This web site menu requires javascript to function properly

equal fun for everyone graphic

Western DuPage Special Recreation Association

2010
Fall Brochure

image of fall cover

REGISTER ONLINE NOW


click here to view
the summer 2010 brochure

Inclusion Notification Form

Questions regarding this from should be directed to Tammy Kerrins at (630) 681-0962
or e-mail tammyk@wdsra.com

Submitted by E-mail Address (for confirmation)
Park Dist Staff
Parent/Guardian

Date Submitted
Season
Year
Participant's Name
Date of Birth
Male
Female
Parent's Name

Phone Number

Zip
Address
City
Parent email
Park District Supervisor
Program Title Program Number
Program Location (include Rm #)
Day of Week Time
Date Program Begins
Date Program Ends Does not meet on:
Minimum Age
Maximum Age Staff/Participant Ratio
Name of Instructor
Class Prerequisites?
Equipment/Supplies Needed
 
Please indicate which type of assistance is requested:
   
Training
Observation Additional Staff Modified Equipment Other  
   
Additional Comments
 
     
  Are Parents Aware of WDSRA Services?
     

 

Charlie Long/
WDSRA Golf Classic
Tues, July 20
Arrowhead G.C.


golf ball pic

Thank You for Your Support


JavaScript DHTML Drop Down Menu By Milonic