group: Teens & Adults
Day: Wednesday
Dates: September 16-November 4
Time: 5:00pm-6:00pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $75 (R), $95 (NR)

We do a wide variety of exciting social activities and outings in the community that you don't want to miss.
Participants must be able to participate at a 1:4 staff to participant ratio and have independent ADL (Activity of Daily Living) skills. South West Special Recreation Association reserves the right to determine if this program is appropriate for an individual. Appropriate behaviors must be demonstrated so as not to distract from another participant's experience.
Fee includes: supplies, transportation and staff supervision
Group: Adults
Day: Thursday
Dates: September 17, October 1, October 15, October 29
Time: 6:30pm-8:30pm
Location: Meet at Alsip Park District-Apollo, Alsip
Min/Max: 4/8
Fee: $155 (R), $310 (NR)
Pick Up: Alsip Park District-Apollo 8:45pm


Being active is the secret to staying healthy, and walking is one of the easiest and least expensive ways to get moving. So come join our walking club?
Fee includes: staff supervision Group: Teens & Adults
Day: Thursday
Dates: September 24, October 8, October 22, November 5
Time: 6:00pm-7:00pm
Location: Palos Heights Recreation Center Track, Palos Heights
Min/Max: 4/8
Fee: $55 (R), $110 (NR)

Pickleball has become a big dill and is a fun and fast-growing sport, combining elements of tennis, badminton, and ping-pong, offering a unique and engaging experience for players of all ages and skill levels.
Fee includes: equipment and staff supervision Group: Teens & Adults
Day: Friday
Dates: September 25-November 6
No Program October 9
Time: 5:00pm-6:00pm
Location: Palos Heights Recreation Center, Palos Heights
Min/Max: 4/8
Fee: $70 (R), $85 (NR)


We know you love bowling and cannot get enough! Come to SWSRA’s Bowling Bonanza for a fun spin on bowling. If you are a regular alley cat or brand new to the scene, you will enjoy this friendly and fun program.
Fee includes: two games, shoe rental and staff supervision Group: Teens & Adults
Day: Monday
Dates: November 16-November 30
Time: 5:00pm-6:00pm
Location: Burr Oak Bowl, Blue Island
Min/Max: 4/8
Fee: $60 (R), $120 (NR)

Looking to add two more weeks of Socialites for the year? Join us for this post-season option! We do a wide variety of exciting social activities and outings in the community that you don't want to miss.
Participants must be able to participate at a 1:4 staff to participant ratio and have independent ADL (Activity of Daily Living) skills. South West Special Recreation Association reserves the right to determine if this program is appropriate for an individual. Appropriate behaviors must be demonstrated so as not to detract from another participant's experience.
Fee includes:supplies, transportation and staff supervision Group: Adults
Day: Thursday
Dates: December 3 & December 10
Time: 6:30pm-8:30pm
Location: Meet at Alsip Park District-Apollo, Alsip
Min/Max: 4/8
Fee: $80 (R) $160 (NR)
Pick Up: Alsip Park District-Apollo 8:45pm
Join us to paint and decorate your own ceramic appetizer plate! While your masterpiece bakes, we'll blend up a refreshing smoothie to beat the summer heat.
Fee includes: snack, supplies, and staff supervision
Group: Teens & Adults
Day: Saturday
Date: September 19
Time: 1:00pm-2:30pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $35 (R), $45 (NR)
Registration Deadline: September 4
Calling all Teens to build-your-own chicken nachos and play table games! Pile your favorite toppings onto crispy tortilla chips, then challenge your friends at table games. Come hungry, and get ready for a night of great food, laughs, and game play!
Fee includes: dinner, supplies, and staff supervision
Group: Teens
Day: Friday
Date: September 25
Time: 6:30pm-8:00pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $30 (R), $40 (NR)
Registration Deadline: September 11

Once you pick your pumpkin in this indoor pumpkin patch, you can visit various fall sensory friendly stations. These stations vary from sensory play, craft and other fun activities. Parents/Guardians must stay for the duration of the event.
Fee includes: supplies
Group: All
Day: Friday
Date: October 2
Time: 5:30pm-6:30 pm
Location: Palos Heights Recreation Center-Orchard Room, Palos Heights
Min/Max: 6/15
Fee: $10 (R), $15 (NR)
Sibling Fee: $5
Registration Deadline: September 25
Celebrate National Chili Day the best way by making chili from scratch. From fresh ingredients to a slow simmer, every step was worth it for a warm, hearty bowl full of homemade flavor.
Fee includes: dinner, supplies, and staff supervision
Group: Adults
Day: Saturday
Date: October 3
Time: 5:30pm-7:30pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $35 (R), $45 (NR)
Registration Deadline: September 18


