Issuu

REGISTRATION DATES

RESIDENT ONLY - PRIORITY • MARCH 9 - MARCH 20

RESIDENT/NON-RESIDENT/CO-OP • MARCH 23 - APRIL 2

2026 • SUMMER CAMP BROCHURE

A Letter from the Executive Director

Dear SWSRA Friends & Family,

Summer is just around the corner, and we welcome our families to join us for a safe, engaging and fun summer of activities, swimming, outings and friendships.

SWSRA offers a variety of summer camps designed for participants of all ages. Our camps provide engaging recreational experiences while focusing on a safe, supportive, and structured environment that meets the individual needs of each camper. Below you’ll find details about our camp sessions, dates, and times. Please note, NEW this summer is our camp for Teens, Sporty Gamers.

If you have any questions or would like additional information, please contact us at 708-389-9423. We look forward to another fantastic summer and hope to see you there!

SESSIONS & CAMPS:

• Session A: June 8-June 26

• Session B: July 6-July 31

• Tiny Turtles Camp (3-7 yrs old; half days)

• Monday-Friday 10:00am-12:00pm

• Extreme Explorers Camp (Youth)

• Monday-Friday 10:00-3:00pm

• Sporty Gamers Camp (Teens)

• Monday-Friday 10:00-3:00pm

• Get Up and Go (Adults)

• Monday-Friday 10:00am-3:00pm

We can’t wait to share a summer full of fun, friendship, and adventure with you!

Warm regards

Nicolette D. Lahman-Morales, CPRP Executive Director

or omissions contained in this brochure publication. In addition, information is subject to change without notice.

Summer Camp 2026, Seasonal Program Brochure

Who We Are

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

MISSION STATEMENT

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.

VISION STATEMENT

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

BOARD OF DIRECTORS

Alsip Park District

Jeannette Huber

Blue Island Park District

Ted Ruthenberg

Hickory Hills Park District

Renee Chavez

Merrionette Park

Michelle Higgins

CONTACT US

Ami Ill, CTRS

Recreation Supervisor aill@swsra.com

708-389-9423 ext. 210

Brittany Izzo, CTRS Recreation Supervisor bizzo@swsra.com 708-389-9423 ext. 207

Tina Izzo-Delbovo Recreation Specialist tizzo-delbovo@swsra.com 708-389-9423 ext. 212

Rose Pilny Main Office Clerk rpilny@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

Registration

PROGRAM DATES

June 8 - July 31

REGISTRATION DATES

Residents Only - Priority Registration*

March 9 - March 20

Resident/Non-Resident/Co-Op Registration

March 23 - April 2

*Please keep in mind our space is limited and in high demand. We encourage residents to enroll during this priority period. Registrations 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.

HOW TO REGISTER

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.

PARTICIPATION AGE GUIDE

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

AMERICANS WITH DISABILITIES ACT

SWSRA is subject to and will comply with the Americans with Disabilities Act (ADA), which prohibits discrimination on the basis 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.

FEE ASSISTANCE PROGRAM

SWSRA offers scholarships for a percentage of fees to our families with financial restrictions because we believe all residents, regardless of financial limitations, should have access to SWSRA programs. Participants in need of financial assistance may obtain a Fee Assistance Program Application by visiting our main office or by calling 708-389-9423.

SWSRA PROGRAM LOCATION(S)

Prairie Junior High School 11910 S. Kostner Avenue Alsip, IL 60803

Agreements

Information & Cooperative

MASTER REGISTRATION FORM

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.

PARTICIPANT ASSESSMENT

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.

STAFF RATIO

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.

INCLUSION

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: 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.

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.

Summer Camp

SUMMER CAMP GOALS

Build Character & Skill

Your goals for your campers are very important to our staff. We focus on building independent skills throughout the summer in areas of selfhygiene, socialization, balance and coordination, and communication. Our staff strives to help each individual reach these goals through fun recreational activities.

Build Friendships

Socialization and communication skills with others are a very important part of building relationships. At camp, we utilize group games and activities to help campers increase their appropriate social interactions, including peer and adult conversational skills.

Have Fun

We are all about FUN! Our programs and camp focus on building skills through recreational activities including swimming, group sports, sensory play and field trips. Our staff organizes games and activities that work on fine and gross motor skills that are fun for campers.

Safe Environment

It is our priority that we provide a safe environment for all our participants. All staff are required to complete a background check and various trainings upon hire with continuous trainings throughout the year.

CAMPER & PARENT ORIENTATION

This is a new format specifically designed for the “new” camper/family who has not previously attended camp. It is required that a parent or guardian attend this orientation. You will get an in-depth overview of the structure of our camp, review policies and procedures, and have time for questions/answers. Returning campers/families are welcome too!

