Sellwood Community Center - Winter 2014 by Portland Parks & Recreation

Winter 2014

Southeast Portland Regional Activities

Mt. Scott Community Center Sellwood Community Center Woodstock Community Center

• Adult Group Exercises Classes NOW included in your pass or drop-in visit!...... MSCC 8 • Winter & Spring Break Camps for Preschoolers and Youth!...... MSCC 14, SCC 42-43 • View & Register for Spring 2014 classes beginning March 3, 2014.

Commissioner Amanda Fritz Director Mike Abbaté

Portland Parks & Recreation

Sellwood Community Center 1436 SE Spokane 97202 Telephone: 503.823.3195 Center Director: Kim Calame Program Leader: Lizzy Spencer Hours: Monday-Friday 8:30am-8:30pm Saturday 9am-12pm Closures: 1/1/14 Bus Lines: #70 12th Avenue Disabled Access: Entrances: Accessible, ramp on east side of building Building: First floor only Restrooms: Not accessible Parking: Street Parking

Sellwood Table of Contents Adult Classes.................................................. SCC45-46 Educational Preschool ......................................... SCC40 Music for Youth..................................................... SCC44 Parent/Child.......................................................... SCC41 Preschool Camp................................................. SCC42 Preschool Classes........................................... SCC41-42 Senior.............................................................. SCC46-47 Youth Classes.................................................. SCC42-45 Youth Camp......................................................... SCC43 Registration Information..............................................50 Registration Form........................................................51

Find us on

Facebook at Sellwood Community Center

SCC38

Sellwood Community Center

503.823.3195

January 11th-February 8th

Portland Parks & Recreation

SELLWOOD CC

SCC39

Portland Parks & Recreation

A $35 non refundable registration fee is due at sign-up.

If you would like more information regarding registration, call us at 503-823-3195.

All fees are paid on or before the first day of the month. A $20 late fee will be assessed after the 5th of the month. Non-payment by the 15th of the month will result in removal from the class roster. Automatic withdrawal payments can be arranged at our customer service desk. (Fees listed for the 2013-14 may differ from the fees set for school year 2014-15.)

SCC40

Sellwood Community Center

503.823.3195

Parent’s Time Off Parents need time too! age: 1-3

Mat 9:30am-11:30am Wednesdays with Staff 417863 1/8-1/29 $64 417864 2/5-2/26 $64 417865 3/5-3/26 $64

Portland Parks & Recreation Drop in may be available. Please call in advance. Classes spaces are limited.

Need to get away? Take a breather & let your child(ren) join us for active games, stories & making new friends! Motor, verbal skills & a sense of independence are enhanced through this social activity. Please bring snacks, diapers and wipes for children. Call for drop-in availability prior to class.

Parent/Child Drop-In Activities (Parent/Child Both Attend) We hope you enjoy our drop-in programs! A great way to meet other families in our community! You can drop-in for $1 or purchase a punch pass with 20 visits for $18. If registration for the punch card is done online, then receipt must be presented at Sellwood CC to receive the actual punch pass. There is no expiration on the punch card & no refunds. Punch card cannot be replaced if lost or stolen. This pass can be used for Baby Play and Indoor Playground. Punch pass – 20 visits does not expire. Good only at Sellwood.

SELLWOOD CC

Fees: 20 visits for $18 or $1 daily drop-in Baby Play age: 1mo-3 yrs Fun & games encourage your babies’ development & help them learn about the world. Increase balance & coordination through exploration in a soft, safe environment. Share ideas & develop friendships with other parents in a supportive friendly setting. A refreshing experience! 416952 F, M 9am-10:30am Mat 1/3-3/21 Indoor Playground age: 1-5yr Play is essential in the human development process! A safe & cooperative time TOGETHER! Encourage the development of motor skills while gaining experience with group interaction & cooperative play on equipment, cars & assorted toys. It’s a great opportunity to network with other parents! Parents get the toys out and replace them at the end of the activity. 416951 M, W, F 10:30am-12pm Gym 1/3-3/21 Kidlets Can Rumble & Roll With Judo age: 1½-3½ Roll, fall, tumble & throw! Based on gentle martial arts principles & developed to build strength & flexibility in a cooperative manner. Enjoy this excellent opportunity for little ones to increase their large motor skills in a safe environment. A fun, engaging experience! No class 11/11. M 10:45am-11:30am Will 418965 Mat 1/6-1/27 $20 418966 Mat 2/3-2/24 $20 418967 Mat 3/3-3/24 $20