Dust off your boots and find your favorite western hat because we are headed to a Hoedown! Join your friends as you hit the dance floor to stomp your boots and enjoy some country music tunes. A tasty country dinner will be served too!
Fee includes: admission, dinner, transportation* and staff supervision Group: Teens & Adults
Day: Friday
Date: October 9
Time: 6:00pm-8:30pm
Location: Lincolnway Special Recreation Center, New Lenox
Min/Max: 4/8
Fee with Transportation: $85 (R), $130 (NR)
Fee without Transportation: $75 (R), $115 (NR)
*Meet at Lincolnway Special Recreation Center
Registration Deadline: September 25 WITH TRANSPORTATION
Meet at Alsip Park District-Apollo: 5:15pm
Pick up at Alsip Park District-Apollo: 9:15pm WITHOUT TRANSPORTATION
Meet at Lincolnway Special Recreation Center: 6:00pm
Pick up at Lincolnway Special Recreation Center: 8:30pm
MVCC ‘A TAYLOR EXPERIENCE’ CONCERT

Get ready to "Shake It Off" in a spectacular theatrical tribute celebrating the music of Taylor Swift! Sing along to the biggest hits, relive every era, and experience dazzling performances, stunning costumes, and unforgettable storytelling in a show that's made for Swifties.
Fee includes: admission, transportation and staff supervision
Group: Teens & Adults
Day: Saturday
Date: October 10
Time: 6:00pm-10:30pm
Location: Meet at Alsip Park District-Apollo, Alsip
Min/Max: 4/8
Fee: $110 (R), $165 (NR)
Registration Deadline: August 28
Get ready to Fall Into Fun! This youth event is packed with engaging fall crafts where participants can create, explore, and celebrate the season through hands-on artistic projects.
Fee includes: supplies and staff supervision
Group: EC & Youth
Day: Saturday
Date: October 17
Time: 10:00am-11:00am
Location: Goy Building, Worth
Min/Max: 3/6
Fee: $20 (R), $25 (NR)
Registration Deadline: October 2
Join us for a chair yoga session to stretch out your muscles for the weekend! We'll wrap up the program by enjoying a healthy snack. Participants must wear gym shoes and are encouraged to bring a filled water bottle.
Fee includes: snack, supplies, and staff supervision
Group: Teens & Adults
Day: Saturday
Date: October 17
Time: 12:30pm-2:00pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $20 (R), $25 (NR)
Registration Deadline: October 2
Bringing the spooky season to life by crafting an adorable rope ghost for the perfect home décor. While our craft dries we will wrap up the day with a batch of deliciously festive ghost brownies.
Fee includes: snack, supplies, and staff supervision
Group: Adults
Day: Saturday
Date: October 24
Time: 1:30pm-3:00pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $30 (R), $40 (NR)
Registration Deadline: October 9
Calling all teens! Join us for a spooky good time as we create a fun "BOO" string art craft and enjoy a deliciously ghoulish snack.
Fee includes: snack, supplies, and staff supervision
Group: Teens
Day: Saturday
Date: October 24
Time: 12:30pm-1:30pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $25 (R), $35 (NR)
Registration Deadline: October 9
Dress in your best costume and get your ghoul on with your SRA friends! There will be a DJ, costume contest with prizes, snacks and a ton of FUN!
Fee includes: admission, snack, and staff supervision
Group: Teens & Adults
Day: Friday
Date: October 30
Time: 7:00pm-9:00pm
Location: Meet at Oak Lawn Park District Pavilion, Oak Lawn
Min/Max: 4/8
Fee: $40 (R), $60 (NR)
Registration Deadline: October 16
Come make homemade pumpkin cupcakes with cream cheese frosting! We'll decorate and enjoy one cupcake during the program, and you'll take the rest home.
Fee includes: supplies, and staff supervision
Group: Adults
Day: Saturday
Date: November 7
Time: 2:30pm-4:30pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $30 (R), $40 (NR)
Registration Deadline: October 23

Enjoy a night out and learn to paint a masterpiece step by step with your loved ones! This program is designed for a parent, or guardian, to join their participant to paint a new painting on canvas you get to take home! Refreshments and a snack will be served at the end of the event. *Limited spots available.
Fee includes: instruction, snack, and supplies Group: Teens & Adults
Day: Friday
Date: November 13
Time: 6:30pm-8:30pm
Location: Goy Building, Worth Min/Max: 4/12
Fee for Guardian & Participant: $75 (R), $90 (NR) 1 Addition Family Member: $25 (R), $35 (NR)
Registration Deadline: October 30

