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34 Registration Dates Resident registration begins: August 27 Non-resident registration begins: September 4 Office Hours Monday - Wednesday Thursday Friday 8:30am - 4:30pm 8:30am - 6:30pm 8:30am - 4:30pm For your convenience A drop box is available for easy drop-off registration at any time of day. Address: 15 W 400 Harvester Drive Burr Ridge, IL 60527 For more information Call: (630) 920-1969 Fax: (630) 920-1973 Internet: www.brparks.org E-mail: Info@brparks.org Registration Procedures 1. Choose the program(s) you wish to register for and fill out the registration form completely, making sure you indicate the proper code numbers. 2. Adults must sign the "Release/Hold Harmless and Emergency Treatment Form" for their own programs as well as for their children under 18 years of age. Registration forms without proper signatures cannot be processed. 3. Payment with cash, credit card or check (a $35 fee will be charged for any returned checks) is acceptable. Make your check payable to Burr Ridge Park District and drop off at or mail to: Burr Ridge Park District, 15 W 400 Harvester Drive, Burr Ridge, IL 60527. Registration is also accepted via fax, 630-920-1973. Proof of Residency Policies set forth by Burr Ridge Park District Board of Commissioners define a resident as anyone living within the geographic boundaries of the Burr Ridge Park District and who pays property taxes to the district. Friendly Refund Policy Burr Ridge Park District strives to ensure participants' quality leisure experiences. Your satisfaction is our number one priority and we would greatly appreciate hearing from you if your programming experience does not meet your expectations. In the event that your expectations are not met and we are not able to resolve the issues to your satisfaction, the following steps will be implemented to issue a refund to you. Refund Steps www,brparks.org At any time up until the mid-way point of a program, you will receive a prorated refund for the number of days not attended after contact. A $3.00 service charge will be instituted for all refunds. Refunds will not be granted after the mid-way point of the program or after a single meeting (i.e. special event) program is completed. Medical situations may be granted as an exception to this policy. If at any point in time you are unable to continue in a program due to a medical situation, you will receive a prorated refund if you follow the above steps and include a doctor's note identifying the medical condition and the date the condition occurred. Due to the nature of the program, certain activities may be exempt from this refund policy. Such exemptions are noted in that particular program's description by the symbol v. Participants who withdraw from a trip may receive a refund or a partial refund. This determination will be made based upon the unique arrangements for that particular trip. Also, our ability to supply a replacement may have an impact on the final refund decision. Make contact with the trip planner to discuss particular arrangements. Gateway Special Recreation Association Programs for Individuals Encompassing a Wide Range of Ages and Ability Level 630-325-3857 web: www.raygraham.org e-mail: gateway_gators@yahoo.com Gateway Special Recreation Association provides recreation services throughout the year to children, teens, and adults with disabilities. Gateway S.R.A. was formed through an intergovernmental agreement and is an extension of the Park Districts of Burr Ridge, Oak Brook, Elmhurst, Pleasant Dale, Westchester, and York Center, the City of Countryside, and the Villages of Hinsdale and Willowbrook. Burr Ridge Park District Programs The Burr Ridge Park District welcomes and encourages persons with disabilities to participate in our seasonal offerings. Please feel free to contact us if we can be of any assistance in facilitating an arrangement for you, as we have done for many others needing special accommodations. Your advance call helps us to properly plan for a successful recreation experience. The Hanson Center The Anna Emery Hanson Center is located on 59th and Garfield in Burr Ridge. The Gateway Board The Gateway Board meets on the second Thursday of each month. All meetings are open to the public. Please call the Hanson Center at 630-325-3857 for further information.
www.brparks.org Please e-mail us at info@brparks.org if you’d like to receive updates/news via e-mail. All e-mail addresses are confidential. MAIN CONTACT: LAST NAME, FIRST NAME Registration may be faxed to 630-920-1973 PREFERRED CONTACT NUMBER SPOUSE (IF APPLICABLE) 35 15 W 400 Harvester Dr. Burr Ridge, IL 60527 Phone 630-920-1969 Fax 630-920-1973 E-mail info@brparks.org On-Line www.brparks.org ADDRESS CITY E-MAIL ADDRESS ZIP HOME PHONE CELL PHONE EMERGENCY PHONE First Time Registrants: Please Complete the Following Section CHILDREN’S NAMES M/F DATE OF BIRTH REQUIRED (MO/DAY/YR) ALLERGIES AND/OR SPECIAL ASSISTANCE NEEDS Registration Payment Method: m A check made payable to Burr Ridge Park District is attached. m VISA m MasterCard m Discover Credit Card Information is not kept on file. Authorized Signature CARD NUMBER - - - EXP: The Following Section Must Be Completed in Full CODE PROGRAM TITLE PARTICIPANT’S NAME AMOUNT DUE $ $ $ $ $ $ A $3.00 fee must be charged for all cancellations due to BRPD policy. PLEASE NOTE: Effective immediately, $35 will be charged for returned checks. TOTAL AMOUNT $ PHOTO INFORMATION On occasion, the park district staff or local newspaper photographers may take pictures of participants in our programs, classes, or events. Please be aware that these pictures are only for Park District use, most likely in future catalogues, brochures, pamphlets, flyers, website or for publication in a local newspaper. IMPORTANT INFORMATION The Burr Ridge Park District is committed to conducting its recreation programs and activities in a safe manner and holds the safety of participants in high regard. The Burr Ridge Park District 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 this program/activity must recognize that there is an inherent risk of injury when choosing to participate in recreational activities/programs. You are solely 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 or impairment, to consult a physician before undertaking any physical activity. WARNING OF RISK Recreational activities/programs 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 activity/program. 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 inclement weather, slipping, falling, poor skill level or conditioning, carelessness, horseplay, unsportsmanlike conduct, premises defects, inadequate or defective equipment, inadequate supervision, instruction or officiating, and all other circumstances inherent to outdoor and indoor recreational activities/programs exist. In this regard, it must be recognized that it is impossible for the Burr Ridge Park District to guarantee absolute safety. WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK Please read this form carefully and be aware that in signing up and participating in this program/activity, 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 this program/activity (including transportation services/vehicle operation, when provided). I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the risk of any and all injuries, damages or loss, regardless of severity, that my child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against the Burr Ridge Park District, including its officials, agents, volunteers and employees (hereinafter collectively referred as Burr Ridge Park District). I do hereby fully release and forever discharge the Burr Ridge Park District from any and all claims for injuries, damages, or loss that minor child/ward or I may have or which may accrue to me or my child/ward and arising out of, connected with, or in any way associated with this program/activity. I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims. If registering on-line or via fax, your online or facsimile signature shall substitute for and have the same legal effect as an original form signature. PARENT/LEGAL GUARDIAN SIGNATURE (OVER 18 YEARS) DATE
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