Dance - Movement & Me age: 2-4 Join your child to leap like gazelles & spin like tops while developing music appreciation, rhythm, coordination & strength through introductory dance steps & movement. Build listening & socialization skills while discovering how FUN dancing can be. Tu 9am-9:45am Jarmila 419553 Meeting Rm 1/7-2/4 $35 419554 Meeting Rm 2/11-3/11 $35 Music - Lil’ Rockers! age: 3-6 Join the Band! It’s all about rockin’ tunes, swinging & jammin’ with instruments kids create! Get your creative juices flowing discovering pitch & rhythm, beat & tempo, while improving fine & gross motor skills. Jump right in and give it a go! Tu 12:30pm-1:15pm RMC Studios 419559 Meeting Rm 2/18-3/18 $45 419560 Meeting Rm 1/14-2/11 $45 Register On-Line at www.PortlandParks.org

SCC41

Portland Parks & Recreation Youth (School Age: 6 yrs - 17yrs) Yoga - Celebrate Movement age: 7-12 Be better prepared for the opportunities of everyday life, sports & school with exercises that benefit both mind & body. Techniques for relaxation, rest & revitalization increase focus & confidence while building strength & stamina. M 4pm-5pm Melissa 418747 Rm 5 1/13-2/3 $26 418748 Rm 5 2/10-3/3 $26 Martial Arts - Judo Kodokan age: 6 & up Discover a form of self-defense that literally means ‘gentle way’. Gain self-control to effectively throw, pin & apply submission holds to the opponent. Explore grappling & groundwork techniques while increasing physical stamina & mental focus. This class is for youth only. Individuals: $30 per month Families: $50 per month Th 4:15pm-5:15pm Rob 418980 Mat 1/9-1/30 418981 Mat 2/6-2/27 418982 Mat 3/6-3/27 Martial Arts - Judo Kodokan age: 6 & up for Homeschoolers Discover a form of self-defense that literally means ‘gentle way’. Gain self-control to effectively throw, pin & apply submission holds to the opponent. Explore grappling & groundwork techniques while increasing physical stamina & mental focus. Individuals: $30 per month Families: $50 per month Tu, Th 12:45pm-1:30pm Jason 418977 Mat 1/7-1/30 418978 Mat 2/4-2/27 418979 Mat 3/4-3/27

Tennis - Easy Start age: 5-8 Foam balls, a short court, junior-sized racquets & a lower net are tools that allow for quick command of skills. Have instant success & enjoy the game immediately! Parents encouraged to help with this lively session, the first step in playing on a full-sized court. Develop eye-hand coordination & increase agility. F 4:30pm-5:15pm Tino 417370 Gym 1/10-1/31 $40 417371 Gym 2/7-2/28 $40 417372 Gym 3/7-3/21 $30

SCC42

Sellwood Community Center

503.823.3195

Tennis - Hot Shots! age: 9-12 Are you exhausting Mom & Dad by having them chase down crazy shots? Continue improving basic strokes with great drills & games. Develop consistency, handeye coordination & court movement while getting exercise. F 5:15pm-6pm Tino 417504 Gym 1/10-1/31 $40 417505 Gym 2/7-2/28 $40 417506 Gym 3/7-3/21 $30

Monday-Friday 2:30pm-6pm 417378 Kitchen 1/6-1/31 417379 Kitchen 2/3-2/28 417380 Kitchen 3/3-3/31

$210

Intergenerational Game Room for Kids age: All ages Join us for supervised after-school fun! Spend your leisure time playing in our game room. Use our equipment to chill-out & meet friends! Equipment varies with sites but may include pool, ping pong, foosball & board games. Deposits or game room passes may be required. Hours may vary. Check us out! M-F 8:30pm 1/3- 3/21 Free