This is a fun-filled way to experience fall up close! Explore textures, scents, and colorful activities designed to spark curiosity and seasonal excitement.
Fee includes: supplies, and staff supervision
Group: EC & Youth
Day: Saturday
Date: November 14
Time: 10:00am-11:00am
Location: Goy Building, Worth Min/Max: 3/6
Fee: $20 (R), $25 (NR)
Registration Deadline: October 30
Our friends at Oak Lawn Special Recreation are putting on a show! Let’s go support our friends at their dress rehearsal of ‘A Christmas Carol”.
Participants must be able to participate at a 1:4 staff to participant ratio and have independent ADL (Activity of Daily Living) skills. South West Special Recreation Association reserves the right to determine if this program is appropriate for an individual. Appropriate behaviors must be demonstrated so as not to distract from another participant's experience.
Fee includes: admission and staff supervision Group: Adults
Day: Thursday
Date: November 19
Time: 6:45pm-10:00pm
Location: Meet at Oak Lawn Park District-Oak View Center, Oak Lawn Min/Max: 4/8
Fee: $35 (R), $55 (NR)
Registration Deadline: November 6
NWCSRA’S FRIENDSGIVING DANCE

November is the month for giving thanks. Let’s give thanks with our SWSRA friends and other SRA friends. We will celebrate by having dinner and dancing the night away!
Fee includes: admission, dinner, transportation* and staff supervision Group: Teens & Adults
Day: Friday
Date: November 20
Time: 6:00pm-8:30pm
Location: Romeoville Recreation Center, Romeoville
Min/Max: 4/8
Fee with Transportation: $80 (R), $120 (NR)
Fee without Transportation: $65 (R), $105 (NR)
*Meet at Romeoville Recreation Center
Registration Deadline: November 6
Meet at Alsip Park District-Apollo: 5:00pm
Pick up at Alsip Park District-Apollo: 9:15pm WITHOUT TRANSPORTATION
Meet at Romeoville Recreation Center: 6:00pm
Pick up at Romeoville Recreation Center: 8:30pm

Do you need to get your holiday shopping done? Join us as we go to various stores at The Promenade Bolingbrook. Participants are welcome to bring a shopping list and money to purchase items.
Participants must be able to participate at a 1:4 staff to participant ratio and have independent ADL (Activity of Daily Living) skills. South West Special Recreation Association reserves the right to determine if this program is appropriate for an individual. Appropriate behaviors must be demonstrated so as not to distract from another participant's experience.
Fee includes: transportation and staff supervision Group: Adults
Day: Saturday
Date: November 21
Time: 1:00pm-5:30pm
Location: Meet at Alsip Park District-Apollo, Alsip
Min/Max: 4/8
Fee: $45 (R), $70 (NR)
Registration Deadline: November 7
Join SWSRA for a magical time at Santa’s Workshop! Meet Santa, enjoy interactive sensory stations, and take part in festive games, crafts, and holiday fun. It's the perfect way to celebrate the season together! Parents/Guardians must stay for the duration of the event.
Fee includes: supplies Group: All
Day: Monday
Date: December 14
Time: 5:00pm-5:45pm; 6:00pm-6:45pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $5 (R), $10 (NR)
Sibling Fee: $5
Registration Deadline: November 25

It’s time to rock and roll this holiday season with your SRA friends. Dress in your best appropriate ugly sweater and get ready to enjoy a great evening. Orland Park Special Recreation will be hosting an unforgettable evening that will include a full dinner and a DJ!
Fee includes: admission, dinner, transportation* and staff supervision
Group: Teens & Adults
Day: Friday
Date: December 4
Time: 6:00pm-8:30pm
Location: Orland Park Civic Center, Orland Park
Min/Max: 4/8
Fee with Transportation: $115 (R), $175 (NR)
Fee without Transportation: $105 (R), $160 (NR)
*Meet at Orland Park Civic Center
Registration Deadline: November 13
Meet at Alsip Park District-Apollo: 5:30pm
Pick up at Alsip Park District-Apollo: 9:00pm WITHOUT TRANSPORTATION
Meet at Orland Park Civic Center: 6:00pm
Pick up at Orland Park Civic Center: 8:30pm
Spend a cozy evening creating a winter-themed craft with your child! This fun event gives guardians and children the opportunity to work together, get creative, and make special memories while creating seasonal keepsake to take home. No crafting experience is needed—just bring your imagination and enjoy a night of family fun!
Fee includes: supplies
Group: EC & Youth
Day: Friday
Date: December 4
Time: 6:30pm-7:30pm
Location: Goy Building, Worth
Min/Max: 3/6
Fee for Guardian & Participant: $20 (R), $25 (NR)
Registration Deadline: November 20
Homemade bacon cheddar gnocchi soup on the stove and a warm bowl in hand. Cozy, cheesy, and packed with flavor to stay warm on a cold winter night.
Fee includes: dinner, supplies, and staff supervision Group: Adults
Day: Saturday
Date: December 5
Time: 5:30pm-7:30pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $35 (R), $45 (NR)
Registration Deadline: November 20
Bring your holiday gifts, and we'll provide the wrapping paper so you can wrap them with ease! We'll wrap up the program with cookies and milk for everyone to enjoy.
Fee includes: snack, supplies, and staff supervision
Group: Teens & Adults
Day: Saturday
Date: December 12
Time: 1:00pm-2:30pm
Location: Goy Building, Worth
Min/Max: 4/8
Fee: $20 (R), $25 (NR)
Registration Deadline: November 20

