Reaching Out a Healthy Hand

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					 Winter 2012

   Reach for                      Reaching Out a Healthy Hand
Resources Board
  of Directors          Access to quality healthcare education can be limited
                        for people with disabilities, either due to inaccessible
   Patrick Boley
                        programming, financial constraints, or a lack of
  Larson King, LLP
                        available wellness opportunities that address specific
                        challenges faced by people experiencing disabilities.
   Kari Schamber        Limited access to health-promoting activities among
      US Bank           adults with disabilities is correlated with a higher
   Vice President       prevalence of chronic conditions, such as obesity,
                        diabetes, and cardiovascular disease, within this
     Erin Kober         population. In response to this issue, Reach for
  Paradysz Matera       Resources developed a Health and Wellness Club for
     Secretary          adults with disabilities that kicked off its first group
                        session this fall. Starting in September, ten participants  Participants record fitness and
  Andy Weinstein        met weekly to practice healthy cooking skills, learn new   health measurements and goals.
  Minnesota Twins       forms of exercise, take baseline fitness and wellness
     Treasurer          measurements, practice stress management techniques, and set goals.
Christala J.B Culhane
     Choice Inc.        This club is being led by REACH employees Becca Stenzel and Tu Phan, who have
                        backgrounds in therapeutic adaptive recreation and nutrition, respectively.
   Sharla Duerre        Collaboratively they have developed a targeted educational and practical health
 The Lacek Group        experience that is specifically designed to address the health concerns of adults with
                        cognitive disabilities. During the first quarter of this           Health Club continued on page 2
     Ben Hirsch
 Insurance Services     Come help us celebrate our achievements this year and enjoy exciting works of art produced by
                        our clients! This is also an opportunity for you to give us feedback about the programs & services we
   Gary Johnson         offer, as well as submit nominations for new board members.
    Wells Fargo
                                                                                                NEW BOARD MEMBERS
                                     Wednesday, December 7, 2011                                     WANTED
    Melissa Rahn
                          Minnetonka Community Center, 14600 Minnetonka Blvd.                    If you are interested in
 Fredrikson & Byron
                                             6:00—8:30 pm                                        offering your skills and
   Maxine Skold                    $5 Donation at the door suggested                             talents to our dynamic
Zachary Lane School                                                                             Board, please call Mary
                                   Refreshments, awards, music, art & more!                    Perkins at 952-988-4177 to
    Jill Menke                                                                                         learn more.
 Canadian Pacific                           EVERYONE WELCOME!
                                                                            Bowl-A-Thon Information…page 2
                                                 More Inside                Winter Programs...pages 3 - 9
                                                                            Ghostly Gala Recap… page 11
                                                                          Saturday, March 24
                                                                           Park Tavern Lanes
                                                                         3401 Louisiana Ave S.
                                                                             St. Louis Park

                                         Register on Page 10

                           Everyone is Welcome!
      Clients, families, and friends of Reach are invited to join us for
                 a morning of bowling fun and fundraising!

      You may form your own bowling team of 4-5 people, or sign
       up to bowl individually and we will assign you to a team.

                                                                 Bowlers gather pledges or make a
                                                                 donation for this fundraising event.

                                                               Minimum pledge/donation: $40
                                                     For your donation you will receive 2 bowling games,
                                                                      lunch and a t-shirt.
                                                    Fabulous prizes are awarded for top pledge gatherers.

                                                     Not a bowler? With a tax-deductible donation of $15,
                                                      spectators can watch the fun and join us for lunch.

Health Club cont. from page 1

club, participants discussed nutritional concerns, fitness needs, healthy cooking methods, illness
prevention methods, and stress triggers. All club members had the opportunity each week to
practice health skills in a supportive environment, including measuring portion sizes, practicing
yoga moves, measuring heart rate, making natural personal care products, and documenting
fitness measurements.

A goal of this program is to provide participants with skills and knowledge that they can
reasonably incorporate into their current lifestyle. Developed with unique circumstances in
mind, this program addresses health concerns and challenges faced by many adults with
disabilities, and offers productive health solutions that can combat these challenges.
Additionally, this new program emphasizes goal setting and creation of a follow-up plan so that
participants continue to practice their health-improvement skills after the group concludes.

