Name: Age: Program Attended: Address: Apt. City: Zip Code: Home Phone# - ( ) - Cell Phone# - ( ) - address:
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1 2018 RECREATION REGISTRATION FORM REGISTRATION I Want an easy way to register for the recreation programs you re interested in? Just complete the form below, along with the consumer information data forms, and return them to: Northview/Rec. Dept., 8114 North Main Street, Dayton, OH You will receive a confirmation letter for the event/activities you get to participate in. Please remember, all events are filled on a first-come, first-served basis. You will be notified if you are closed out of any events/activities. Name: Age: Program Attended: Address: Apt. City: Zip Code: Home Phone# - ( ) - Cell Phone# - ( ) - address: Please place a checkmark next to the events/activities that you/your consumer wish to attend. A check next to any of the ongoing events will indicate to us that you wish to be registered for the entire duration of that activity. Registration starts, in person, at Northview on January 6, 2018, for families and January 27, 2018 for residential agencies. Abbreviations on check-off list: NV=Northview, L=Liberty, SV=Southview, WCA=We Care Arts, FHS=Family Support Service Program DATE EVENT/ACTIVITY ONGOING EVENT Various Dates King s Island - Season Pass (separate sheet will be mailed out with the dates) ORGANIZATION SPONSORED EVENTS Friday - February 16, 2018 Thursday - May 10, 2018 Saturday - May 12, 2018 Saturday - June 2, 2018 Sunday June 24, 2018 (tentative) SPECIAL OLYMPICS Practice: Saturdays: Jan. 13, 20, Tournament: Saturday, Feb. 17, 2018 Practice: Saturdays: Mar. 3 Apr. 21, 2018 (No Practice 3/31) Tournament: Saturday, Apr. 28, 2018 Practice: Thursdays: Apr May 3, 2018 Tournament: Saturday, May 5, 2018 U.C.T. Valentine s Dance - (NV) Women's Guild Dance (Northridge High School) VSA Elvis Concert at WSU # of tickets North Dayton Anglers Fishing Derby (North Dayton Anglers Club) Shiloh Sportsman s Club Fishing Derby (Shiloh Sportsman s Club) *We feel these are important and will make every attempt to find a way for each individual to participate. Special Olympics Bowling - Practice at (Pla-Mor) (Tournament held at Beaver Vu) Special Olympics Track & Field Practice at (NV) (Tournament held at Centerville High School) Special Olympics Bocce Ball - (NV) (Tournament held at Bella Villa Hall)
2 SOCIAL ACTIVITIES Mondays Feb. 5 May 21, 2018 Thursdays Feb. 1 - May 24, st Friday of each month - Feb. 2 - July 6, nd Friday of each month Feb. 9 July 13, 2018 Sunday, February 4, 2018 Sunday, March 18, 2018 Sunday, April 22, 2018 Sunday, May 20, 2018 Sunday, June 17, 2018 Sunday, July 8, 2018 Sunday, August 5, 2018 Saturday, January 20, 2018 Saturday, February 17, 2018 Saturday, March 24, 2018 Saturday, April 21, 2018 Saturday, May 19, 2018 Saturday, June 16, 2018 Saturday, July 21, 2018 Saturday, August 18, 2018 Saturday, February 24, 2018 Saturday, March 31, 2018 Saturday, April 28, 2018 Saturday, May 12, 2018 Saturday, June 30, 2018 Saturday, July 14, 2018 Saturday, August 25, 2018 Monday, January 8, 2018 Monday, February 12, 2018 Monday, March 12, 2018 Monday, April 9, 2018 Monday, May 14, 2018 Monday, June 11, 2018 Monday, July 9, 2018 Monday, August 13, 2018 CLASSES Wednesdays Feb. 21 March 28, 2018 Mondays - Feb. 26 May 14, 2018 Mondays - March 5 April 2, 2018 Saturdays - March 10 April 14, 2018 You can check off up to (12) activities. You cannot do both Monday & Thursday night Recreation, or both Movie Madness North & South. If you have checked off (12) activities and would You do not have to re-register for activities you signed up for on the previous registration. Monday Night Recreation (L) Thursday Night Recreation (NV) Movie Madness North (Danbarry Huber Heights) Movie Madness South (Danbarry Dayton Mall) Social Night Very Merry Un-Birthday (L) Social