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R E G I S T E R T O D A Y A T WI N N E T K A C O MMU N I T Y H O U S E . O R G !

N o n - P r o f t O r g .
U . S . P o s t a g e
P A I D
P e r m i t N o . 5 0
W i n n e t k a , I L
SUMMER CAMP GUIDE
Winnetka Community House
W I N N E T K A C O M M U N I T Y H O U S E
6 2 0 L I N C O L N A V E . , W I N N E T K A I L 6 0 0 9 3
W I N N E T K A C O M M U N I T Y H O U S E . O R G
F A C E B O O K . C O M / W I N N E T K A C O M M U N I T Y H O U S E
T W I T T E R . C O M / W C H N E W S
8 4 7 - 4 4 6 - 0 5 3 7
COR NF L A K E S
S U MME R CA MP
L E A R N , G R O W A N D P L A Y
WI N N E T K A C O M M U N I T Y H O U S E . O R G / C O R N F L A K E S
WI NNETKA COMMUNI TY HOUSE | 620 L I NCOL N AVE. , WI NNETKA, 60093 | 847- 446- 0537
Tuesdays and Thursdays June 12July 26
69000 Mornings Member: $549 Non-Member: $649
69001Extended day Member: $707 Non-Member: $838
MondayFriday June 11July 27
69004 Mornings Member: $960 Non-Member: $1142
69005 Extended day Member: $1427 Non-Member: $1702
Monday, Wednesday and Friday June 11July 27
69002 Mornings Member: $692 Non-Member: $822
69003 Extended day Member: $1007 Non-Member: $1198
This unique outdoor-oriented camp offers a combination of creative activities
and educational experiences for children ages 33 months through six years of
age. Children are encouraged to explore their outdoor world through develop-
mentally appropriate activities. The Outdoor approach helps to increase each
child's awareness, enjoyment and respect for nature. Daily activities may
include adventure walks down the Green Bay Trail, swimming at Maple Beach
and arts and crafts. Each week culminates with a special event. e staff help
foster positive self concept by providing opportunities for achieving success and
develop a child's creativity and use of problem solving. Cornflakes has been an
integral part of the Community House for over 30 years. All counselors are
college age or older. All children will be grouped by age. Children must be
toilet trained by the first day of camp. Payment: 50% when registering and 50%
by the first day of camp.
New to the program: Each child will be introduced to the art of ceramics with
weekly classes!
For more information contact Patti Schmidt, Early Childhood Supervisor
at 847-446-7615.
Choose mornings (9:00 a.m.12:00 p.m.) or extended days
(9:00 a.m.2:00 p.m.) two, three or five days a week.
COR NF L A K E S
S U MME R CA MP
L E A R N , G R O W A N D P L A Y
WI N N E T K A C O M M U N I T Y H O U S E . O R G / C O R N F L A K E S
WI NNETKA COMMUNI TY HOUSE | 620 L I NCOL N AVE. , WI NNETKA, 60093 | 847- 446- 0537
Tuesdays and Thursdays June 12July 26
69000 Mornings Member: $549 Non-Member: $649
69001Extended day Member: $707 Non-Member: $838
MondayFriday June 11July 27
69004 Mornings Member: $960 Non-Member: $1142
69005 Extended day Member: $1427 Non-Member: $1702
Monday, Wednesday and Friday June 11July 27
69002 Mornings Member: $692 Non-Member: $822
69003 Extended day Member: $1007 Non-Member: $1198
This unique outdoor-oriented camp offers a combination of creative activities
and educational experiences for children ages 33 months through six years of
age. Children are encouraged to explore their outdoor world through develop-
mentally appropriate activities. The Outdoor approach helps to increase each
child's awareness, enjoyment and respect for nature. Daily activities may
include adventure walks down the Green Bay Trail, swimming at Maple Beach
and arts and crafts. Each week culminates with a special event. e staff help
foster positive self concept by providing opportunities for achieving success and
develop a child's creativity and use of problem solving. Cornflakes has been an
integral part of the Community House for over 30 years. All counselors are
college age or older. All children will be grouped by age. Children must be
toilet trained by the first day of camp. Payment: 50% when registering and 50%
by the first day of camp.
New to the program: Each child will be introduced to the art of ceramics with
weekly classes!
For more information contact Patti Schmidt, Early Childhood Supervisor
at 847-446-7615.
Choose mornings (9:00 a.m.12:00 p.m.) or extended days
(9:00 a.m.2:00 p.m.) two, three or five days a week.