The Health and Wellness Club program will be offered again this coming Spring. For more
information about this club or to find out how to join, please contact Becca at 952-988-4176.         Participants measure out
                                                                                                     ingredients to make stress
 2                                                                                                              balls.
                                                                                                              Winter 2012

     1001 Highway 7, #235
     Hopkins, MN 55305                         EDUCATION, THERAPY, LEISURE ACTIVITIES
     (952) 988-4177 Phone                 REACH is an agency that serves individuals with developmental disabilities and their families in            the West and Northwest metro area. Services include counseling, therapy groups, community
                                          living training and support, therapeutic recreation and leisure, information & referral.

             COUNSELING                                               ARMHS
                                                         For Adults with Mental Health Disorders and
                                                                                                                  REACH OUT
  Reach for Resources specializes in working                     Mild Cognitive Impairments                         Independent Living
with people with developmental disabilities
                                                                                                                        Support for
such as mental retardation, Down Syndrome,            REACH for Resources offers Adult
autism, and mild to borderline cognitive                                                                           Adults with Disabilities
                                                      Rehabilitative Mental Health Services (ARMHS)
  difficulties, and their families. We believe in a   that can help you successfully live on your own
friendly, supportive, person-centered                 in the setting of your choice. An ARMHS case            Reach Out is an in-home support
  approach, and in setting personalized goals         worker can teach you skills to:                         service for adults with disabilities who
for each client.                                          Cope with stress, fear and anxiety                  want to live independently, but have
 Reach accepts: Medical Assistance, Blue                  Find safe, affordable housing                       been denied access to other public
Cross Blue Shield of MN, MHP, Medica/UBH,                                                                     assistance programs.
                                                          Find a job and learn job skills
Ucare, Health Partners & sliding scale private
                                                          Manage your money                                  Clients are assigned a case manager
                                                          Develop a healthy lifestyle                        who can provide on-going support
     To schedule an intake interview or for
                                                          Learn to use community resources                   with:
    information on counseling options call
               Lisa Rivers, MA, LP at
             (952) 988-4177 or email                  To be eligible for REACH ARMHS you must:                   Daily Living Skills                    Have a Mental Health Diagnosis                         Managing Finances
                                                          Have a Mild Cognitive Disability (ie. Borderline       Physical and Mental Health Issues
                                                          IQ, Autism Spectrum Disorder, Fetal Alcohol            Socialization
                                                          Syndrome, Learning Disability, or Traumatic
                                                          Brain Injury)
                                                                                                                 Government Benefits Application
                                                          Be 18 years or older
                                                                                                                 Regular phone Check Ins
                                                          Qualify for Medical Assistance                         Crisis Situations

   Empowerment Group                                                                                             Reach Out is tailored to your
                                                             Support Group                                    individual needs. Some fees may
Men and Women in this group learn to                                                                          apply and will vary depending on
support each other, solve their own                             Women’s Group                                  income, personal situation, and
problems, advocate for themselves, and                                                                          eligibility for other government
                                                      This group provides an opportunity
form a strong social network. Participants
                                                      for Women (age 18 and above)                                   assistance programs.
must arrange their own transportation and
be able to wait independently for their               with borderline to mild cognitive
ride.                                                 disabilities to talk with other women                   Call Mary Perkins at 952-98-4177 for a Free
                                                      about their concerns and                                         Preliminary Assessment
WHERE: Eisenhower Center                              experiences regarding relationships,
       1001 Highway 7, Hopkins                        sexuality, grief and loss, or other
                                                      topics of interest.
WHEN: Tuesday, 6:30—8:00 pm
      Begins January 10th                                                                                    Did You Know? Reach is also a SILS
                                                      If you would like to be a part of the
                                                      group, an intake is required. Call Lisa at             and Waiver provider. If you are
COST: $10                                             952-988-4177 for more information.                     looking for a worker who can meet
                                                                                                             your needs, give us a call!
An intake is required for new participants.
Call Matt at 952-988-4177 to register or to
schedule an intake.                                                                                                                                      3
                        Adaptive Recreation Program
The Adaptive Recreation program is a cooperative effort between REACH for Resources and the Northwest Consortium and West
Consortium of cities. Participants of the cities below are considered ―Residents‖ and given priority in registering according to the
registration deadlines at the bottom of this page.

The Northwest Consortium: Brooklyn Park, Brooklyn Center, Golden Valley, Maple Grove, and Plymouth.
The West Consortium: Chanhassen, Chaska, Hopkins, Minnetonka, and St. Louis Park.

