Spring 2018 Registration Form
(Page 2)
Please Print Participant’s Name: ________________________________________________
REGISTRATION INFORMATION CONTINUED
Program Information
Program
Code
Transportation Information
Fee
Code
Fee
Pick Up Site
SUBTOTAL
Drop Off Site
(Program &
Transportation Fees)
SUBTOTAL:
Please carry this subtotal over to front of form.
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:
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If you would like to discuss your comments with an NSSRA staff member, please check the appropriate box:
Yes
No
REGISTRATION DEADLINE: FRIDAY, FEBRUARY 23 @ 5:00 PM
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Register online at register.nssra.org.