A m a z i n g M i n d s
M i n i C a m p N e w !
Amazing Minds
This exciting mini-camp will give your chil-
dren the opportunity to see what exciting,
educational activities Amazing Minds has
to offer! The camp offers a variety of inter-
active topics that will expand your childs
knowledge of the world. For example your
child may become a junior geologist and
explore the world of rocks and minerals,
investigate owl pellets, or fnd out how to
make raisins bounce through interactive
games and scientifc experiments. Learn
about rare Australian animals, sharks,
whales and dolphins or other animals in
the animal kingdom. Excavate hidden trea-
sures from an ancient Egyptian tomb, or
sample the ethnic cuisine of China or Italy.
All materials are included.
June 11June 15 6610-2
MondayFriday 9:0010:30 a.m.
Grades: 13
Member: $135 Non-Member: $162
June 11June 15 6610-3
MondayFriday 1:00 2:30 p.m.
Grades: 13
Member: $135 Non-Member: $162
C h e s s W i z a r d s C a m p
Chess Wizards
Would you like to go on a journey to learn
cool openings, mid-games with all the pins,
double attacks, endgames and even bug-
house? Would you like to be a part of a
successful chess team, designed to cater to
all levels of chess players? If so, come join
Chess Wizards for this new camp! Camp-
ers will learn how to play chess in a fun
atmosphere, with both indoor and outdoor
activities. This camp is for beginning and
intermediate level players. No previous ex-
perience is needed! Children should bring
their own lunch and a drink, but snacks
will be provided. All campers will receive
a chessboard, a Chess Wizards T-shirt,
scorebook, trophy, work folder, and cer-
tifcate of achievement!
June 18June 22 7720-7
MondayFriday 9:00 a.m.12:00 p.m.
Grades: K8
Member: $220 Non-Member: $264
August 6August 10 7720-8
MondayFriday 9:00 a.m.12:00 p.m.
Grades: K8
Member: $220 Non-Member: $264
T h e J o y o f C r e a t i v i t y
A r t C a m p N e w !
Carole Pearlman
Join us for a summer of creative explora-
tion! We will utilize many materials in-
cluding watercolors, oil pastels, tempera
paint, collage and more. Each morning be-
gins with a free draw, the introduction
to the project through a story, and then
the independent creating. Campers will
enjoy a new project every day.
June 12July 26 6803-0
Tuesday Thursday 9:1511:15 a.m.
Ages: 47
Member: $406 Non-Member: $546
F a n t a s y D a n c e C a m p
Meghann Mueller
This very popular camp incorporates
imagination, movement, pantomime, mu-
sic, dance and enchanting costumes to
make for a wonderful summer experience.
Each week we will explore a theme, learn
basic ballet, improve our motor skills,
complete an arts and craft project, and
enjoy a yummy snack. Boys are welcome.
Please have your child toilet-trained as
the instructor will not change diapers.
Each child will receive a special surprise
during the last week of camp. This camp
meets one day a week for two hours. The
same theme is used each day for a week.
However, you may register for more than
one day a week.
June 12July 24 6412-1
Tuesday 9:3011:30 a.m.
Ages: 34
Member: $196 Non-Member: $238
June 13July 25 6412-2
Wednesday 9:3011:30 a.m.
Ages: 34
Member: $168 Non-Member: $204
June 14July 26 6412-3
Thursday 9:3011:30 a.m.
Ages: 34
Member: $196 Non-Member: $238
June 15July 27 6412-4
Friday 9:3011:30 a.m.
Ages: 34
Member: $196 Non-Member: $238
T i n y T o t D a n c e C a m p N e w !
Meghann Mueller
This very popular camp incorporates
imagination, movement, pantomime, mu-
sic, dance and enchanting costumes to
make for a wonderful summer experience.
Each week we will explore a theme, learn
basic ballet, improve our motor skills,
complete an arts and craft project, and
enjoy a yummy snack. Boys are welcome.
June 11July 23 6412-0
Monday 9:3011:30 a.m.
Ages: 45
Member: $196 Non-Member: $238
M u l t i m e d i a C l a y C a m p N e w !
Gabriella Verbovszky
Children learn to explore, imagine, and dis-
cover in their own unique ways to become
creators, innovators and problem-solvers
of the future. Multimedia Clay Camp pro-
vides to kids the chance to explore the ex-
citing world of art and creativity through
a wide range of multimedia activities.