SCC43

SELLWOOD CC

M-F 7:30am-6pm 417389 Kitchen 3/24-3/28

Portland Parks & Recreation Music Music - Guitar Private Lessons age: 8 & up Always wanted to start playing or improve upon existing skills? One-on-one time in a private setting can boost confidence as well as musical abilities. From classical to popular, explore styles of interest! Registrations at Sellwood CC ONLY. Tu 1/7-2/11 Dover 417518 Rm 1 3pm-3:30pm $90 417519 Rm 1 3:35pm-4:05pm $90 417520 Rm 1 4:10pm-4:40pm $90 417521 Rm 1 4:45pm-5:15pm $90 417522 Rm 1 5:20pm-5:50pm $90 417523 Rm 1 5:55pm-6:25pm $90 417524 Rm 1 6:30pm-7pm $90 417525 Rm 1 7:05pm-7:35pm $90 417526 417527 417528

W 1/8-2/12 Rm 1 3pm-3:30pm Rm 1 3:35pm-4:05pm Rm 1 4:45pm-5:15pm

Dover $90 $90 $90

417529 417530 417531 417532 417533 417534 417535 417536

Tu 2/18-3/18 Rm 1 3pm-3:30pm Rm 1 3:35pm-4:05pm Rm 1 4:10pm-4:30pm Rm 1 4:45pm-5:15pm Rm 1 5:20pm-5:50pm Rm 1 5:55pm-6:25pm Rm 1 6:30pm-7pm Rm 1 7:05pm-7:35pm

Dover $75 $75 $75 $75 $75 $75 $75 $75

417537 417552 417551

W 2/19-3/19 Rm 1 3pm-3:30pm Rm 1 3:35pm-4pm Rm 1 4:05pm-4:35pm

Dover $75 $75 $75

Music - Let’s Rock! age: 5-6 Imagine yourself tearing it up with a band! Increase confidence & musical knowledge as you expand skills playing rockin’ instruments such as: guitar, drums, electric bass, keyboard & vocals. Jam with professional & aspiring musicians to learn more about the music scene & performance. Classes provided by RMC Studios Portland. Tu 1/14-2/11 RMC Studios 418991 Meeting Rm 3pm-3:50pm $50 418993 Meeting Rm 4pm-4:50pm $50 Tu 2/18-3/18 RMC Studios 418992 Meeting Rm 3pm-3:50pm $50 418994 Meeting Rm 4pm-4:50pm $50

SCC44

Sellwood Community Center

503.823.3195

Music - Piano age: 5-12 Explore the elements of rhythm, harmony & melody learning to read & play music you love. Encourages finger dexterity, appreciation of sounds, self-discipline & listening skills. Start or continue a life-long skill today! Registrations at Sellwood CC ONLY. 417589 417591 417599 417592 417593 417596 417597 417598

M 1/6-2/10 Rm 2 2pm-2:30pm Rm 2 2:35pm-3:05pm Rm 2 3:10pm-3:40pm Rm 2 3:45pm-4:15pm Rm 2 4:20pm-4:50pm Rm 2 4:55pm-5:25pm Rm 2 5:30pm-6pm Rm 2 6:05pm-6:35pm

Philippa $108 $108 $108 $108 $108 $108 $108 $108

417618 417619 417620 417621 417622 417623 417624 417625

M 2/17-3/17 Rm 2 2pm-2:30pm Rm 2 2:35pm-3:05pm Rm 2 3:10pm-3:40pm Rm 2 3:45pm-4:15pm Rm 2 4:20pm-4:50pm Rm 2 4:55pm-5:25pm Rm 2 5:30pm-6pm Rm 2 6:05pm-6:35pm

Philippa $90 $90 $90 $90 $90 $90 $90 $90

417578 417577 417587 417588

Tu 1/7-2/11 Rm 2 4pm-4:30pm Rm 2 4:35pm-5:05pm Rm 2 5:10pm-5:40pm Rm 2 5:45pm-6:15pm