    Persons not living in one of the above communities and who have not purchased a                 Inclusion Services
    membership are considered “Non-Residents”. Persons with non-resident status will not
    be allowed to register until after the Priority Registration deadline. Non-residents also   Reach for Resources provides inclusion
    need to add $8 to the registration fee.                                                     facilitators for individuals with disabilities who
                                                                                                would like to participate in their city park
    Adult participants may only register for ONE social program. If you are unsure which        and recreation programs. Registration for
    program is the best fit for you, call Becca at 952-988-4176                                 these programs is done through your park
                                                                                                and recreation department. After
    Please do not sign up unless you will be able to attend! Participants who consistently      registering, contact Reach for Resources to
    do not attend programs they have registered for may lose their resident status for the      discuss the needs/accommodation for your-
    next quarter.                                                                               self or your child. We require a minimum of
                                                                                                two weeks notice for a successful inclusion.
    If you are concerned about your program filling up quickly, please feel free to stop by
    the Reach for Resources office to complete a registration form in person. The               Available in: Brooklyn Park, Brooklyn Center,
    registration form is also available on our website: on the        Chanhassen, Chaska, Crystal, Golden
    Therapeutic Recreation page.                                                                Valley, Hopkins, Minnetonka, New Hope,
                                                                                                Robbinsdale and St. Louis Park.
    You will receive a letter confirming your registration along with schedules for all
    programs you have been registered for at least one week prior to the start of the
    program.                                                                                     Call Becca at (952) 988-4176 for more

                  MEMBERSHIPS                                         NON-RESIDENT MEMBERSHIP FORM
A Non-Resident Membership option is available for             For residents of cities OTHER THAN: Brooklyn Park, Brooklyn Center,
$200 annually for those non-resident participants             Chanhassen, Chaska, Golden Valley, Hopkins, Maple Grove,
who wish to receive priority registration,                    Minnetonka, Plymouth or St. Louis Park. You may purchase an annual
guaranteed slots in programs* and reduced                     REACH membership that will give you the same benefits as residents of
                                                              those cities including priority in registration and reduced program fees.
program fees.
                                                              PLEASE NOTE: Members must still pay the resident program fees in
                                                              addition to their membership fee.

Scholarships: Reach has limited scholarship funds             To purchase an annual membership, please complete this form and
available to help cover the cost of this membership           mail with your payment to REACH.
fee. If you would like more information regarding
scholarships or to apply, contact Becca at                    Name:

                                                              City                               Zip

                                                              Payment Options:
Guaranteed Registration 11/28/11—12/1/11: Residents
of consortium cities and Members are guaranteed a
                                                                         Annual (1 payment of $200)
spot in programs if registration and payment is received
by 12/1/11.
                                                                      Bi-Annual, 2 payments of $100.
                                                              (REACH will bill you for the 2nd payment)
Priority Registration 12/2/11—1/1/12 Residents of consor-
tium cities and Members are given priority for open
                                                              $          Amount enclosed today
program slots on a first-come, first-served basis.
                                                              Please contact Reach at 952-988-4177 if you would like to discuss other
Open Registration 1/2/12–on: Registration is open to
                                                              payment options.
Non-Residents as well as Residents and Members who
will be placed in any remaining open program slots on a
                                                              **Members/residents are guaranteed a spot in a program ONLY if they
first-come, first-served basis.
                                                              register and pay by the Guaranteed Registration Deadline**
       Community Connections: A Social Play Group for                                                         Bowling
                  Parents and Children                                                                          (ages 5-21)
                                                                                               Join us for fun, non-competitive bowling.
This program provides kids with disabilities an opportunity to have fun, make new                 You will bowl 2 games each week.
friends, and try new activities. Parents attend the program with their kids and have
the opportunity to network with other families. Each week
will have a different activity such as games, crafts, sports,                                                     North
theme days and more. This group is designed for both                                           WHERE:      Doyle’s
parent & child participation.
                                                                                                           5000 W Broadway
WHEN:         Saturday afternoons                                                              WHEN:       Saturdays, Jan. 21—Mar. 10
              January 28– March 3                                                              TIME:       12:00—2:00 pm
WHERE:        Elim Lutheran Church                                                             FEE:        $35.00 Resident
              3978 W. Broadway in Robbinsdale                                                              $43.00 Non-resident
                                                                                                           Plus $3.00 Per Week
FEE:          $40.00 Resident for Parent/Child pair
              $48.00 Non-resident Parent/Child pair                                                               West
                                                                                               WHERE:      Park Tavern
                                                                                                           3401 Louisiana Ave S
                                                               Girls Club                                  St Louis Park
                                                                 (ages 13-21)                  WHEN:       Saturdays, Jan. 21—Mar. 10
                                                 For young women with Asperger’s/High          TIME:       9:30—11:30 am
                                                  Functioning Autism who want to meet
                                                        new friends and have fun!              FEE:        $35.00 Resident
                                                                                                           $43.00 Non-resident
                                                WHEN:         Saturday afternoons                          Plus $3.00 Per Week
                                                              Jan 21, Feb 18 and Mar 17
                                                                                                       Program Minimum 5, Maximum 10
                                                WHERE:        Various locations
                                                FEE:          $30.00 Resident,
                                                              $38.00 Non-resident,
                                                              Plus additional activity fees               Teen Explorers
                                                                                                                 (ages 13-21)
                                                       Program Minimum 5, Maximum 10
                                                                                                Make new friends while trying new
                                                                                                activities. This is a weekly social group
                                                                                                that gives teens the opportunity to go to
                                                Family                                          concerts, restaurants, movies, plays,
                                                                                                sporting events, shopping and more!
                                                Yoga                                            WHERE: Various metro locations
 Take Five Respite                                                                              WHEN:      Tuesdays, Jan 17—Mar. 6
                  Ages 13-21
                                                This class is designed for children/teens
                                                with disabilities and their parents to learn    TIME:      6:30 - 8:30 pm
Looking for something fun to do over
                                                yoga together. Increase attention span,         FEE:       $40.00 Resident
Winter Break? Come meet new friends at
                                                focus, muscle tone and flexibility! Siblings               $48.00 Non-resident
this great all-day program filled with field
                                                welcome too. All children must be
trips, friends and fun!
                                                accompanied by at least one adult.                      Plus additional activity fees
                                                                                                       Program Minimum 5, Maximum 15
WHEN:       Dec. 27—30
                                                WHERE:     St. Louis Park Rec Center
WHERE:      Elim Church in Robbinsdale                     3700 Monterey Dr.
TIME:       9:00 am—3:30 pm
FEE:       $280                                 WHEN:      Tuesdays
                                                           Jan. 24—Feb 28
Payment Options: Private pay, Waiver,
and CDCS. Some scholarships available.          TIME:      5:45—6:45 pm

         For an application, please             FEE:       $50 for parent/child pair
       call Danielle at (952) 988-4178                     $58 for non-residents

                                                           $20 for each additional person
          Walking Club
                           Keep that body
                          moving and enjoy
                        the community! We
                          will walk at various
                           indoor locations.

                                                          Adult Bowling                          Non-Competitive
WHERE:      Various Locations                    Join us for fun, non-competitive
WHEN:       Mondays                              bowling. You will bowl two games                  Basketball
            Jan 23—Mar. 5                        each week.
                                                                                           Have fun and get some exercise in this
TIME:       6:30 - 8:00 pm                                                                    great non-competitive league!
FEE:        $25.00 Resident                      WHERE:    Doyle’s                       WHERE:     Sabes Jewish Community Ctr
            $33.00 Non-Resident                            5000 W Broadway                          4330 S Cedar Lake Road
                                                           Crystal                                  Minneapolis, MN 55416
       Program Minimum 5, Maximum 15             WHEN:     Saturdays, Jan. 21—Mar. 10
                                                                                         WHEN:      Thursdays
                                                               Young Adult Group 18-26              Jan. 5—Mar 8
                                                               Adult Group 27+
                                                                                         TIME:      5:30 - 7:00 pm
                                                 TIME:     12:00—2:00 pm
                                                 FEE:      $35.00 Resident               FEE:       $40.00 Resident
                                                           $43.00 Non-resident                      $48.00 Non-resident
                                                          Plus $3.00 Per Week
                                                                                         A Competitive Basketball League is offered
                                                  Program Minimum 5, Maximum 20          by the Ridgedale YMCA on Mondays. Call
                                                                                            Molly at 952-982-8264 for information.
                                                 WHERE:    Maple Lanes
                                                           6310 Hwy 65 NE
                                                           Fridley                               Basketball Team
                                                 WHEN:     Saturdays, Jan. 21—Mar. 10             Sponsors and
                                                 TIME:     3:00—5:00 pm
                                                                                                Volunteer Coaches
       Yoga for Adults                           FEE:      $35.00 Resident                           Needed!
                 (ages 18+)                                $43.00 Non-resident
                                                                                            Help adults with disabilities have fun
                                                          Plus $3.00 Per Week                       playing basketball
Relax, gain flexibility, and get in shape         Program Minimum 5, Maximum 20                 Full sponsorships are $275
at this great program.                                                                   Contributions of any amount welcomed!