Campers will focus on the creative pro-
cess and develop their imagination as they
explore the potters wheel and learn the
art of trimming. They will also master the
basic shapes such as bowls, cylinders and
plates and learn different ways to decorate
including burnishing, carving and stamp-
ing. Please bring a sack lunch.
June 25June 29 7777-1
MondayFriday 9:00 a.m. 3:00 p.m.
Ages: 612
Member: $199 Non-Member: $239
C a m p A m i g o s
Amigos Program
Every day will be a special day at Camp
Amigos. We will laugh, play, create, sing,
paint, cook and discover great wonders.
Best of all, we will do it all while learning
Spanish! Camp Amigos uses a highly con-
trolled vocabulary introduced in conjunc-
tion with fun theme days. All instructors
are experienced in early childhood and at
least one instructor is a native speaker.
June 4June 8 6305-0
MondayFriday 9:3011:30 a.m.
Grades: 35
Member: $120 Non-Member: $144
S u m m e r H o o p s C a m p
3Point Athletics
The camp will focus on drills that will
improve skill sets of individual players
in areas such as dribbling, passing, shoot-
ing, defense and teamwork. The ultimate
goal will be daily full-court scrimmages
that will showcase all of the drills honed
throughout the week. All campers will
receive a 3Point Athletics t-shirt. Please
send your child with a lunch.
July 16July 20 5900-2
MondayFriday 9:00 a.m.3:00 p.m.
Grades: 16
Member: $270 Non-Member: $324
H o t S h o t s S p o r t s
S u m m e r S p o r t s C a m p
Hot Shots Sports
Join us for our annual Summer Camp
where kids participate in a stimulating
and competitive environment. Focus will
be on helping the kids with teamwork and
fundamentals while playing a variety of
sports throughout the week. Prizes and
awards will be given out daily, and par-
ticipants will be rewarded for effort and
sportsmanship. Campers are encouraged
to bring a snack and water bottle. Camp
Highlights: 6:1 camper-to-counselor ratio,
camp t-shirt, team gameplay and competi-
tion, daily prizes and awards.
August 13August 17 5440-6
MondayFriday 9:00 a.m.12:00 p.m.
Ages: 47
Member: $155 Non-Member: $186
August 13August 17 5440-7
MondayFriday 1:004:00 p.m.
Ages: 47
Member: $155 Non-Member: $186
August 13August 17 5440-8
MondayFriday 9:00 a.m. 4:00 p.m.
Ages: 47
Member: $330 Non-Member: $396
3 P o i n t A t h l e t i c s
M u l t i - S p o r t C a m p
3Point Athletics
Join us this summer as we have fun playing
some of our favorite PE and playground
games. Our Multi-Sport Camp is designed
to include a variety of sports and games,
from basketball and soccer to whiffe-ball
and kick ball. We also challenge the camp-
ers to help create their own game through-
out the week so they can put their own
personal stamp on the fun-flled activities.
This program will keep your child active
in an enjoyable environment.
July 23July 27 5900-1
MondayFriday 9:00 a.m. 3:00 p.m.
Ages: 612
Member: $270 Non-Member: $324
C h i c a g o B u l l s B a s k e t b a l l S c h o o l s
Bulls/Sox Academy
The Chicago Bulls are coming to your neighborhood! This summer, learn from the best
and let the Chicago Bulls teach you how to play like a champion. For over 17 years,
the Chicago Bulls have brought quality basketball camps to boys and girls through-
out Chicagoland. More than 45,000 youth basketball players have developed essen-
tial basketball fundamentals including ball handling, passing, shooting, rebounding,
individual moves, footwork and team concepts. High school and college courts across
the country are home to graduates of a Chicago Bulls Basketball Summer Camp. We
work on every part of your childs game. On the fnal day all participants will receive
an evaluation form and graduation certifcate. Student to instructor ratio will be 10:1
or less. Every Chicago Bulls summer camp participant receives an exclusive Uniter
Center experience. Each camp participant, along with one guest, will be invited to the
United Center, home of the Chicago Bulls, for a question and answer session with a
Bulls personality and a current and or former Bulls player! During the camp each player
will compete in the Bulls Skills Competition. At the end of the summer, the top three
contestants will compete in the fnals on the foor of the United Center (date TBD).
Each camper will receive a Chicago Bulls duffel bag, Bulls indoor/outdoor basketball,
t-shirt, evaluation report and graduation certifcate. The rookie camp for children ages
68 is a beginner camp focused on building fundamentals and fun drills to get the kids
to understand the game and improve their play. For the older kids ages 912, coaches
work on the team concept and refning and advancing the skills for the serious or
soon-to-be serious player.