Susan $108 $108 $108 $108

417594 417595 417610 417579

Tu 2/18-3/18 Rm 2 4pm-4:30pm Rm 2 4:35pm-5:05pm Rm 2 5:10pm-5:40pm Rm 2 5:45pm-6:15pm

Susan $90 $90 $90 $90

417600 417602 417601 417603 417604 417605 417606 417607

W 1/8-2/12 Rm 2 2pm-2:35pm Rm 2 2:35pm-3:05pm Rm 2 3:10pm-3:40pm Rm 2 3:45pm-4:15pm Rm 2 4:20pm-4:50pm Rm 2 4:55pm-5:25pm Rm 2 5:30pm-6pm Rm 2 6:05pm-6:35pm

W 2/19-3/19 417626 Rm 2 2pm-2:30pm 417627 Rm 2 2:35pm-3:05pm 417628 Rm 2 3:10pm-3:40pm 417629 Rm 2 3:45pm-4:15pm 417630 Rm 2 4:20pm-4:50pm 417631 W 4:55pm-5:25pm 417638 Rm 2 5:30pm-6pm 417632 Rm 2 6:05pm-6:35pm

Philippa $108 $108 $108 $108 $108 $108 $108 $108 Philippa $90 $90 $90 $90 $90 $90 $90 $90

Portland Parks & Recreation Th 1/9-2/13 Rm 2 2:35pm-3:05pm Rm 2 3:10pm-3:40pm Rm 2 3:45pm-4:15pm Rm 2 4:20pm-4:50pm Rm 2 4:55pm-5:25pm Rm 2 5:30pm-6pm Rm 2 6:05pm-6:35pm

Philippa $108 $108 $108 $108 $108 $108 $108

417633 417634 417635 417636 417637 418160 418161

Th 2/20-3/20 Rm 2 2:35pm-3:05pm Rm 2 3:10pm-3:40pm Rm 2 3:45pm-4:15pm Rm 2 4:20pm-4:50pm Rm 2 4:55pm-5:25pm Rm 2 5:30pm-6pm Rm 2 6:05pm-6:35pm

Philippa $90 $90 $90 $90 $90 $90 $90

417582 417583 417580 417581

F 1/10-2/14 Rm 2 4pm-4:30pm Rm 2 4:35pm-5:05pm Rm 2 5:10pm-5:40pm Rm 2 5:45pm-6:15pm

417615 417616 417617 417640

F 1/10-2/14 Philippa Rm 2 1:55pm-2:25pm $108 Rm 2 2:25pm-2:55pm $108 Rm 2 2:55pm-3:25pm $108 Rm 2 3:25pm-3:55pm $108

417584 417586 417585 417590

F 2/21-3/21 Rm 2 4pm-4:30pm Rm 2 4:35pm-5:05pm Rm 2 5:10pm-5:40pm Rm 2 5:45pm-6:15pm

Susan $90 $90 $90 $90

418162 418163 418164 418165

F 2/21-3/21 Rm 2 1:55pm-2:25pm Rm 2 2:25pm-2:55pm Rm 2 2:55pm-3:25pm Rm 2 3:25pm-3:55pm

Philippa $90 $90 $90 $90

Susan $108 $108 $108 $108

High School/Adult (12 yrs & up) Martial Arts - Judo Kodokan age: 6 & up Discover a form of self-defense that literally means ‘gentle way’. Gain self-control to effectively throw, pin & apply submission holds to the opponent. Explore grappling & groundwork techniques while increasing physical stamina & mental focus. Individuals: $30 per month Families: $50 per month Families M, W 6:30pm-8pm Jason 418968 Mat 1/6-1/29 418969 Mat 2/3-2/26 418970 Mat 3/3-3/26 Adults Only Tu 6:30pm-8pm 418971 Mat 1/7-1/28 418972 Mat 2/4-2/25 418973 Mat 3/4-3/25 Tu, Th 11:30am-12:30pm 418974 Mat 1/7-1/28 418975 Mat 2/4-2/27 418976 Mat 3/4-3/27 Saturday Drop-in Sa 9:30am-11am 418984 Mat 1/4-3/29