WHERE:      St. Louis Park Rec. Center                           West                    Call Becca at 952-988-4176 if you would like to
            3700 Monterey Dr.                    WHERE:    Park Tavern                            sponsor or coach a team.
            St. Louis Park                                 3401 Louisiana Ave S
WHEN:        Tuesdays                                      St Louis Park

             Jan. 24—Feb 28                      WHEN:     Saturdays, Jan. 21—Mar. 10

TIME:        6:45—7:45 pm
FEE:         $40.00 Resident                     TIME:     9:30—11:30 am
             $48.00 Non-resident                 FEE:      $35.00 Resident
       Program Minimum 5, Maximum 15                       $43.00 Non-resident
                                                          Plus $3.00 Per Week

6                                                 Program Minimum 5, Maximum 20
                                                                                                             On the Town I
 Club West (west metro) and Wednesday Night Social (northwest metro)
                                                                                              A social group for young adults, ages 18 - 30 who are
 are social programs for adults age 18 and older. Meet new friends and visit
                                                                                              independent and would like to explore their
 with old friends while enjoying games, dances, movies, bingo, etc.                           community. Intake required for new participants. Call
                            Staff to participant ratio is 1:10                                952-988-5321 to schedule intake.

               Program Minimum 5, Maximum 20 (for each program)                               WHERE:    Various locations in the Northwest &
                                                                                                        West Suburbs
                                                                                              WHEN:     Every other Friday evening
           Club West                        Wednesday Night Social                                      Beginning mid-January

WHERE:     Various west metro             WHERE:     Various north metro                      TIME:     Varies with activity
           locations                                 locations                                FEE:      $20.00 Resident , $28.00 Non-resident
WHEN:      Wednesdays                     WHEN:      Wednesdays                                         Plus additional activity fees
           Jan. 18—Mar. 7                            Jan. 18—Mar. 7                                     Program Minimum 5, Maximum 15
TIME:      6:30 - 8:30 pm                 TIME:      6:30 - 8:30 pm
FEE:       $40.00 Resident                FEE:       $40.00 Resident                                         On the Town II
           $48.00 Non-resident                       $48.00 Non-resident
                                                                                              A social group for adults, ages 31 and over, who can
           Plus additional activity fee              Plus additional activity fee             access the community independently with minimal
                                                                                              supervision. Intake required for new participants. Call
                                                                                              952-988-5321 to schedule intake.
               Dances (No Pre-registration required)                                                    Various locations in the Northwest & West
                            All dances are from 7-9pm                                         WHEN:     Every other Saturday evening
                                  $5 at the door                                                        Beginning mid-January
              ST. LOUIS PARK                                  BROOKLYN PARK                   TIME:     Varies with activity
                                                                                              FEE:      $20.00 Resident, $28.00 Non-resident
WHEN:      Jan. 20                                WHEN: Friday, February 10                             Plus additional activity fees
           Feb. 17—Valentines Dance!              WHERE: Brooklyn Park Comm. Ctr.
                                                                                                        Program Minimum 5, Maximum 15
           March 16                                      5600 85th Ave. N.
                                                                                              On the Town Transportation may be available
                                                                   CHASKA                     depending on where you live. Cost: $35. If you have
WHERE:     St. Louis Park H.S.                                                                used On the Town Transportation before,
           6425 W. 33rd St.                       WHEN: Friday, January 27                    register on page 9. New participants call
                                                                                              Steve at 952-988-5321 to see if you are
                                                  WHERE: Chaska Comm. Ctr.
                                                                                              eligible for the bus service.
        Co-sponsored by Project Soar                     1661 Park Ridge Drive

                                                                 SUPERBOWL PARTY!!
                                                                                    (ages 16+)

                                                    Join your friends for food, fun, prizes & the big game!