Night Breakfast on the Farm (NV) Social Night March Madness (L) Social Night Earth Day (L) Social Night Rock n & Roll n (NV) Social Night Summer Fun (L) Social Night Independence Day (L) Social Night Friendship (NV) Breakfast Club The Brunch Club (Dayton) Breakfast Club Broken Egg Café (Miamisburg) Breakfast Club Panera (Miller Lane) Breakfast Club First Watch (Kettering) Breakfast Club Perkins (Englewood) Breakfast Club Tank s Bar & Grill (Dayton) Breakfast Club IHOP (Beavercreek) Dinner Night Christy s Family Pizzeria (Vandalia) Dinner Night Archer s Tavern (Kettering) Dinner Night Ruby Tuesday (Miller Lane) Dinner Night Rusty Bucket (Centerville) Dinner Night MOD Pizza (Englewood) Dinner Night Bagger Dave s (Centerville) Dinner Night Basil s On Market (Dayton) Dinner Night BD s Mongolian Grill (The Greene) You can check off up to (10) activities. If you have checked off (10) activities and would Healthy Living Class (NV) Fitness Class (Vandalia Rec. Center) Tap Dance Class (NV) Hip Hop Dance Class (Quest)
3 Wednesdays - April 4 April 25, 2018 Jewelry Making 101 (NV) Saturdays - May 19 June 16, 2018 Party Dance Class (NV) Saturdays - March 3, April 7, May 5, 2018 Cooking Class Session I/A (NV) Saturdays Mar. 17, Apr. 21, May 19, 2018 Cooking Class Session I/B (NV) Saturdays - June 2, July 7, August 4, 2018 Cooking Class Session II/A (NV) Saturdays - June 16, July 28, Aug. 11, 2018 Cooking Class Session II/B (NV) Saturday, March 3, 2018 Craft Class Wooden Bunny & Chick (NV) Saturday, April 7, 2018 Craft Class Cake Holder/Fondant Cake Dec. (NV) Saturday, May 5, 2018 Craft Class Roped Basket (NV) Saturday, June 2, 2018 Craft Class Mosaic (NV) Saturday, July 7, 2018 Craft Class Fourth of July T-Shirt (NV) Saturday, August 4, 2018 Craft Class String Art (NV) Thursday, February 15, 2018 Art Class Chalk Pastels Snowman on Velvet (WCA) Thursday, March 15, 2018 Art Class Painting with Watercolors (WCA) Thursday, April 19, 2018 Art Class Clay I: Flower Bowl (WCA) Thursday, May 17, 2018 Art Class Clay II: Flower Bowl (WCA) Thursday, June 21, 2018 Art Class Kite Fish (WCA) Thursday, August 16, 2018 Art Class Painting Wooden Fish (WCA) You can check off up to (3) interest groups. If you have checked off (3) interest groups and would like to be put on the waiting list for other activities, Make sure that you meet the qualifications for the INTEREST GROUPS group. Various Concert Club (varies) Tuesdays - January 23 February 27, 2018 Transition Group (NV) *Ages 18-25, only. Thursdays - March 1 April 5, 2018 Music Club Session I (SV) Thursdays - June 14 July 19, 2018 Music Club Session II (SV) Wednesdays - Mar. 28, Apr. 25, May 23, June 27, 2018 Rockstar Wrestling Club - (Dayton) Wednesdays - May 2, June 6, July 11, Aug. 1, 2018 Gamers Club - (NV) Wednesdays - May 9 June 20, 2018 Nature Club (varies) Saturdays - May 19, June 16, July 21, Aug. 18, 2018 Sports Interest Group (varies) Monday, July 16 Thursday, July 19, 2018 Scrapbooking Group (NV) Saturday - May 19, 2018 Festival Hoppers A World Affair (Dayton) Saturday June 2, 2018 Festival Hoppers Yellow Springs Street Fair (SV) Saturday July 21, 2018 Festival Hoppers Swamp Romp (SV) Saturday August 18, 2018 Festival Hoppers Sweet Corn Festival (SV) FIELD TRIPS April 2018 (exact date TBD) August/September 2018 (exact date TBD) Friday January 12, 2018 Sunday January 21, 2018 You can check off up to (22) of these trips. If you have checked off (22) activities and would Ohio State Spring Football Game - (NV) Columbus Crew Soccer Game - (NV) Cincinnati Bengals Football Game - (SV) Cleveland Browns Football Game - (NV) WWE Live Wrestling - (SV) Cleveland Cav./Indiana Pacers Basketball Game - (SV) LaComedia: Smoke on the Mountain - (SV)