H o o p s 4 H e a l t h L i t t l e
B a l l e r s C a m p
Hoops4Health
Our basketball summer camp will help
the beginner and advanced basketball
player. Each week will cater to a differ-
ent fundamental basketball skill. These
skills include shooting, dribbling, passing,
rebounding, and defense. We will also
teach proper teamwork and sportsman-
ship, which is vital to becoming a strong
basketball player. We will also teach the
rules of the game. Our professional staff
has worked with kids of all ages and skill
levels. We take great pride in personal at-
tention and hands on teaching. There will
be many fun games and prizes throughout
the clinic. We will develop how to play
in 5-on-5 games while using proper spacing
and teamwork. At the end of the camp we
will have a 5-on-5 tournament with medals
and trophies. Our goal is that each player
comes out with a better understanding
of how to play the game and develop the
fundamental basketball skills necessary to
excel at the game.
June 18June 29 5312-1
Monday Wednesday Friday
11:30 a.m. 1:00 p.m.
Grades: K3
$180
H o o p s 4 H e a l t h S k i l l s
B a s k e t b a l l C a m p
Hoops4Health
This camp will focus on a different bas-
ketball skill each day. Players will be bro-
ken down by age and skill. We cater to all
players from basic to advanced. Each week
will feature many fun unique drills and
games. Hoops4Health professional staff
will be on hand each day working to build
the fundamental basketball skills neces-
sary to excel at the game. Final week will
conclude with a 3-on-3 tournament as well
as medals and trophies.
June 18June 28 5312-2
MondayThursday 1:303:00 p.m.
Grades: 412
$240
Rookie Camp
August 6August 10 5099-6
MondayFriday 8:3011:30 a.m.
Ages: 68
Member: $199 Non-Member: $199
Veteran Camp
August 6August 10 5099-7
MondayFriday 1:004:00 p.m.
Ages: 912
Member: $199 Non-Member: $199
Winnetka Community House is committed to conducting its recreation programs and activities in the safest manner possible, and holds the safety of the participants in the highest possible regard. Participants and
parents registering their child in recreation programs must recognize, however, that there is an inherent risk of injury when choosing to participate in recreation activities. Winnetka Community House continually
strives to reduce such risks, and insists that all participants follow safety rules and instructions which have been designed to protect the participants safety. Please recognize that Winnetka Community House does
not carry medical accident insurance for injuries sustained in its programs. The cost of such would make program fees prohibitive. Therefore, each person registering himself\herself or a family member for a
recreation program/activity should review his/her own health insurance policy for coverage. It must be noted that the absence of health insurance coverage does not make Winnetka Community House automatically
responsible for payment of medical expenses. Due to the difficulty and high cost of obtaining liability insurance, the agency providing liability coverage for Winnetka Community House requires the execution of
the following Waiver and Release. Your cooperation is greatly appreciated. Please read this form carefully, and be aware in participating in the program(s) listed on this page, you will be waiving and releasing all
claims for injuries you might sustain arising out of the activities of this program.
WAI VER AND RELEASE OF ALL CLAI MS
As a participant in the program, I recognize and acknowledge that there are certain risks of physical injury, and I agree to assume the full risk of any injuries, including death, damages or loss, regardless of severity,
which I may sustain as a result of participating in any and all activities connected with or associated with such program. I agree to waive and relinquish all claims I may have as a result of participating in the program
against Winnetka Community House and its officers, agents, servants and employees. I do hereby fully release and discharge Winnetka Community House and its officers, agents, servants and employees from any
and all claims from injuries, including death, damages or loss which I may have or which may accrue to me on account of my participation. I further agree to indemnify and hold harmless and defend Winnetka Commu-
nity House and its officers, agents, servants and employees from any and all claims from injuries, including death, damages or losses sustained by me or arising out of, connected with, or in any way associated with
the activities of the program. In the event of emergency, I authorize Winnetka Community House officials to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary
for my immediate care, and agree that I will be responsible for payment of any and all medical services required. All participants agree that any photography taken while participating in a class, special event or use
of a facility may be used for promotional purposes Winnetka Community House. Participants agree to receive emails from Winnetka Community House.