Create your own festive fall décor with this paint and decorate a wooden block set! Transform the handcrafted blocks into a pumpkin, turkey, and scarecrow. Supplies include: 3 wooden blocks, stencils, chalk, paint, paint brushes, craft glue, and sponge brush.
Group: All
Fee: $20
Delivery (Residents ONLY): $5
Registration Deadline: August 28
Pick up & Delivery Date: September 4
Pick up Location: SWSRA Main Office
Delivery: Date listed above, time will be between 10:00am-11:00am
Create a one-of-a-kind winter cutting board décor piece that will make the perfect seasonal accent for your home. Decorative use only—not for cutting or serving. Supplies include: (2) unfinished wooden cutting board, stencil, paint, paint brush, and ribbon.
Group: All
Fee: $20
Delivery (Residents ONLY): $5
Registration Deadline: August 28
Pick up & Delivery Date: September 4
Pick up Location: SWSRA Main Office
Delivery: Date listed above, time will be between 10:00am-11:00am
Pictures below are of the fall recreation boxes.



OASIS was created to meet the needs of individuals with disabilities ages 18 and older. This is a structured program designed to help increase independence in various areas that foster personal growth for each individual.

The general program goals are to provide quality recreation services and to increase and maintain social skills through well-designed activities and community integration. Other areas of focus include skills to promote independence through daily living skills, social interactions, cooking, health & fitness, and leisure activities. OASIS supports social interaction with peers and within the community.
New participants may be placed on a waitlist until a spot becomes available. Note, residents will receive priority on a waitlist before non-residents. To be placed on the waitlist, all prospective participants must have completed the initial intake process and registration forms. Individuals must be able to participate successfully at a minimum staff-to-participant ratio of 1:4. Before acceptance, SWSRA will complete an intake assessment and determine that eligibility requirements are met.
Days: OASIS is offered Monday-Friday; participants can register for 2-5 days a week.
Dates: September 8, 2026-May 28, 2027;
The program follows the days off and holidays of a local school district calendar.
Time: 10:00am - 2:00pm
Location: Worth Park District - Terrace Centre, Worth
Monthly Fee: 2 Day Option: $430 (R), $645 (NR)
3 Day Option: $595 (R), $890 (NR)
4 Day Option: $750 (R), $1,125 (NR)
5 Day Option: $935 (R), $1,405 (NR)

A sensory room is a specifically designed environment for people ages 3 to adult with various ability levels to experience a variety of senses and to assist in developing specific skills. Sensory rooms are used to create a safe atmosphere to relax and benefit specific sensory processing difficulties.
By Appointment Only Monday - Saturday.



