Registration Form ( Page 2 )
Please Print Participant ’ s Name : ________________________________________________ REGISTRATION INFORMATION CONTINUED
Program Information
Transportation Information
Program Code Fee Code Fee Pick Up Site Drop Off Site
SUBTOTAL
Special Events
Who Let the Dogs Out ? |
337001-61 |
$ 76 |
Walking is S ' mores Fun with Friends |
337002-61 |
$ 70 |
Kenosha Kingfish Baseball Game |
337004-61 |
$ 101 |
Elephant and Piggie " We are in a Play " |
337005-61 |
$ 78 |
Family Movie Night : |
337003-02 |
FREE |
Northbrook Days |
333001-01 |
FREE |
All Aboard |
337006-61 |
$ 105 |
Summer Bash |
333002-01 |
FREE |
Let ' s Play Ball |
337007-61 |
$ 26 |
SUBTOTAL : Please carry this subtotal over to front of form .
Register additional family members and friends for Summer Bash :
______________________________________________________________________________________________________ ______________________________________________________________________________________________________
Register additional family members for Northbrook Days :
______________________________________________________________________________________________________ ______________________________________________________________________________________________________
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 !
66 Registration Form | nssra . org