REFUND AND PRORATE I NFORMATI ON
Full refunds will be issued for courses that are cancelled by Winnetka Community House due to insufficient registration. A refund, less a 10% service charge (not to exceed $25), may be granted if the refund request
is received five full working days prior to the start of the program. No refunds will be allowed after this time unless a medical condition develops and a written explanation from a physician on his/her letterhead is
presented. Due to advanced reservation requirements, no refunds for trips, outings, or special events will be given. Classes may be prorated if you would like to enroll in a class after it has started, provided the
instructor has space, and allows for late registration. The supervisor must approve the prorated amount.
Please list any specific medical allergies, medications, chronic illness or other conditions which staff should be aware of:
Winnetka Community House operates in compliance with the Americans with Disabilities Act. If you believe you or your child need accommodations to facilitate participation
in Winnetka Community House program(s) for which you are registering, please check box.
CONTACT I NFORMATI ON
PARENT/GUARDI AN S LAST NAME: PARENT/GUARDI AN S FI RST NAME:
ADDRESS: CI TY: STATE: ZI PCODE:
PHONE: WORK PHONE:
EMAI L: I WOULD LIKE TO RECEIVE NEWS FROM THE WCH
EMERGENCY CONTACT NAME: EMERGENCY CONTACT PHONE:
REGI STRATI ON FORM
Register online at winnetkacommunityhouse.org, via fax at 847-446-0609 or mail this form with payment in full to: Registraiton - Winnetka
Community House, 620 Lincoln Ave., Winnetka, IL 60093. Contact us by phone at 847-446-0537 with any questions. Please print.
PARTI CI PANT I NFO CLASS I NFO
FULL NAME BI RTH DATE M/F SCHOOL CLASS CODE CLASS NAME FEE
I would like to register for a Community House Membership! Please list all family members on the reverse side of this form $150
$100
I would like to donate a Centennial gift of $100 to the Community House along with my registration.
TOTAL
SI GNATURE: DATE:
Regi s t r at i on f or m wi l l not be pr oc es s ed wi t hout wai ver s i gnat ur e.
CASH VI SA
CHECK MASTERCARD
CARD NUMBER EXP. DATE
TOTAL PAYMENT SI GNATURE
I have read and fully understand the aforementioned Program Details, Waiver and Release of All Claims and Permission to Secure Treatment.







For more information CaII : Cathy
Hirschmann (847) 446-7068 or Toby
NichoIson (847) 441-6359

LOLtOtGD`S LOLtOtGD`S LOLtOtGD`S LOLtOtGD`S OG&1tG OG&1tG OG&1tG OG&1tG O1 MLDDG1V& O1 MLDDG1V& O1 MLDDG1V& O1 MLDDG1V& M MM MLtt LG LDG O1 1OG Ltt LG LDG O1 1OG Ltt LG LDG O1 1OG Ltt LG LDG O1 1OG
VGtU VGtU VGtU VGtU kLtS1 kLtS1 kLtS1 kLtS1 1O VO1 OD OLS LtG&1 LOOU 1O VO1 OD OLS LtG&1 LOOU 1O VO1 OD OLS LtG&1 LOOU 1O VO1 OD OLS LtG&1 LOOU
LG V&t1 O1 L1 LG V&t1 O1 L1 LG V&t1 O1 L1 LG V&t1 O1 L1 - -- - FkLLLLW FkLLLLW FkLLLLW FkLLLLW
Wanted: Actors, Singers and Dancers
grades 4 through 8 are invited to audition at
the Winnetka Community House Monday
August 27
th
or Tuesday August 28
th
.

4
th
& 5
th
Grades at 4 PM
6
th
, 7
th
& 8
th
Grades at 5 PM
Audition MateriaIs on Iine at
chiIdrenstheatrewinnetka.com Aug. 1
Performances November 15
th
- 18
th
, 2012

PIease note, ChiIdren's Theater of Winnetka
charges a Production Fee of $350. SchoIarships
are avaiIabIe.

Children's Theatre of Winnetka is a non-profit volunteer
theatre company known for high quality children's
productions. Established in 1974, CTW uses a cast & crew
of children from New Trier Township, grades 4 thru 8
ArieI, a fun-Ioving and mischievous mermaid, is off on the adventure of a Iifetime with
her best friend, the adorabIe FIounder, and the reggae-singing Caribbean crab Sebastian
at her side. But it wiII take aII of her courage and determination to make her dreams
come true -- and save her father's beIoved kingdom from the sneaky sea witch UrsuIa!