                                                    WHEN: Sunday, February 5th from 5:00—9:00 pm

                                                    WHERE: Brookview Golf Grill, 200 Brookview Pkwy, Golden Valley

                                                    COST: $10.00 Resident, $18 Non-resident

                                                                                         Register on page 9

       NOTE: Residency restrictions do not apply to these programs. ALL registrations are taken on a
                                        first-come, first-served basis.

         Weekend                                     Social Seekers
                                                 Social Seekers is a fun, age
         Ventures                            appropriate program for teens and
                                                young adults with Asperger’s                    HOLIDAY PARTY & ART
        for teens 16+ & adults              Syndrome or High-Functioning Autism.                    SHOWCASE
                                            WHERE:     The Depot Coffee House , Hopkins
 DOWNTOWN MINNEAPOLIS                                                                           Come help us celebrate our
                                            WHEN:      Mondays, Jan. 9—Mar. 19
                                            TIMES:     4:00 - 5:30 (ages 12-14) Min 4 * Max 6
                                                                                                achievements this year and
We will stay at a fabulous                             5:45 - 7:15 (ages 15-18) Min 5 * Max 8    enjoy exciting works of art
hotel right downtown, tour                                                                        created by our clients!
Macy’s 8th floor display,
                                            WHERE:     Living Waters Market & Café, Mtka
watch the Holidazzle
parade and more!!                           WHEN:      Wednesdays, Jan. 11—Mar. 21
                                            TIME:      5:15—6:45 (ages 19+) Min 5 * Max 12      Food, REACH Annual Awards,
WHEN: Friday, Dec. 9 at 6pm to
                                                                                                Dancing, Door Prizes, & More!
      Sunday Dec. 11 at 11am                FEE: $210.00 for 10 Sessions. $10 discount
                                            if you pay by check or cash. Price includes
FEE:      $350 for entire weekend           2 to 3 community activities in addition to the 10    Wednesday, December 7, 2011
                                            regular sessions.                                    Minnetonka Community Center,
                                                                                                    14600 Minnetonka Blvd.
 MALL OF AMERICA WEEKEND                      Returning participants should contact                      6:00—8:30 pm
                                             REACH to register. An intake is required
                                                for new participants. Please call
                                                         (952) 988-4176.                          Cost: $5 donation at the door
Escape winter with a
weekend at Minnesota’s
giant mall!! We will
spend the weekend at a                                                                          Please bring the exact amount—we
hotel in Bloomington and                                                                             will not have any change.
spend all day Saturday
exploring the MOA!
                                                                                                      EVERYONE WELCOME!
WHEN: Friday, Mar 23rd at 6pm to
      Sunday Mar 25th at 11am.
FEE:      $350 for entire weekend

      For more information or to register
     for either of these great weekends,
            please call Danielle at
                                                              Do You Have a
                (952) 988-4178.                           Special Artistic Talent?
                                                    Display your work at the REACH Art Showcase on
                                                                   December 7, 2011

                                            We will exhibit paintings, drawings, photographs, crafts, woodworking,
                                            sculpture or collections from REACH clients.

                                                     Contact Becca at 952-988-4176 or
                                                               If you would like to put a piece in the exhibit.
                                                               Registration Form—Winter 2012
Advance payment is required for all programs. NO REGISTRATION AT PROGRAMS OR BY PHONE. Residents of the West & Northwest
consortium of cities and Members receive priority registration up to the deadline. Registration is then open to non-residents (unless
program is full). Guaranteed Rgstn for residents/members 11/28—12/1. Priority Rgstn 12/2—1/1. Open Rgstn 1/2—on.

Name:                                                                             __                     Gender:                 Birth date:                 _______ ______

Address:                                                                          City/Zip:              ______________Home Phone:___________________________

Alt. Phone:                                                     Email                             ___ _________________________  I have a Waiver  I have SILS
DISABILITY/DIAGNOSIS(ES): (Please check ALL that apply)
            ___Developmental Disability ___Autism                        ___Asperger’s/PDD             ___TBI     ___Deafness      ___Blindness      ___ADD/ADHD
            ___ Down Syndrome                      ___ Cerebral Palsy       ___Seizures           ___Emotional/Behavior Disorder ____ Uses Wheelchair
Other Disability or Mental Health Conditions: __________________________Allergies/Medical Concerns/Diet: _______________________
Function Level of Client: ____Borderline ____Mild                          ____Moderate             ____ Severe     ____ Other: ___________________

         Photo Waiver: My photo may be taken at Reach programs and used for promotional materials, unless I check below:
                                           No, I DO NOT wish to have my photo used.