4 Friday January 26, 2018 LaComedia: SP: Smoke on the Mountain - (SV) Tuesday February 6, 2018 Painting with a Twist - (meet there) Wednesday February 7, 2018 University of Dayton Basketball Game - (SV) Sunday February 18, 2018 Schuster: The Sound of Music - (Schuster Center) Tuesday February 20, 2018 Cozy Melts & Dinner - (meet there) Saturday March 3, 2018 Step Afrika! - (Victoria Theatre) Sunday March 11, 2018 Ele Cake Co. Cake Decorating Class - (SV) Sunday March 18, 2018 LaComedia: SP: The Color Purple - (SV) Saturday March 24, 2018 Columbus Blue Jacket Hockey Game - (NV) Sunday March 25, 2018 LaComedia: The Color Purple - (SV) Friday April 6, 2018 Laser Web - (SV) Saturday April 7, 2018 Journey to Oz - (Victoria Theatre) Thursday April 12, 2018 Schuster: Phantom of the Opera - (Schuster Center) Friday May 18, 2018 LaComedia: SP: Little Shop of Horrors - (SV) Sunday May 20, 2018 LaComedia: Little Shop of Horrors - (SV) Wednesday May 23, 2018 Cedar Point - (NV) Saturday May 26, 2018 Roaring Twenties Dinner & Prom - (St. Peter s) Saturday May 26, 2018 Roaring Twenties Prom - (St. Peter s) Friday June 1, 2018 Monday June 4, 2018 Newport Aquarium - (SV) Wednesday June 6, 2018 Columbus Clippers Baseball Game - (NV) Friday June 8, 2018 Caesar s Creek Fishing - (SV) Monday June 11, 2018 Cincinnati Zoo - (SV) Wednesday June 13, 2018 Cincinnati Museum Center - (SV) Monday June 18, 2018 Young s Dairy & John Bryan State Park - (SV) Wednesday June 20, 2018 King s Island Play Day - (SV) Friday June 22, 2018 Carillon Park & Bowling - (SV) Saturday June 23, 2018 Monday June 25, 2018 Hollywood Gaming at Dayton Raceway - (SV) Wednesday June 27, 2018 COSI - (NV) Friday June 29, 2018 Dave & Buster s - (SV) Saturday June 30, 2018 B&B Riverboat Sightseeing Cruise - (SV) Monday July 2, 2018 Columbus Zoo - (NV) Friday July 6, 2018 Neil Armstrong Museum & Movie - (NV) Monday July 9, 2018 Air Force Museum - (NV or Museum) Wednesday July 11, 2018 Graeter s Ice Cream Tour - (SV) Thursday July 12, 2018 Montgomery County Fair - (SV) Friday July 13, 2018 Putt-Putt Golf & Lunch - (NV) Friday July 13, 2018 LaComedia: SP: Annie - (SV) Monday July 16, 2018 Tuesday July 17, 2018 A Day of Beauty *Women Only - (NV) Tuesday July 17, 2018 Carriage Hill Farm & Fishing *Men Only - (SV) Wednesday July 18, 2018 B&B Riverboat Lunch Cruise - (SV) Friday July 20, 2018 Exploring Cincinnati - (SV) Sunday July 22, 2018 LaComedia: Annie - (SV) Monday July 23, 2018 Boonshoft Museum & Aullwood Farm - (SV) Wednesday July 25, 2018 Soak City Water Park - (SV) Thursday July 26, 2018 Dayton Escape & Dinner - (SV) Friday July 27, 2018 Saturday July 28, 2018 Ohio State Fair - (NV) Sunday July 29, 2018 Turtlecreek Valley Railway - (SV) Monday July 30, 2018 Coney Island - (SV) Wednesday August 1, 2018 Ohio State Fair - (NV)
5 Thursday August 2, 2018 Scene 75 - (NV) Friday August 3, 2018 B&B Riverboat Sightseeing Cruise - (SV) Monday August 6, 2018 Progressive Dinner - (SV) Tuesday August 7, 2018 LaComedia: Mike Albert as Elvis - (SV) Picnic & Games at Thomas Cloud Park - (NV or Thomas Wednesday August 8, 2018 Cloud Park) Friday August 10, 2018 Newport Aquarium - (SV) Sunday August 12, 2018 Wednesday August 15, 2018 King s Island Play Day - (SV) Friday August 17, 2018 Sunday August 19, 2018 B&B Riverboat Dixieland Brunch - (SV) Sunday August 26, 2018 LaComedia: Driving Miss Daisy - (SV) Friday August 31, 2018 LaComedia: SP: Driving Miss Daisy - (SV) OVERNIGHT TRIPS Thursday, March 1 Friday, March 2, 2018 Tuesday, May 29 Wed., May 30, 2018 Thursday, June 14 Friday, June 15, 2018 Tuesday, July 31 Wed., August 1, 2018 You can check off up to (1) overnight trip. If you have checked off (1) overnight trip and would like to be put on the waiting list for other overnights, Cleveland Ohio Overnight - (NV) Kentucky Overnight - (SV) The Wild s Overnight - (SV) Cincinnati Overnight - (SV) Submit via Mail: Northview/Rec. Dept., 8114 North Main Street, Dayton, Ohio Submit via Fax: (937) Submit via kduffin@mcbdds.org
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