Bevin

Ryan

Jason $5

Martial Arts -Traditional Japanese Karate-Do age: 12 & up Acquire defensive skills & master the art of being a quality member of society. Bring together the energy of the mind, body & spirit. Become skilled in Kodokan, Shotokan, Ateme Waza striking & blocking methods with Judo throws, pins & submission techniques in a cooperative & safe environment. Th 5:30pm-7pm Rupert 418962 Mat 1/9-1/30 $30 418963 Mat 2/6-2/27 $30 418964 Mat 3/6-3/27 $30 Cooking With Friends age: 16 & up One part food, two parts pals create the formula for a good tasting event. Gain confidence & cooperative skills while discovering new recipes & preparing a wonderful dish to share. Smile while enjoying the fruits of your labor. Th 6pm-7:30pm AIR 417294 Kitchen 1/30-3/6 $45

SCC45

SELLWOOD CC

417608 417609 417611 417612 417613 417614 417639

Portland Parks & Recreation Be fit! Be Well! Exercise For Every ‘Body’ age: 18 & up Want or need to exercise but don’t know where to start? Here’s your chance! A workout that’s fun for those with little experience, out of shape & for all sizes. General conditioning in the areas of strength, cardiovascular endurance & flexibility stressed. Enjoy a variety of styles 2 days a week $20 3 days a week $30 Drop-in $4 M, W, F 8:45am-9:45am 416953 Gym 1/3-1/31 416954 Gym 2/3-2/28 416955 Gym 3/3-3/31 ToneZone age: 18 & up Try this eclectic approach to exercise that combines yoga, pilates, dance, martial arts, weights, bands & aerobics for overall toning. Experience a sense of wellbeing while improving balance, strength, flexibility &coordination. Begin the journey of life-long fitness! Drop-in: $11 Tu, Th 8:30am-9:30am Haynes 418943 Gym 1/21-2/18 $50 418944 Gym 2/25-3/18 $40 Yoga - Premier age: 18 & up Relaxation is one of the most important & beneficial skills to learn. Benefit mind & body while expanding strength, stamina & flexibility. An excellent way to learn to meet the changing demands of daily life while increasing a sense of well being. Drop-in $15

age: 18 & up

Beginners: evenings M 7:10pm-8:40pm Jarmila 417508 Rm 5 1/6-3/10 $110 All levels: mornings M 9am-10:30am 417509 Rm 5 1/6-2/3 418168 Rm 5 2/10-3/10 All levels: evenings M 5:30pm-7pm 417507 Rm 5 1/6-3/10

SCC46

Sellwood Community Center

503.823.3195

Judy $44 $55 Jarmila $110

Portland Parks & Recreation It’s NEVER too Late!

Van Trip - Quiet Roads age: 55 & up Senior Rec Van Trip -Holiday Tea Luncheon & Ridgefield Wildlife Drive. Take tea with the pleasure of leisure, conversation & company at Myrtle’s Tea House in downtown Ridgefield. Four-course tea lunch includes savories, sorbet, sandwiches, soup, scones, fresh fruit & delectable sweets with luncheon & holiday teas. Fee includes tea & gratuity. All items contain dairy. Tea followed by slow drive in wildlife refuge for winter bird-spotting. You may wish to bring binoculars.

Zumba Gold age: 55 & up Enjoy modified moves & pacing with the same elements Zumba is known for: zesty Latin music like salsa, merengue, cumbia & reggaeton, exhilarating easy-tofollow moves & an invigorating atmosphere. Build cardiovascular health by challenging the heart & working the muscles of the hips, legs & arms. It’s a dance-fitness class that feels friendly & fun! Drop-in: $12 417368 Th 9:30am-10:25am Michelle Gym 1/2-3/20 $120

Van departs from 1436 SE Spokane promptly at 11am. Meet in the lobby. Parking is available on the street; please do not park on SE Spokane block directly in front of center, by center request.