Emergency Contact:                                                                                       Emergency Phone:____________________________________

Social Worker:     ______________________________________________________________                        Social Worker’s Phone :    ____________________________________

Parent(s)/Guardian(s): _______________________________________________________                           Parent(s) Email: ____________________________________________

Home Address: ______________________________________________________ City: ____________________________________ Zip : ______________________

Parent(s) Primary Phone: ______________________________________________ Secondary Phone: ___________________________________________________

Annual House-          $0 - $24,999                            $25,000 - $49,999           $50,000 - $74,999             $75,000 - 99,999
 hold Income:          $100,000 - $124,999                     $125,000 - $149,999         $150,000 - $174,999           $175,000 - $199,999          $200,000+
I, the undersigned, certify that the above information is accurate. I understand that participation in this activity is completely voluntary and the activity is being offered
for the benefit of the participant. Reach for Resources shall not be liable for any claims, injuries, or damages of whatever nature, incurred by the participant arising out
of, or connected with, the activity. On behalf of myself and the participant, I expressly forever release and discharge Reach for Resources, its agents or employees, from
any such claims, injuries or damages. I have received a copy of Notice of Privacy as required by HIPAA. I have read, understood and agree to these privacy practices.

Legal Guardian: ________________________________________________________ Date: ________________________________

                                                                                                           Adult Programs                          Resident/Non-Res
 Youth & Special Programs                              Resident/Non-Res
                                                                                                               Adult Bowling Doyle’s               $35.00 / $43.00
 Youth/Teen Bowling Doyle’s                            $35.00 / $43.00
                                                                                                               Young Adult Bowling Doyles          $35.00/ $43.00
 Youth/Teen Bowling Park Tav.                          $35.00 / $43.00

 Teen Explorers                                        $40.00 / $48.00                Winter                  Adult Bowling Park Tavern           $35.00 / $43.00

 Family Yoga # Attending _______                       $50.00 / $58.00 (+$20)         2012                    Adult Bowling Maple Lanes           $35.00 / $43.00

      Girls Club                                       $30.00 / $38.00                                        On the Town I                       $20.00 / $28.00

      Community Connections Group                      $40.00/$48.00                                           On the Town II                      $20.00 / $28.00
      Weekend Ventures (teens & adults)                Send Me Info                                            On the Town Transportation          $35.00
      Take Five Respite      (ages   13-21)            Send Me Info                                           Club West                           $40.00 / $48.00

       Superbowl Party (ages 16+)                       $10.00 / $18.00                                        Wednesday Night Social              $40.00 / $48.00
                                                                                                               Adult Yoga                          $40.00 / $48.00

                                                                                                               Walking Club                        $25.00 / $33.00
     Please mail completed form with payment to:
  REACH at 1001 Highway 7, #235 Hopkins, MN 55305                                                              No-Compete Basketball               $40.00 / $48.00

                                                                                                         Program Total:                              $
    _____ Approved by __________                       Amt Pd $_______ Ck#___________                    Donation to support REACH
     Date                               Initials
                                                                                                         programs (optional):                        $
                                                       Cash ____ Waiver Exp___________
    _____ Registered by __________
                                                                                                         Total Enclosed:                             $
     Date                               Initials       _____ Schedule Sent by________
                                                        Date                           Initials
    _____ Pymt Rec’d by _________
     Date                               Initials        DB Entry Member Exp.                              I have made arrangements with the County for Reach to
                                                                                                          bill my Waiver directly for recreation programs. (If not, you
                                                                                                          must pay for programs when registering)
                        2012 BOWL-A-THON REGISTRATION
                        You must be registered in order to bowl. We will send you a pledge packet
                                        when we receive your registration form.
                                         Registration Deadline: March 16, 2012



     City:                                           State             Zip



     Please register me for:

             Bowling and Lunch—$40 minimum pledges or donation (Pledges should be turned in at the event)

                      I am bowling alone                     T-Shirt Size:   S   M   L   XL   XXL [adult sizes only]
                                                             (circle one)
                      I am bowling with a team*

              Other team members:

              *(Note: ALL Team Members must fill out their own registration form)

             Lunch Only—My $15 donation is enclosed (checks payable to Reach for Resources)

             I am unable to participate, but enclosed is my donation of $
              (checks payable to Reach for Resources)

     Photo Waiver: Photos may be taken at the Bowl-A-Thon and used in Reach publications. If you DO
     NOT want your photo used, initial here: No, I do not want my photo used

                         GHOSTLY GALA
Thank you to all of our guests, sponsors, & volunteers for helping raise $5400 for REACH programs!