Benefits May Include:
• Improved mood
• Improved communication
• Decreased anxiety
• Decreased fear
• Enhanced interpersonal interactions
• Fewer disruptive behaviors Who May Benefit:
• Autism Spectrum Disorders
• ADHD
• Sensory processing disorders
• Dementia
Sensory Depot Offers:
• Aromatherapy
• Relaxing sounds and lights
• Interactive tools to promote skills and tranquility
• Bubble tubes
• Fiber optic lights
• And much more!
Sensory Depot Location:
• 10707 S. Oak Park Ave., Worth, IL
• Individual Sessions:
• ONE Session is 30 Minutes
• 1 Session for $10
• 5 Sessions for $45
• 10 Sessions for $90
Group Trips:
Ask to speak with a Recreation Team Member for group rates at 708-389-9423.
How to Register:
• Call or visit SWSRA's main office at:
– 708-389-9423
– 12521 S. Kostner Ave., Alsip
Cancellations made 4 hours or less or no-shows will be charged a fee of $15 and the cost of the session.
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Bowling
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Bowling
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Bowling
4:00pm-4:45pm; 4:45pm-5:30pm Junior Athletes
6:00pm-7:00pm Basketball Skills & Drills
4:00pm-4:45pm; 4:45pm-5:30pm Junior Athletes
6:00pm-7:00pm Basketball Skills & Drills
11:30am-12:00pm Lunch w/Friends
3:00pm-3:30pm Hangman
5:00pm-6:00pm Boards & Bags
6:30pm-8:30pm Socialites 6:00pm-7:00pm Walking Club 29
4:00pm-4:45pm; 4:45pm-5:30pm Junior Athletes
6:00pm-7:00pm Basketball Skills & Drills
11:30am-12:00pm Lunch w/Friends
3:00pm-3:30pm Hangman
5:00pm-6:00pm Boards & Bags
11:30am-12:00pm Lunch w/Friends
3:00pm-3:30pm Hangman
5:00pm-6:00pm Boards & Bags
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Pickleball
6:30pm-8:00pm A Nacho Night
10:00am-11:00am Bakers Club 1:00pm-2:30pm Pallet & Paint
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Bowling
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Bowling
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Bowling
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
4:00pm-4:45pm; 4:45pm-5:30pm Junior Athletes
6:30pm-8:00pm SO Coyotes Basketball
4:00pm-4:45pm; 4:45pm-5:30pm Junior Athletes
6:30pm-8:00pm SO Coyotes Basketball 4:00pm-4:45pm; 4:45pm-5:30pm Junior Athletes
6:30pm-8:00pm SO Coyotes Basketball
4:00pm-4:45pm; 4:45pm-5:30pm Junior Athletes
11:30am-12:00pm Lunch w/Friends
3:00pm-3:30pm Hangman
5:00pm-6:00pm Boards & Bags
11:30am-12:00pm Lunch w/Friends
3:00pm-3:30pm Hangman
5:00pm-6:00pm Boards & Bags
6:30pm-8:30pm Socialites 6:30pm-8:30pm Socialites
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO 5:00pm-6:00pm Pickleball
5:30pm-6:30pm Sensory Pumpkin Patch
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
11:30am-12:00pm Lunch w/Friends
3:00pm-3:30pm Hangman
5:00pm-6:00pm Boards & Bags
5:00pm-6:00pm Bowling 6:00pm-7:00pm Walking Club
6:30pm-8:00pm SO Coyotes Basketball
6:00pm-7:00pm Walking Club
6:00pm-8:30pm LWSRA Hoedown Dance
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Pickleball
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Pickleball
10:00am-11:00am Bakers Club 6:00pm-10:30pm MVCC 'A Taylor Experience' Concert
10:00am-11:00am Fall into Fun 12:30pm-2:00pm Seated Serenity 12:30pm-1:30pm Cobweb Creations 2:00pm-3:30pm Boo-tiful Creations 31 28 29
11:30am-12:00pm Lunch w/Friends
3:00pm-3:30pm Hangman
5:00pm-6:00pm Boards & Bags
7:00pm-9:00pm Halloween Hip-Hop Dance 5:30pm-7:30pm Chili Cook Off 30 6:30pm-8:30pm Socialites
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Pickleball
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Bowling
4:00pm-4:45pm; 4:45pm-5:30pm Junior Athletes
6:30pm-8:00pm SO Coyotes Basketball
11:30am-12:00pm Lunch w/Friends 3:00pm-3:30pm Hangman
5:00pm-6:00pm Boards & Bags
6:30pm-8:00pm SO Coyotes Basketball
9:00am-9:30am
Coffee Talk
3:00pm-3:30pm BINGO
11:30am-12:00pm Lunch w/Friends
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
10:00am-11:00am Bakers Club 2:30pm-4:30pm Pumpkin Cupcakes
5:00pm-6:00pm Pickleball 10:00am-11:00am Sensory Station 6:00pm-7:00pm Walking Club
6:30pm-8:30pm Family Paint Night
1:00pm-5:30pm Holiday Shopping 2 3 4 5
5:00pm-6:00pm Bowling Bonanza
9:00am-9:30am
Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Bowling Bonanza
9:00am-9:30am
Coffee Talk
3:00pm-3:30pm BINGO
5:00pm-6:00pm Bowling Bonanza
6:30pm-8:00pm SO Coyotes Basketball
6:30pm-8:00pm SO Coyotes Basketball
3:00pm-3:30pm Intro into Drawing 6:45pm-10:00pm Oak Lawn Theater Night
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
6:00pm-8:30pm NWCSRA's Friendsgiving Dance
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
6:30pm-8:00pm SO Coyotes Basketball 6:30pm-8:30pm Socialites II 11:30am-12:00pm Lunch w/Friends 3:00pm-3:30pm Intro into Drawing 11:30am12:00pm Lunch w/Friends 3:00pm-3:30pm Intro into Drawing
6:30pm-8:00pm SO Coyotes Basketball
5:00pm-5:45pm; 6:00pm-6:45pm Santa's Workshop
6:30pm-8:00pm SO Coyotes Basketball
9:00am-9:30am Coffee Talk
3:00pm-3:30pm BINGO
6:00pm-8:30pm Orland Park Winter Ball
6:30pm-7:30pm Family Craft Night
10:00am-11:00am Bakers Club 5:30pm-7:30pm Bacon Cheddar Gnocchi Soup 1:00pm-2:30pm That's a Wrap 6:30pm-8:30pm Socialites II
9:00am-9:30am Coffee Talk 3:00pm-3:30pm BINGO
SWSRA promotes the concept of “equal fun for everyone.” Participants, Family Members, and Guardians are expected to exhibit appropriate behavior at all times. SWSRA’s behavior guidelines have been developed to help make the programs safe and enjoyable for all participants.
1. Participants, Family Members, and Guardians must show respect to all participants, staff, and volunteers.
2. Participants, Family Members, and Guardians must refrain from threatening or causing bodily harm to self, other participants, or staff.
3. Participants, Family Members, and Guardians must refrain from using foul language or discussing inappropriate topics.