Exercise - Creative Chair age: 55 & up Join us on a road to improved health, stretching & strengthening from a seated position. Incorporate light movement & conditioning into your daily routine. Feel better, look better & increase fitness levels while moving to your favorite songs. Drop-in: $11 418945 Tu, Th 10:45am-11:30am Linda Lobby 1/21-2/18 $50 418946 Tu, Th 10:45am-11:30am Linda Lobby 2/25-3/18 $40

417883 417884 417885 417886 417887

M 2/17-3/17 Rm 2 10:30am-11am Rm 2 11:05am-11:35am Rm 2 11:40am-12:10pm Rm 2 12:15pm-12:45pm Rm 2 12:50pm-1:20pm

Philippa $90 $90 $90 $90 $90

Tuesdays! 6-8pm

Music - It’s Never Too Late for Piano! age: 55 & up Always wanted to ‘tickle the ivories’ or just brush up on skills? Designed to challenge anyone who wants to learn or improve. Note-reading, style & rhythm are techniques essential to putting you on the right path! Why wait another minute? M 1/6-2/10 Philippa 417878 Rm 2 10:30am-11am $108 417879 Rm 2 11:05am-11:35am $108 417880 Rm 2 11:40am-12:10pm $108 417881 Rm 2 12:15pm-12:45pm $108 417882 Rm 2 12:50pm-1:20pm $108

For Mobility Rating Guide or if using a wheelchair, motorized scooter or need special assistance, please contact Senior Recreation at 503-823-4328 as soon as possible. For additional information please refer to your receipt. 416911 Tu 11am-4:30pm Lobby 2/4 $42

first Thursdays!

SCC47

SELLWOOD CC

Exercise - Moderate Pace age: 55 & up It is always the right time to improve your fitness! Build strength & stamina & help increase flexibility. Move at a moderate pace, seated & standing while listening to your favorite songs. 417875 W, F 12:30pm-1:30pm Philippa Rm 5 1/8-1/31 $40 417876 W, F 12:30pm-1:30pm Philippa Rm 5 2/5-2/28 $40 417877 W, F 12:30pm-1:30pm Philippa Rm 5 3/5-3/21 $30

Tickets are pre-purchased & non-refundable after January 21. If calling 3 working days in advance the program fee of $18 is refundable.

Portland Parks & Recreation

for adopting Sellwood Park in Southeast Portland Your donation of $100,000 per year for ten years to maintain the park shows your dedication to parks and to your community.

Sellwood Community Center Refund & Credit Policy REFUNDS & CREDITS We ask that you notify Sellwood Community Center at least 3 business days before the start of your program so we can refund or credit your account for the registration fee. Why this is important? This allows us time to either 1) contact participants on the waiting list or 2) cancel the class if the enrollment drops below the minimum required. If you withdraw less than 3 business days in advance: the cancellation or transfer is subjected to being prorated for the first class & any other classes that have already occurred at the time of withdrawal. Remember, the earlier you notify us of a withdrawal, the more we can credit or refund you. How will I receive my refund? • Payments made with checks or cash will be refunded by a check issued through the Portland Parks & Recreation accounting system. Please allow at least 10 days for processing time. • Payments made with Visa or Mastercard will be credited back to the same charge card.

Find us on

Facebook at Sellwood Community Center

INCLUSION SERVICES FOR PEOPLE WITH SPECIAL NEEDS Within the Americans with Disability Act (ADA) of 1990, Portland Parks & Recreation (PP&R) provides accommodations to individuals with disabilities/special needs, so that they may receive an equal opportunity to fully participate in programs offered citywide. How it Works First choose the activity you’d like to do & the PP&R site at which you’d like to do it. Next, register for the class. When registering, let the person know that you will need accommodations in order to participate in the activity. Once registered, contact Inclusion Services at (503) 823-4328. If this is your first accommodation through Inclusion Services, you will need to do a phone intake with a staff member at that number. At the end of the phone intake it will be determined whether an assistant will be needed on the first day of the activity to provide on-site support at the age-appropriate class. Future assistance will be provided based on need. The inclusion staff will work with the instructor on how to support you and your individual needs. A general program may be adapted using auxiliary aids & services, but the basic structure of the program remains the same. Accommodations are made as needed & can be flexible & creative, ensuring the participant engages as independently as possible. If you have questions about Inclusion Services, please call 503-823-4328 V/TTY. A minimum of 10 business days (Monday-Friday) advance notice is required. The Inclusion Services staff will do their best to accommodate each participant.