                                                                                   Thank You
                                                                    Corporate & Civic Sponsors

Best Female Costume: Judge Judy   Best Male Costume: Prince
         Jenny Weldon                Weston Gardebring

                                                                                          The Goldbricks Club
                                                                                       Minneapolis Elks Lodge
                                                                                                VFW Post 494

                                                              Individual Sponsors      In-Kind Donors

                                                              Dawn’s Creative Play     Aerital Consulting Group
                                                                 Daycare               Anna Dadabo
                                                              Jeff and Maxine Skold    Bell Museum of Natural History
                                                              Matt Miron               Buca di Beppos Restaurant
                                                              Patrick Boley            Cub Foods
                                                              Steve and Marcia Crist   Dave and Busters
                                                              Tim and Piper Garmon     Dickey’s BBQ Pit
                                                                                       Dominos Pizza Brooklyn Park
                                                                                       Emily Gillespie
                                                                                       Jessica Cermak
                                                               Special thanks          Larissa Beck
                                                                                       Lisa Rivers
                                                               to the Brooklyn         Mad Jacks
                                                                     Park              Marsha Miller
                                                                                       Matthew Smith
                                                                 Community             Megan Bailey
                                                               Center and Jen          Minnesota Historical Society
                                                                                       Minnesota Timberwolves
                                                                  Gillard for          Minnesota Twins
                                                                                       Minnesota Vikings
                                                                 hosting the           Mongo’s Grill
                                                                Ghostly Gala!          Old Log Theater
                                                                                       Qdoba Mexican Grill
                                                                                       Saint Paul Saints Baseball
                                                                                       Sam’s Club Maple Grove
                                                                                       Stages Theater Company
                                                                                       Taco Bell

                                                                                                                                  U.S. POSTAGE

                                                                   Address Service Requested                                    LITTLE FALLS, MN
                                                                                                                                  PERMIT NO. 9

      1001 Highway 7 #235
      Hopkins, MN 55305
      (952) 988-4177

Reach For Resources Staff                                      Give to the Max Day– November 16, 2011
Mary Perkins, LICSW
Executive Director
                                               What if you could help us win $1000 just by giving 10 bucks? On
Lisa Rivers, MA, LP                            November 16, 2011- Give to the Max Day- you can.
Director of Counseling Services
Matthew Smith
Director of Education & Training               Last year, more than 42,000 donors logged on to on Give
Becca Stenzel, CTRS
Director of Recreation & Inclusion Services    to the Max Day and gave over $10 million to Minnesota charities
Melissa Kloek
Marketing & Fundraising                        within 24 hours. Together, donors like you have the power to create a
                                               strong nonprofit community in Minnesota despite the challenging
Megan Bailey, Community Living Specialist
Larissa Beck, Asst. Dir. of Education &
                                               economic situation.
Tony Boldon, Community Living Specialist
                                               On November 16, every hour for 24 hours, $1,000 will be given to a
Dan Brown, Community Living Specialist
Jessica Cermak, Mental Health Practitioner     random donor’s charity. You could be that donor! Give $1 or $100
Anna Dadabo, Community Living Specialist
                                               and your chances will be the same! Donate at 2:00 a.m. or make
Emily Gillespie, Mental Health Practitioner
Analisa Jayasekera, Mental Health              small donations throughout the day to increase your chance of
Emma Kachelmeier, Community Living
                                               winning the ―Golden Ticket‖- a $1000 prize for Reach!
Marsha Miller, Family Housing Advocate
Brittany Schweim, Mental Health Practitioner
                                                                     GET YOUR REACH READER EARLY!
Stephen Savior, Asst. Director of Recreation
                                               Sign up to receive email delivery of the Reach Reader. You will have access to great
                                               stories, information and our recreation program schedules approximately one week before the paper
Sarah Selseth, Community Living Specialist
                                               copy is available in the mail!
Jamie Schroeder, Supported Employment
Specialist                                     It’s easy! Go to our website and use the ―Sign Up for Our Newsletter‖ tool at
Danielle Sweany, CTRS Recreation Specialist    the bottom of the home page.

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