4. Participants, Family Members, and Guardians must show respect for equipment, supplies, and facilities.
5. Additional rules may be developed for specific programs and athletic programs as deemed necessary by staff.
6. If inappropriate behavior occurs, a prompt resolution will be sought specifically to each individual’s situation. SWSRA reserves the right to dismiss participants whose behavior endangers the safety of themselves or others. Actions may be, but not limited to: Participants, Family Members, and/ or Guardians sent home, suspend the Participants, Family Members, and/or Guardians, or expel the Participants, Family Members, and/or Guardians.
SWSRA asks that participants arrive no earlier than 5 minutes prior to the start of a program or slated pickup time, and be picked up promptly at the end of the program or slated drop-off time. SWSRA requires you to walk the participant(s) into and out of the building and/or their program room. Please do not drop off or leave anyone early or without a staff member present.
Please pick-up participants at the designated times. If parents/guardians are not on time for a participant pick-up/drop-off, a $15 fee will be assessed after 15 minutes late and every 15 minutes thereafter. This fee assists us in paying for the additional staff wages. In addition, for anyone 5 minutes late, in excess of 2 times, the fee will start at 5 minutes late, from there on after.
In the event of severe weather, SWSRA may cancel programs in the best interest of our participants. For the safety of our participants, program supervisors may make the decision to cancel a program in progress, should weather become questionable. The following guidelines will be used to determine cancellations:
• Outdoor programs: Temperature range of 0 degrees or less, including wind chill.
• Programs with transportation: Temperature of 0 degrees or less, including wind chill.
• 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.
• Outdoor programs, or indoor sites without airconditioning, a heat index of 100 degrees or higher.
• Programs with Transportation: Heat index of 100 degrees or higher.
• All programs (including indoor): Weather situations when a tornado warning is in effect.
• When there is a high wind advisory in effect, strong winds can make driving difficult, especially for high profile vehicles.
SWSRA attempts to hold programs whenever possible. However, inclement weather or emergencies occasionally make it difficult for participants and staff to travel to program locations. SWSRA’s cancellation guidelines are as follows:
• At the scheduled program time, if no participants arrive within the first 30 minutes, the program session will be canceled, and staff will be sent home. NO refunds will be given.
• SWSRA staff look at all circumstances, (weather reports), two hours prior to the starting time of the program or transportation route to determine if the program should be canceled.
• If the program is canceled, staff will attempt to reach all participants by phone to inform them. You will only be called if the program is canceled.
• If SWSRA cancels a program, we will make attempts to extend the program to make up missed dates.
SWSRA will make calls announcing any program extensions.
1. SWSRA reserves the right to determine and or decline participant appropriateness for programs, trips, special events and overnight trips based on the participant appropriateness for the activity(s).
2. When arriving and departing a program, parents/ guardians/group home staff are required to notify the Program Leader.
3. If a participant cannot attend a program, he/she cannot send a substitute in their place.
4. When participants of varying ages and ability levels are in the same program, SWSRA will group them appropriately.
5. SWSRA provides appropriate staff-to-participant ratios based on the information provided to us on the registration form, annual master, and parent/ teacher input & new participant assessments. We provide an approximate 1:4 staff-to-participant ratio.
6. SWSRA is not responsible for lost or stolen property. Participants are encouraged to leave valuables at home.
– With the participant’s best interest in mind, we
have found that having parents/guardians, and/ or siblings present during a program can tend to distract participants during program time. This can affect the quality of their participation. Our staff always welcome the opportunity to discuss a participant’s progress with parents/guardian at any time.
7. Vacation Trips, Weekend Trips, and Overnights: Participants must be completely independent in their daily life skills. SWSRA does not provide supervision of participants after “lights out” and during sleeping hours. Participants must be able to function in a 1:4 staff-to-participant ratio, and have participated in SWSRA weekly programs at least one season before registering for any of these types of trip(s).
• To prevent the spread of contagious illnesses, it is recommended that participants refrain from attending programs when any of the following conditions exist:
– Fever of 100 degrees or higher.
– Vomiting within the last 24 hours.
– Persistent diarrhea in conjunction with other symptoms.
– Contagious rash or a rash of unknown origin or ringworm.
– Persistent cough and/or cold symptoms.
– “Pink eye” (conjunctivitis) or discharge from the eye.
– Symptoms of mumps, measles, chicken pox, strep throat, flu, impetigo, coxsackie virus
– Head lice or mites
– Runny nose with yellow or green discharge, which indicates infection.
• Please notify the SWSRA office of any contagious disease that will affect attendance. Participants can return at doctor’s recommendation, or when symptoms have clearly passed.
SWSRA staff has the right to deny participation to any individual exhibiting symptoms of a contagious illness.
For additional policies and guidelines, visit our website at www.swsra.org