SCC48

Sellwood Community Center

503.823.3195

Portland Parks & Recreation

SELLWOOD CC

1. Go to www.PortlandParks.org. 2. Click on the Recreation Activities tab and then select Register Online! and then Search and Register for Classes. 3. If you have a course number, enter it into the box. 4. If you do not know the course number, Scroll down and click on the Advanced Search bar. Here you can enter keywords and narrow your search by days and dates. All of our class catalogs are online at www.PortlandParks.org. From our home page click on the Recreation Activities tab then select your program - community centers, pools, Senior Recreation, etc. From these links you can refine your search to a specific site or program and find current catalogs. Our flip-catalogs make browsing super easy - you can flip pages and zoom to find the information you want. If you experience any difficulties call us during regular business hours at 503-823-2525.

SCC49

Registration Information

Portland Parks & Recreation

Southeast Community Centers

Portland Parks & Recreation

CHECK ONE:

 New Customer

 Taken class with PP&R before  My account information has changed

Main Contact Name _______________________________________________________________________ Birthdate ___________________________ M_____ F_____ African immigrant White

American Indian/Alaska Native Slavic/Eastern European Immigrant

Black/African American Asian

Hispanic/Latino Multi-Racial

Native Hawaiian/Pacific Islander Other

Home Address ________________________________________________________________________ City/St/Zip _______________________________________________ Home Phone ( _________)________________________________________________ Work Phone ( _________)_________________________________________________ Cell Phone ( _________)_____________________________________________ Email Address _______________________________________________________________ Emergency Contact Name & Phone Number ___________________________________________________________________________________________________ Portland Parks & Recreation welcomes individuals with disabilities and special needs into programs. Please describe any accommodations needed for successful inclusion: _____________________________________________________________________________________________ PARTICIPANT INFORMATION Name (last, first)

Birthdate

M/F

Class Title

Course #

Class Location

Non-Residents of the City of Portland pay a 40% surcharge. Or you may purchase a non-resident pass at the amounts listed below. List pass price or 40% surcharge in column at right and add to your total.

 I already have a non-resident pass. Kind of card

Passholder name

_______________________ Purchase

date ______/______/______

________________________________________________________________________________________________

 I need a pass. Circle one: 3 month | 6 month | 9 month | 1 year

Circle one: Individual | Family Name of person(s) needing card _______________________________________________________________________________ 3 month pass: individual, $25; family, $50 | 6 month pass: individual, $45; family, $90 9 month pass: individual, $65; family, $130 | 1 year pass: individual, $85; family, $170

Start Date

Cost

Subtotal 40% non-resident surcharge or pass

 I do not want a pass. I choose to pay the 40% surcharge.

Total

PAYMENT INFORMATION

 CHECK

Check number_____________________

 CREDIT CARD Account #

(make check payable to the City of Portland)

Information

____ ____ ____ ____

- ____

____ ____ ____

Cardholder’s Name_____________________________________________________ Please print

- ____

____ ____ ____

Expires ____________________________________

Signature______________________________________________________________

 VISA  MasterCard

Registration Information

CIRCLE ONE:

Mt. Scott Community Center 5530 SE 72nd Portland, OR 97206

PP&R_PPF_HolidayAd_MECH4.pdf

10/31/13

11:48 AM

The nonprofit Portland Parks Foundation has launched a scholarship fund to make community centers affordable for all children this winter, regardless of financial means. Make a donation in honor of a friend’s name, and the Portland Parks Foundation will send them an e-greeting card. It’s Portland’s most sustainable holiday gift program: promoting healthy families while conserving resources. As a token of our appreciation, scholarship fund donors and their honorees receive 30%-off special offers from Columbia Sportswear, Mountain Hardwear, and Icebreaker, for staying warm over the holidays.

GIVE ONLINE AT

Parklandia.org/makewaves

Keeping Portland a City of Parks 111 SW Oak St, Suite 400, Portland, OR 97204