Fall 2019 Registration Form
(Page 2)
Please Print Participant’s Name: ________________________________________________
REGISTRATION INFORMATION CONTINUED
Program Information
Program
Transportation Information
Code
Fee
Northbrook Days Festival | Saturday, August 3 397300-01 FREE
397301-01 FREE
Summer Bash | Wednesday, August 14
Code
Fee
Pick Up Site
SUBTOTAL
Drop Off Site
(Program &
Transportation Fees)
SUBTOTAL:
Please carry this subtotal over to front of form.
Register additional family members and friends for Northbrook Days:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Register additional family members for Summer Bash:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
COMMENTS: We Welcome Your Input
You or your child is participating in programs through NSSRA and/
or your local park district or recreation department. NSSRA services
include providing year-round recreation programs for the residents
of its thirteen partner communities, Inclusion support, sign language
interpreters, behavior management support and training, disability
awareness training and any other services necessary to involve you and
your child in community recreational activities.
We encourage you to share with us your thoughts and ideas about our
current services or other services which you would like to see us offer.
We use your comments to develop new programs, train support staff
and companions, and improve the quality of NSSRA and park district
or recreation department programs.
We value your feedback!
We invite you to share with us your program ideas and comments about our services:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
If you would like to discuss your comments with an NSSRA staff member, please check the appropriate box:
Yes
No
REGISTRATION DEADLINE: FRIDAY, AUGUST 9 @ 5:00 PM
68
Fall 2019 Program Guide • register.nssra.org