Sue Bonnick
Mary Ann Merritt
Murphy Family
Wadsworth Golf Charities Foundation
Palos Heights Women’s Club
Social Media Birthday Fundraiser
Christine Flynn
SUMMER CAMP SPONSORS
PREMIER SPONSOR
Menasha Corporation Foundation
Marsha Amraen
Anton-Argires, Inc.
CJ Erickson Plumbing Company
Victoria Ganz-Czarney
SILVER SPONSOR
BBC Fasteners, Inc

Friends of Bill Cunningham

Joe & Barb Hogan
Geraldine Strelchuk
Tom White Family Fund
Worth Lions Club

(Signature required annually with MASTER FORM and notify SWSRA if any information changes)
SWSRA is committed to conducting its recreation programs and activities in a safe manner and holds the safety of participants in high regard. SWSRA continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participants' safety. However, participants and parents/guardians of minors registering for the programs/activities listed above must recognize that there is an inherent risk of injury when choosing to participate in recreational programs/activities. You are so lely responsible for determining if you or your minor/child/ward are physically fit and/or skilled for the activities contemplated by this agreement. It is always advisable, especially if the participant is pregnant, disabled in any way, or recently suffered an illness, injury, or impairment, to consult a physician before undertaking any physical activity. Recreational programs/activities are intended to challenge and engage the physical, mental, and emotional resources of each participant. Despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury when participating in any recreational program/activity. Understandably, not all hazards and dangers can be foreseen. Depending on the particular activity, participants must understand that certain risks, dangers, and injuries due to i nclement weather, slipping, falling, poor skill level or conditioning, carelessness, horseplay, unsportsmanlike conduct, premises, defects, inadequate or defective equipment, animal bites, inadequate supervision, instruction or officiating and all other circumstance inherent to indoor and outdoor recreational activities/programs exist. In this regard, it must be recognized that it is impossible for SWSRA to guarantee absolute safety. Please read this form carefully and be aware that in signing up and participating in the above-identified programs/activities, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages, or loss which you or your minor/child/ward might sustain as a result of participating in any and all activities connected with and associated with said programs/activities (including transportation services/vehicle operation, when provided).
Virtual Programs and Online Activities: You should consult your physician or other health care professional before starting this or any other fitness program/activity to determine if it is right for your needs. If you experience faintness, dizziness, pain, or shortness of breath at any time while exercising you should stop immediately. If you choose to exercise to this virtual program/activity, you do so at your own risk and acknowledge that the exercises carry an inherent risk of physical injuries. To the extent permitted by law, SWSRA and its affiliates disclaim any and all liability in connection with the exercises in the video and any instructions and advice provided. I recognize and acknowledge that there are certain risks of physical injury to participants in these programs/activities, and I voluntarily agree to assume the full risk of any and all injuries, damages, or loss, regardless of severity, that my minor/child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims, I or my minor/child/ward may have (or accrue to my minor/child/ward or myself), as a result of participating in these programs/activities against SWSRA including its officials, agents, volunteers and employees (hereinafter collectively referred as SWSRA). I do hereby fully release and forever discharge SWSRA from any and all claims of injuries, damage, or loss that my minor/child/ward or I may have or which may accrue to myself or my minor/child/ward and arising out of, connected with, or in any way associated with these programs/activities. I have read and understand the above important information, warning of risk, assumpt ion of risk and waiver and release of all claims. If registering online or via fax, your online or facsimile signature shall substitute for and have the same legal effect as an original form signature.
Say Cheese!
SWSRA occasionally takes photographs or videos of participants for promoting/advertising our programs, services, events, activi ties, and facilities in our brochures, website or agency social media, and other promotional avenues. By registering for, participating in, or attending SWSRA programs, events, or other activities, the participant (or parent/guardian of a minor/child/ward participant) irrevocably agrees to the use and distribution by SWSRA of his or her image (or of his minor/child/ward) in photographs, video recordings, and any other electronic reproductions of such programs, events, and activities for any purpose without inspection or approval and without compensation, rights to royalties, or any other consideration now and in the future.
Print Participant’s Name:_______________________________________________________Date:_______________________
Signature:
(If Under 18, Parent/Guardian Signature)
Print Name of Signature:


