NEDSRA | Registration Forms

REGISTRATION FORMS

Registration Forms

Registration Guidelines
When you first participate with NEDSRA, an Annual Information Form and Registration Form must be on file. For your convience these form are located online. Please print and fully complete the Annual Information Form and Registration Form and mail to NEDSRA at 1770 W. Centennial Place, Addison, IL 60101-1076. You can also fax the form to the NEDSRA Office at (630) 620-4598, attention Registrar.

Please note that registration deadlines exist for all programs and are specifically stated by each program description. Full payment is due at the time of registration unless you are on a scholarship or pre-arrange payment plan. Scholarship details are found in each seasonal brochure.

If you are a nonresident of NEDSRA, please refer to the Nonresident Registration and Fees section in our current seasonal brochure.

Registration Form PDF

Annual Information Form PDF

Medication Release Form PDF

Special Olympics Forms

E-69 Class A Volunteer Registration Form - Minor.pdf

E-67 Class A Volunteer Registration Form - Adult.pdf

E-14 English Medical Application.pdf

E-16 Spanish Medical Application.pdf

Medication Dispensing Policy
The staff of Northeast DuPage Special Recreation Association (NEDSRA) will dispense medication at programs only when necessary for the health and welfare of the participants. When possible, we will request that the medication be given by the parent or guardian prior to or after program participation.

The procedures for dispensing
medication(s) are as follows:

Parent /Guardian Responsibilities:

1. Complete and authorize Medication Release Form. A completed and signed form must be on file at the NEDSRA office prior to program participation.
2. All medication is given to the NEDSRA office prior to the program date or given to the program leader in the original prescription container clearly labeled with the participant’s name, name of medication, dosage, dispensing and storage information, and possible side effects.
3. Notify NEDSRA immediately of any medication changes and complete a new Medication Release Form.

Staff Responsibilities:

1. Confirm that a Medication Release Form has been completed by the parent or guardian specifically citing the medication(s) to be dispensed.
2. Medication should be dispensed by the program leader only.
3. Medication must be dispensed to participants/campers one at a time. Do not open other participants’ medication until you have completed dispensing to the previous participant.
4. Administer the medication. Remain with the participant to ensure all medication is completely taken and swallowed.
5. After administering a participant’s medication, sign your name and record the time the medication was dispensed on the Medication Distribution Log.
6. At conclusion of program, return the completed medication log and medication release forms to the registrar for permanent filing with the registration form.

Any questions regarding this policy can be directed to Lisa Deets, Superintendent of Recreation, (630) 620-4500, ext. 140.

NEDSRA High-Risk Program Waiver Form PDF file