Winnetka Community House is committed to conducting its recreation programs and activities in the safest manner possible, and holds the safety of the participants in the highest possible regard. Participants and
parents registering their child in recreation programs must recognize, however, that there is an inherent risk of injury when choosing to participate in recreation activities. Winnetka Community House continually
strives to reduce such risks, and insists that all participants follow safety rules and instructions which have been designed to protect the participants safety. Please recognize that Winnetka Community House does
not carry medical accident insurance for injuries sustained in its programs. The cost of such would make program fees prohibitive. Therefore, each person registering himself\herself or a family member for a
recreation program/activity should review his/her own health insurance policy for coverage. It must be noted that the absence of health insurance coverage does not make Winnetka Community House automatically
responsible for payment of medical expenses. Due to the difficulty and high cost of obtaining liability insurance, the agency providing liability coverage for Winnetka Community House requires the execution of
the following Waiver and Release. Your cooperation is greatly appreciated. Please read this form carefully, and be aware in participating in the program(s) listed on this page, you will be waiving and releasing all
claims for injuries you might sustain arising out of the activities of this program.
WAI VER AND RELEASE OF ALL CLAI MS
As a participant in the program, I recognize and acknowledge that there are certain risks of physical injury, and I agree to assume the full risk of any injuries, including death, damages or loss, regardless of severity,
which I may sustain as a result of participating in any and all activities connected with or associated with such program. I agree to waive and relinquish all claims I may have as a result of participating in the program
against Winnetka Community House and its officers, agents, servants and employees. I do hereby fully release and discharge Winnetka Community House and its officers, agents, servants and employees from any
and all claims from injuries, including death, damages or loss which I may have or which may accrue to me on account of my participation. I further agree to indemnify and hold harmless and defend Winnetka Commu-
nity House and its officers, agents, servants and employees from any and all claims from injuries, including death, damages or losses sustained by me or arising out of, connected with, or in any way associated with
the activities of the program. In the event of emergency, I authorize Winnetka Community House officials to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary
for my immediate care, and agree that I will be responsible for payment of any and all medical services required. All participants agree that any photography taken while participating in a class, special event or use
of a facility may be used for promotional purposes Winnetka Community House. Participants agree to receive emails from Winnetka Community House.
REFUND AND PRORATE I NFORMATI ON
Full refunds will be issued for courses that are cancelled by Winnetka Community House due to insufficient registration. A refund, less a 10% service charge (not to exceed $25), may be granted if the refund request
is received five full working days prior to the start of the program. No refunds will be allowed after this time unless a medical condition develops and a written explanation from a physician on his/her letterhead is
presented. Due to advanced reservation requirements, no refunds for trips, outings, or special events will be given. Classes may be prorated if you would like to enroll in a class after it has started, provided the
instructor has space, and allows for late registration. The supervisor must approve the prorated amount.
Please list any specific medical allergies, medications, chronic illness or other conditions which staff should be aware of:
Winnetka Community House operates in compliance with the Americans with Disabilities Act. If you believe you or your child need accommodations to facilitate participation
in Winnetka Community House program(s) for which you are registering, please check box.
CONTACT I NFORMATI ON
PARENT/GUARDI AN S LAST NAME: PARENT/GUARDI AN S FI RST NAME:
ADDRESS: CI TY: STATE: ZI PCODE:
PHONE: WORK PHONE:
EMAI L: I WOULD LIKE TO RECEIVE NEWS FROM THE WCH
EMERGENCY CONTACT NAME: EMERGENCY CONTACT PHONE:
REGI STRATI ON FORM
Register online at winnetkacommunityhouse.org, via fax at 847-446-0609 or mail this form with payment in full to: Registraiton - Winnetka
Community House, 620 Lincoln Ave., Winnetka, IL 60093. Contact us by phone at 847-446-0537 with any questions. Please print.
PARTI CI PANT I NFO CLASS I NFO
FULL NAME BI RTH DATE M/F SCHOOL CLASS CODE CLASS NAME FEE
I would like to register for a Community House Membership! Please list all family members on the reverse side of this form $150
$100
I would like to donate a Centennial gift of $100 to the Community House along with my registration.
TOTAL
SI GNATURE: DATE:
Regi s t r at i on f or m wi l l not be pr oc es s ed wi t hout wai ver s i gnat ur e.
CASH VI SA
CHECK MASTERCARD
CARD NUMBER EXP. DATE
TOTAL PAYMENT SI GNATURE
I have read and fully understand the aforementioned Program Details, Waiver and Release of All Claims and Permission to Secure Treatment.

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