Participant’s Name (Last) _______________________________________(First) ___________________________________________
Address _________________________________________________ City _______________________________ Zip _______________
Primary Disability
Secondary Disability
Sex: Female ______ Male ______ Age: _____ Birthdate: (MM/DD/YY) _____ /_____ /_____
*E-mail: _______________________________________________________________
GROUP HOME PARTICIPANTS ONLY: Name of Group Home/House _______________________________________________________________
* By providing your e-mail address, you give SWSRA consent to send you promotional materials via e-mail and will only be used b y SWSRA. You can request to be taken off SWSRA’s mailing list at any time.
Case Manager _______________________________________ Work
House Manager _______________________________________ Work
EMERGENCY CONTACT INFORMATION REGARDING PARTICIPANT IN ORDER OF PREFERENCE:
In the event of an emergency, cancellation of program, etc., list in order of preference those who have your consent and authorization to pick up participant if needed.
MEDICAL INFORMATION:
A. Wheelchair: *Yes_____ No_____ *If Yes, completion of SWSRA FORM 1 required
B. Seizures: *Yes_____ No_____ *If Yes, completion of SWSRA FORM C (pages 1-3) required Is Vagus Nerve Stimulation (VNS) Used: Yes _____ No_____ *Note: In case of a seizure, you will be notified
C. Asthma: *Yes_____ No_____ *If Yes, completion of SWSRA FORM A (pages 1-2) required
D. G-Tube: *Yes_____ No_____ *If Yes, completion of SWSRA FORM B (pages 1-5) required
E. List any other Medical Conditions AND/OR Assisted Devices *Note: Additional forms may be required
F. Allergies: *Yes No *If Yes, Please Complete Chart Below
ALLERGIES
MEDICATION
INSECT BITES/STINGS
OTHER
C. Will staff need to assist with Medication during program? *Yes ____ No ____ *If Yes, SWSRA FORM 4 (pages 1-2) will be required to complete
A. Doctor's Name: ________ ____Phone: ___ _______________
B. Medication: SWSRA needs to know ALL medications participant is taking, regardless of when/where dispensed. Please list ALL medications below: (If more than 4 medications, please attach a separate sheet)
TYPE OF MEDICATION
C. Medication Assistance: Will staff need to assist with Medication during program? *Yes _____ No _____ *If Yes, SWSRA FORM 4 (pages 1-2) will be required to complete
A. T-Shirt Size: CHILD SIZES: S(6-8) _____ M(10-12) _____ L(14-16) _____ ADULT SIZES: S_____ M_____ L_____
B. General Questions:
Please fill out the following questions thoroughly so that we can best serve your participant.
1. Participant’s favorite activities are: __________________________________________________________________________________
2. Participant should not eat (please consider allergies/medical conditions) _______________________________________________
3. Inappropriate behaviors participant displays: ___________________________________________________________________________ ______
4. Areas/Goals for the participant to work toward: _________________________________________________________________________ ______
5. Toilet Training: ____________________________________________________5b. Does Participant require assistance? Yes ______ No ______
6. SWSRA provides an approximate 1:4 staff-to-participant ratio. Please note if you are requesting a closer ratio and why:
C. Sensory Needs:
1. Please list what sensory equipment is needed or used: ____________________________________________________________________
D. Visual Supports and Communication: Verbal ______ Nonverbal ______ ______Communication Device, please list: __________________________________ _______ Picture Exchange Communication System(PECS) ______Visual Directions _______ ASL American Sign Language _______ Homemade Sign ______Cue Cards (stop, wait, sit, etc.) _______ Other Languages: ___________________________ ______ Read Lips
E. Swim Information:
1. Pre-beginner _____ Beginner _____ Intermediate _____ Advanced _____
2. Does participant use: Flotation device? Yes ______ No ______ Ear plugs? Yes _______ No______
3. Is participant allowed to swim in deep water? Yes ______ No ______
PERMISSIONS:
1. Parents/Guardians are asked to provide bug spray & sunscreen. Can staff apply these products on participant? Yes _______ No ______
2. Transportation Permission: Transportation as a part of weekly activities, special events, or trips? Yes ______ No ______
Signature (If under 18, parent/guardian signature please) Date
*Note: This SWSRA MASTER FORM is completed annually. Please notify SWSRA if any information changes.