Date: Thursday, June 4

Time: 5:30pm-6:30pm

Location: SWSRA Main Office

RETURNING CAMPERS

This is for returning campers and families to pick up their Summer Camp Packet, backpack and camp shirt. Please allow time to review any updated policies and procedures and sign to acknowledge these changes. A parent or guardian must sign the paperwork and pick up the camper’s packet during our extended office hours on the dates listed below:

Date(s): Wednesday, June 3 OR Thursday, June 4

Time: 9:00am-5:00pm

Location: SWSRA Main Office

Your camper cannot attend camp until this paperwork is signed and the packet is picked up.

Fee: Session A: $295 (R)

Session B: $390 (R)

Session A & B: $685** (R)

SUMMER CAMP TRANSPORTATION PROCEDURES

SWSRA has implemented the following transportation procedures for the safety of all the participants while being transported in SWSRA vehicles. The following procedures must be adhered to at all times. Failure to follow procedures may lead to suspension or removal from transportation privileges:

1. Participants must be sitting in seats or wheelchairs securely fastened at all times. Wheelchairs must have working brakes able to securely lock or participant cannot be transported.

2. Participants must keep arms and hands inside the windows at all times.

3. Yelling, fighting or disruptive behavior is prohibited while in transport.

4. No food or drink may be consumed while in vehicles.

LATE PICK UP FEE

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.

Program Policies

BEHAVIOR GUIDELINES

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.

DROP OFF/PICK-UP & DROP OFF POLICY

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.

LATE PICK-UP FEE POLICY

SEVERE WEATHER CANCELLATIONS

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:

Severe Cold Weather

• 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.

Severe Hot Weather

• 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.

High Wind Advisory

• When there is a high wind advisory in effect, strong winds can make driving difficult, especially for high profile vehicles.

Program Policies

PROGRAM CANCELLATIONS

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.

PROGRAM GUIDELINES

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.

7. 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.

8. 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).

GUIDELINES WHEN ILLNESS OCCURS

• 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

June 8-June 26

Session B: 4 Weeks

July 6-July 31 Session A & B: 7 Weeks

June 8-July 31

July 6-July 31 Session A & B: 7 Weeks

June 8-July 31

Summer Camp 2026 Registration

Session A: 3 Weeks

June 8-June 26

Session B: 4 Weeks

July 6-July 31

Session A & B: 7 Weeks

June 8-July 31

Shirts are distributed on a first-come, first-served basis.

Size requests will be accommodated when possible but cannot be guaranteed.

Early registration increases the likelihood of receiving the preferred size.

June

Session B: 4 Weeks

July 6-July 31

Session A & B: 7 Weeks

June 8-July 31

June 8-June

Session B: 4 Weeks

July 6-July 31

Session A & B: 7 Weeks

June 8-July 31

SWSRA WAIVER, RELEASE OF ALL CLAIMS AND HOLD HARMLESS AGREEMENT

(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. 1.

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

MEDICAL INFORMATION CONTINUED:

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

COMMUNICATION & ADDITIONAL INFORMATION:

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.

SWSRA Seasonal Program Brochure, Summer Camp 2026

A Letter from the Executive Director

Who We Are

MISSION STATEMENT

VISION STATEMENT

BOARD OF DIRECTORS

CONTACT US

FOLLOW US

Registration

PROGRAM DATES

REGISTRATION DATES

HOW TO REGISTER

PARTICIPATION AGE GUIDE

AMERICANS WITH DISABILITIES ACT

FEE ASSISTANCE PROGRAM

SWSRA PROGRAM LOCATION(S)

Agreements

Information & Cooperative

MASTER REGISTRATION FORM

PARTICIPANT ASSESSMENT

STAFF RATIO

INCLUSION

LINCOLNWAY SPECIAL RECREATION ASSOCIATION COOPERATIVE AGREEMENT

Summer Camp

SUMMER CAMP GOALS

Build Character & Skill

Build Friendships

Have Fun

Safe Environment

CAMPER & PARENT ORIENTATION

RETURNING CAMPERS

Summer Camp

TINY TURTLES

EXTREME EXPLORERS

SPORTY GAMERS

GET UP & GO

Transportation

TRANSPORTATION

SUMMER CAMP TRANSPORTATION PROCEDURES

LATE PICK UP FEE

Program Policies

BEHAVIOR GUIDELINES

DROP OFF/PICK-UP & DROP OFF POLICY

LATE PICK-UP FEE POLICY

SEVERE WEATHER CANCELLATIONS

Severe Cold Weather

Severe Hot Weather

High Wind Advisory

Program Policies

PROGRAM CANCELLATIONS

PROGRAM GUIDELINES

GUIDELINES WHEN ILLNESS OCCURS

Summer Camp 2026 Registration

SWSRA WAIVER, RELEASE OF ALL CLAIMS AND HOLD HARMLESS AGREEMENT

MEDICAL INFORMATION CONTINUED:

COMMUNICATION & ADDITIONAL INFORMATION: