APPLICATION FOR ADMISSION PERSONAL INFORMATION
First Name
MI
Last Name
Mailing Address City
State
Zip
Social Security Number
Date of Birth
Father’s Name
Birthplace
Phone ( ) ‐
Email Address
Age
Legal Residence During Past Ten Years
Birthplace
Birthplace
Mother’s Name
MARITAL INFORMATION With Whom Do You Reside Marital Status □Single □Married □Widow □Widower □Divorced □Separated First Marriage to Whom Date of Marriage Date Ended Second Marriage to Whom EMPLOYMENT Past Occupation
Date of Marriage
Date Ended
Last Place of Employment / Date Employment Ended
Highest Level of Education Completed
Spouse’s Occupation Have You Ever Been Employed By Swiss Village? If Yes, Please Indicate Position and Years Employed CHILDREN/BROTHERS AND SISTERS OR CLOSE RELATIVES (IF NO LIVING CHILDREN) Name Address / Phone Marital Status Occupation
Relationship
Name
Address / Phone
Marital Status Occupation
Relationship
Name
Address / Phone
Marital Status Occupation
Relationship
Name
Address / Phone
Marital Status Occupation
Relationship
CHURCH RELATIONSHIP Church Affiliation Church Address
Name of Pastor Phone ( ) ‐
PHYSICAL CONDITION Condition of Your Health Do you require special attention □Good □Fair □Poor or care? □Yes □No Are you able to be up and about, and to take care of your personal needs such as dressing, bathing, toileting, eating independently, etc? □Yes □No I understand, Swiss Village is a Smoke‐Free Campus and smoking is not permitted anywhere on Swiss Village’s property at anytime. Signature:______________________________________ Do you require a special diet? (If so please indicate type of diet) Are you on any medication? (If so please indicate medication) Condition of Eyesight Condition of Hearing □Good □Fair □Poor □Good □Fair □Poor Have you had any of the following: □Stroke □Epileptic Attack □Heart Attack □Arthritis □Diabetes □Broken Hip or Limb □Mental Illness □Communicable Disease, such as Tuberculosis □Other Chronic Ailments Name of Physician Address of Physician
Phone ( ) ‐
INSURANCE Life Insurance Company: Amount: $ Premium: $ Beneficiary: Insurance Agent: Healthcare/Assisted Living Long Term Care Insurance: Daily Benefit: $ Length of Coverage: Insurance Provider: Intermediate Healthcare Coverage: □Yes □No Medicare Claim Number: (Please submit a copy of your Medicare Card)
Medicare Supplemental Insurance or Medicare Replacement Plan: Identification No.: Effective Date: Policy No. / Group No.: (Please submit a copy of your Medicare Supplement/Replacement Card)
WILL/ LIVING WILL/POWER OF ATTORNEY/HEALTHCARE REP Have you made a Will? □Yes □No If Yes, in whose possession is it now? Do you have a Power of Attorney? □Yes □No Name of Power of Attorney: (Please submit a copy of Power of Attorney Paperwork)
Do you have a Living Will? □Yes □No
Name of Dentist
(Please submit a copy of Living Will Paperwork)
Address of Dentist
Phone ( ) ‐ Name of Optometrist/Ophthalmologist Address of Optometrist
Phone ( ) ‐
Do you have a Healthcare Representative? □Yes □No Name of Healthcare Representative: (Please submit a copy of Healthcare Representative Paperwork)
Do you have a Guardian? □Yes □No Name of Guardian: (Please submit a copy of Guardian Paperwork)
OTHER INFORMATION Are you a Veteran? □Yes □No If Yes, Have you applied for Veteran Benefits? □Yes □No www.va.gov
Name and Address of Attorney: Phone: ( ) ‐ Have you transferred any property, real estate or personal, within five years prior to application? □Yes □No If Yes, Explain: Is someone willing to supplement your support if you should outlive your assets? If so who? I agree to make application for Public Assistance (Medicaid) when my resources are depleted. Signature:______________________________________________ To whom should the monthly statement be sent? Name: Address: Phone: ( ) Have funeral arrangements been made? □Yes □No If No, who is to make the arrangements? Name of Funeral Director: Address: Phone: ( ) ‐ Name and Location of Cemetery: Cemetery Lot Number: Cemetery Grave Marker: EMERGENCY CONTACT INFORMATION Name: Address: Phone: ( ) ‐ Cell Phone: ( ) ‐ Relationship: Name: Address: Phone: ( ) ‐ Cell Phone: ( ) ‐ Relationship:
FINANCIAL INFORMTION Checking Account: Savings Account: CD’s, Annuities, Stocks, Bonds, Mutual Funds: Real Estate (Home Value): Other Real Estate: Automobile (Auto 1): Automobile (Auto 2): Other Assets: Total Assets: INCOME His Monthly Social Security: Pension: Investments: Annuity: Other: Total Income $ EXPENSES Medication: Medical Supplement: Insurance Premiums: Transportation: Contributions: Telephone: Travel: Personal: Other Expenses: Total Expenses: LIABILITIES Mortgage: Credit Cards: Notes: Other Liabilities: Total Liabilities:
$ Her Monthly $ $ $
Joint Annually $
PREFERENCE OF ACCOMODATIONS Type and location of Room Preferred: Desired Date of Entrance:
Additional Remarks:
PAYMENT WITH APPLICATION – RESIDENTIAL AND INDEPENDENT LIVING (PAYMENT NOT APPLICABLE IF ENTERING HEALTH CARE DIRECTLY) Amount paid with application is $______________ which is a non‐refundable application processing fee. This does not apply toward the initial charge (facility fee) and is not deductible for tax purposes. I understand and agree that the acceptance of the amount paid with this application does not constitute acceptance or approval of the application, and the applicant must meet all other requirements for entrance into Swiss Village. The applicant agrees, at his/her expense, to submit to a physical examination before entering. This form will be supplied near the time of entrance. To the best of my knowledge, the foregoing answers are true and represent the facts fairly. I understand that this information is to be held confidential and to be used for the purpose of determining my eligibility for residence at Swiss Village. I agree not to impair my ability to meet financial obligations by transferring assets without consent of the Village, other than to meet ordinary and customary living expenses. Signature of Applicant: _________________________________________________ Date: / / Form filled out by (if other than applicant): _________________________________ Date: / / OFFICE USE ONLY ***All persons who wish to enter Swiss Village are Date Application Received: / / asked to furnish the information on this form. The information submitted, to be treated confidentially, Date of Payment of Application Processing Fee: / / is needed so that proper selection and evaluation may be made. When two persons are making application together, a separate application form Copy of Check Made: □Yes □No should be filled out by each. Applicants may find the help of a friend or member of the family desirable in Signed Disclosure Statement: □Yes □No filling out this form. Admitted: / / Room Number: Locker Number:
North Campus Map
South Campus Map
Duplex Homes “We lived in a Tri-Level before moving to our duplex, and we actually gained space, and we are on one level.”
Matterhorn en Kitc h 0 ’ 7” x1 12 ’
-Swiss Village North Campus Resident
a ge Ga r 2 1’ 2 1 ’x
TV
. o lC
Clo.
uit e ter S Ma s 12 ’-6” 4”x ’ 3 1
g Livin 1 ’ 6” x 2 13 ’- he d ra l t a C w/ i ng Ce il
Clo.
ath M. B
g D inin10’ 11’ x
Clo.
Bat h
Patio 12 ’ x 8’
Den ’ x 11 11 ’
Cl o. ro o m B ed 1 0’ 2 ” 8” x 11 ’
Den 18’ x10’
Bed room 13 ’-11 ”x 1 1’-9 ” Living/Dining 18’ x 21’-4”
Clo.
Bath
TV
TV Laundry 12’ x 6’
Clo.
• Attached Garage • Dishwasher, Refrigerator, Stove Included • Den • Full Size Kitchen • Living/ Dining Room • Patio • Two Bedrooms / Bathrooms
Clo.
B ath
2 Ca r Ga rage 21’ x 22 ’
Clo.
Ma ster B ed roo m 14 ’ 6” x 1 4’
Kitche n 16’ x 1 2 ’ Fo yer 4’ x 8’
Bernerhof Deluxe
“I don’t have to worry about anything. I only own the space inside the walls, if something goes wrong, Swiss Village takes care of it.”
-Swiss Village North Campus Resident
A/C
Bernerhof: Living Space 1,359 sq. ft. Payment Plan
Facility Fee
Traditional Plan
$65,906 $21,969
58.3% Refund Plan Facility Fee/ Monthly Plan
Fund Deposit
Total
Facility Fee Amortization
$87,875 First Year: Second Year: Third Year: Fourth Year: $54,966 $76,847 $131,813 First Year: Second Year: Third Year: Fourth Year: $65,906 $300 $65,906 First Year: Monthly Second Year: Facility Third Year: Fee Fourth Year:
$49,430 $32,953 $16,477 $0 $41,225 $27,483 $13,742 $0 $49,430 $32,953 $16,477 $0
Fund Deposit Amortization
Daily Rate*
During Years 5-10 of residency at a rate of approx. $305 per month Fully Refundable $76,847
$20.40
$20.40
Additional Monthly $20.40 Facility Fee of $300 Not Refundable
Bernerhof Deluxe: Living Space 1,435 sq. ft. Payment Plan
Facility Fee
Traditional Plan
$70,575 $23,525
58.3% Refund Plan Facility Fee/ Monthly Plan
Fund Deposit
Total
Facility Fee Amortization
$94,100 First Year: Second Year: Third Year: Fourth Year: $58,860 $82,290 $141,150 First Year: Second Year: Third Year: Fourth Year: $70,575 $300 $70,575 First Year: Second Year: Monthly Third Year: Facility Fee Fourth Year:
$52,931 $35,288 $17,644 $0 $44,145 $29,430 $14,715 $0 $52,931 $35,288 $17,644 $0
Fund Deposit Amortization
Daily Rate*
During Years 5-10 of residency at a rate of approx. $326 per month Fully Refundable $82,290
$21.40
$21.40
Additional Monthly $21.40 Facility Fee of $300 Not Refundable
Matterhorn: Living Space 1,444 sq. ft. Payment Plan
Facility Fee
Traditional Plan
$70,331 $23,444
58.3% Refund Plan Facility Fee/ Monthly Plan
Fund Deposit
Total
Facility Fee Amortization
$93,775 First Year: Second Year: Third Year: Fourth Year: $58,656 $82,007 $140,663 First Year: Second Year: Third Year: Fourth Year: $70,331 $300 $70,331 First Year: Monthly Second Year: Third Year: Facility Fee Fourth Year:
$52,748 $35,166 $17,583 $0 $43,992 $29,328 $14,664 $0 $52,748 $35,166 $17,583 $0
Fund Deposit Amortization
Daily Rate*
During Years 5-10 of residency at a rate of approx. $325 per month Fully Refundable $82,007
$21.40
$21.40
Additional Monthly $21.40 Facility Fee of $300 Not Refundable
Daily Rate* covers building insurance, lawn care, snow removal, trash pickup, water, sewer, cable television, and maintenance/
repairs to building and appliances.
Effective 6/1/2013
Independent Living g Sto ra
om edro
B Two
e
C l os
e Kitc h
et
“It is convenient to have a library, boutique, banking center, and hair salon all in one place.” -Swiss Village Resident
n
roo m B ed
Kitche n
oo m Be dr
g/ Livin g Dinin
Storage
Living/ Dining
Pa tio
• Attached Garage • Dishwasher, Refrigerator, Stove Included • Full Size Kitchen • Living/ Dining Room • Patio “Swiss Village is one of the finest retirement homes available.”
Patio
Bedroo m
One Bedroom
-Swiss Village Resident
Independent Living Apartments: Basel & Zermatt Haus Apartment Traditional Plan One Bedroom Apartment
Facility Fund Fee Deposit $34,425 $11,475
(724 Sq. Ft.)
Monthly Plan One Bedroom Apartment
$8,606
Included in Daily Facility Fee
(724 Sq. Ft.)
Traditional Plan Two Bedroom Apartment
$48,581 $16,194
Monthly Plan Two Bedroom Apartment
$12,145
(1007 Sq. Ft.)
Included in Daily Facility Fee
(1007 Sq. Ft.)
Total
Facility Fee Amortization $45,900 First Year: $25,818 Second Year: $17,212 Third Year: $8,606 Fourth Year: $0 $8,606 Additional Daily Plus Additional Facility Fee scheduled Daily Facility to end after 84 months Fee
Fund Deposit Amortization During Years 5-10 of residency at a rate of approx. $159 per month
$64,775 First Year: $36,435 Second Year: $24,290 Third Year: $12,145 Fourth Year: $0 $12,145 Additional Daily Plus Additional Facility Fee scheduled Daily Facility Fee to end after 84 months
During Years 5-10 of residency at a rate of approx. $225 per month
N/A
N/A
Daily Rate* $20.10
$37.10
$20.60
$44.55
Independent Living Apartments: Zurich & Lucerne Haus Apartment
Facility Fee
Fund Deposit
Traditional Plan One Bedroom Apartment
$32,138 $10,712
(636 Sq. Ft.)
Monthly Plan One Bedroom Apartment
$8,034
Included in Daily Facility Fee
(636 Sq. Ft.)
Traditional Plan Two Bedroom Apartment
$45,900 $15,300
(917 Sq. Ft.)
Monthly Plan Two Bedroom Apartment
$11,475
w/ Additional Daily Fee
(917 Sq. Ft.)
Included in Daily Facility Fee
Total
Facility Fee Amortization
Fund Deposit Amortization
Daily Rate*
$42,850 First Year: $24,103 Second Year: $16,068 Third Year: $8,034 Fourth Year: $0 $8,034 Additional Daily Plus Additional Facility Fee scheduled Daily Facility Fee to end after 84 months
During Years 5-10 of residency at a rate of approx. $149 per month
$19.90
$61,200 First Year: $34,425 Second Year: $22,950 Third Year: $11,475 Fourth Year: $0 $11,475 Additional Daily Plus Additional Facility Fee scheduled Daily Facility Fee to end after 84 months
During Years 5-10 of residency at a rate of approx. $213 per month
N/A
N/A
$35.75
$20.40
$43.05
Daily Rate*: The daily rate covers building insurance, lawn care, snow removal, trash pickup, water, sewer, laundry facilities, cable television, housekeeping of common areas, and maintenance/repairs to building and appliances. (The monthly plan daily rate includes an additional fee for facility fee and fund deposit.) Attached garages are available for an additional $50.00 per month. Traditional Plan Facility Fee and Fund Deposit: The facility fee is amortized over a four year period and is only refundable if the resident leaves Swiss Village or passes away. The entire fund deposit is refundable through the fourth year of residency. During the fifth through tenth year of residency, the fee is amortized according to the above schedule. Monthly Plan: Non-refundable.
Effective 6/1/2013
Residential Living “There are so many activities available. We can be as active as we desire.”
Bath
Storage
- Swiss Village Resident
Living Bedroom Alcove Alcove Unit
Living Bedroom Kitchen/ Dining
• Emergency Call System • Three Meals Daily in Main Dining Room
One Bedroom Unit
• Weekly Housekeeping Services
Residential Living Apartment
Square Feet (approx.)
Studio Apartment Langfeld & Steingarten
250-330
Alcove Apartment Steingarten
410
Alcove Apartment Langfeld
435
Studio Apartment Langfeld
495
One Bedroom Apartment Langfeld & Steingarten One Bedroom Apartment Langfeld
620
742
Facility Fee
Facility Fee Amortization
$15,300 First Year: Second Year: Third Year: Fourth Year: $22,700 First Year: Second Year: Third Year: Fourth Year: $25,500 First Year: Second Year: Third Year: Fourth Year: $30,600 First Year: Second Year: Third Year: Fourth Year: $38,775 First Year: Second Year: Third Year: Fourth Year: $41,825 First Year: Second Year: Third Year: Fourth Year:
$11,485 $7,650 $3,825 $0 $17,025 $11,350 $5,675 $0 $19,125 $12,750 $6,375 $0 $22,950 $15,300 $7,650 $0 $29,081 $19,387 $9,693 $0 $31,368 $20,912 $10,456 $0
Daily Rate* $49.15
Double Occupancy Rate* N/A
$50.60
N/A
$51.90
N/A
$75.90
N/A
$75.90
$101.20
$77.90
$105.20
Daily Rate* The daily rate includes cable television, laundry facilities, maintenance/repairs, three meals daily, utilities, and weekly housekeeping. Healthcare Discount Residents who have paid a facility fee of $15,300 or more are eligible for a discount of $8.75 per day in healthcare once apartment has been vacated.
Effective 6/1/2013
Assisted Living “I love all of the activities at Swiss Village. There is always something to do.” - Swiss Village Resident.
• Bathing Assistance • Medication Management • Personal Laundry Services • Scheduled Activities
750 Sq
. Ft.
588 Sq. Ft.
• Three Meals Daily • Weekly Housekeeping
Assisted Living: Blumengarten Apartment/ Square Feet (approx.) One Bedroom Apartment (475 Sq. Ft.) One Bedroom Apartment (588 Sq. Ft.) One Bedroom Apartment (750 Sq. Ft.)
Facility Fee
Facility Fee Amortization
$27,330 First Year: $20,497.50 Second Year: $13,665.00 Third Year: $6,832.50 Fourth Year: $0 $34,190 First Year: $25,642.50 Second Year: $17,095.00 Third Year: $8,547.50 Fourth Year: $0 $43,610 First Year: $32,707.50 Second Year: $21,805.00 Third Year: $10,902.50 Fourth Year: $0
Daily Rate Single Occupancy*
Double Occupancy Rate*
$93.50
N/A
$98.50
$157.60
$103.50
$165.60
Daily Rate* The daily rate includes assistance with bathing, cable television, laundry services, maintenance/repairs, medication management, three meals daily in Blumengarten dining room, utilities, and weekly housekeeping. Healthcare Discount Residents who have paid a facility fee of $15,300 or more are eligible for a discount of $8.75 per day in healthcare once apartment has been vacated.
Effective 6/1/2013
Rehab / Healthcare Short Term Rehabilitation
• Private Furnished Suites • Private Bath w/ Walk-in Shower • Flat Screen TV and Cable • Wireless Internet and Phone • Private Entrance and Parking • Therapy Services
Healthcare
• Daily Activities • Dementia Care Unit • Medicare & Medicaid Certified • Private Rooms • Semi Private Rooms • Skilled & Intermediate Care • Therapy Services Alpenrose Place
Edelweiss Place
s
b Suite
Reha Private
Lavendel Place
Sonnenblum Place
Short Term Rehabilitation Room Private Furnished Suite
Square Feet
Daily Rate Intermediate Care
250 $265.50
Daily Rate Skilled Care $265.50
Healthcare Room Semi-Private Room Sonnenblum
Square Feet
Daily Rate Intermediate Care
Daily Rate Skilled Care
218-276 $175.60
$196.70
Private Room Sonnenblum
205 $190.55
$211.65
Semi-Private Room Lavendel
316 $182.60
$203.70
Private Room Lavendel
197 $196.75
$217.85
Semi-Private Room Alpenrose (Dementia Care)
319 $192.10
$213.20
Private Room Alpenrose (Dementia Care)
197 $206.25
$227.35
Private Room Shared Bathroom Edelweiss
240 $197.75
$218.85
Private Room Shared Bathroom Edelweiss
270 $200.35
$221.45
Private Room Private Bathroom Edelweiss
250 $203.60
$224.70
Private Room Private Bathroom Edelweiss
260 $204.50
$225.60
Private Room Private Bathroom Edelweiss
315 $209.30
$230.40
Private Room Private Bathroom Edelweiss
380 $214.95
$236.05 Effective 6/1/2013
Swiss Village Celebrate Retirement... Engage Life!
Berne, Indiana 260.589.3173 www.swissvillage.org
Retirement Living At Swiss Village Situated on 185 acres of beautifully landscaped and gently rolling land, Swiss Village residents are free to experience a peaceful, rural setting, surrounded by five ponds and walking paths. Picturesque views can be found at Swiss Village each season of the year. Swiss Village offers small town living with all of the comforts of home. As the area’s premier continuing care retirement community, residents may choose from a variety of living options to meet their ongoing needs.
• • • • • •
Duplex Homes Independent Living Apartments Residential Apartments Assisted Living Apartments Healthcare & Dementia Care Therapy Services
Celebrate Retirement...
Community Life An on-site banking center, boutique, hair salon, computer lab with internet, library, woodworking shop, a variety of craft classes, and intergenerational programming all can be enjoyed by Residents of Swiss Village. Residents may engage in regularly scheduled activities and trips, or may sit back and savor the contentment of Swiss Village’s community life. In addition, Residents may take advantage of The Arthur & Gloria Muselman Wellness Pavilion, which provides a resort style of living with its aquatic center, cardio and strength training equipment, fitness classes, jacuzzi, and massage therapy. Residents may also enjoy wireless internet while lounging by the fire with a cup of coffee.
Engage Life!
Independent Living Swiss Village’s North Campus is a neighborhood of 28 duplex homes located near the Arthur & Gloria Muselman Wellness Pavilion. Swiss Village’s main campus is the home of 52 independent congregate living apartments with attached garages. Residents residing in a duplex or independent living apartment receive peace of mind by freeing themselves from the responsibilities of yard work and home maintenance. Each duplex and apartment is equipped with an emergency call system. In the event that healthcare services are needed, residents are given precedence over individuals living outside of the Swiss Village Community. “Swiss Village is one of the finest retirement homes available.” -Swiss Village Resident
Celebrate Retirement...
Residential and Assisted Living A variety of residential and assisted living apartments are available on Swiss Village’s main campus. Residents living in residential apartments receive weekly housekeeping services and three meals a day in the main dining room. Assisted living apartments are available for residents who may need additional assistance with certain activities of daily living. Apartments range in size from one bedroom units to studio units. Each apartment is equipped with an emergency call system. In the event that healthcare services are needed, residents are given precedence over individuals living outside of the Swiss Village Community.
Engage Life!
Healthcare and Dementia Care Swiss Village offers 128 skilled and intermediate care healthcare beds, and is certified to provide Medicare and Medicaid services. Semi-private and private rooms available. Alpenrose Place is a unique healthcare setting within Swiss Village that is dedicated to making a constructive difference in the lives of those who have memory loss. It is specifically designed and staffed for residents who have functional limitations resulting from Alzheimer’s Disease or other disorders that impair memory. Alpenrose Place is a secured environment that is well supervised with a high staff to resident ratio. Swiss Village staff is committed to the preservation of the personal dignity of each resident and to providing life engaging opportunities for them for as long as possible.
Celebrate Retirement...
Healthcare Services Our competitive daily rates include three meals a day, utilities, laundry services, and required nursing care, with qualified nurses on duty 24-hours a day. All rooms have telephone and television hook-ups, with some rooms equipped for computer internet access. A variety of daily activities are available based on the individual’s needs, ability levels, and interests. Community lounges are open to family members and guests.
Therapy Services Individualized therapy services are available for residents living at Swiss Village. Therapists and care teams create therapy programs specific to individual recovery goals. Services include physical, occupational, and speech therapy.
Engage Life!
Swiss Village 1350 W. Main Street Berne, Indiana 46711
Swiss Village Mission Statement Swiss Village Retirement Community is a not-for-profit corporation committed to providing quality services and affordable facilities in a Christian environment that enhances life with dignity, meaning, and opportunities for growth. Swiss Village does not discriminate on the basis of race, color, religion, national origin, sex, or handicaps.
260.589.3173 • www.swissvillage.org
5HKDELOLWDWLRQ 6HU YLFHV
5 H K D ELOLWD WLR Q 3U R JU D P V
WŚLJƐŝĐĂů dŚĞƌĂƉLJ KĐĐƵƉĂƟŽŶĂů dŚĞƌĂƉLJ ^ƉĞĞĐŚ >ĂŶŐƵĂŐĞ WĂƚŚŽůŽŐLJ /ŶƉĂƟĞŶƚ ZĞŚĂďŝůŝƚĂƟŽŶ KƵƚƉĂƟĞŶƚ dŚĞƌĂƉLJ tĞĞŬĞŶĚ dƌĞĂƚŵĞŶƚƐ ,ŽŵĞ ^ĂĨĞƚLJ ŶĂůLJƐŝƐ ĚĂƉƟǀĞ ƋƵŝƉŵĞŶƚ ǀĂůƵĂƟŽŶ ZĞŚĂďŝůŝƚĂƟǀĞ EƵƌƐŝŶŐ &ĂŵŝůLJ Θ WĂƟĞŶƚ ĚƵĐĂƟŽŶ WƌĞǀĞŶƟŽŶ Θ tĞůůŶĞƐƐ ĚƵĐĂƟŽŶ ĂůĂŶĐĞ dƌĂŝŶŝŶŐ Θ &Ăůů WƌĞǀĞŶƟŽŶ ŽŵŵƵŶŝƚLJ ZĞŝŶƚĞŐƌĂƟŽŶ tŽƌŬĞƌ͛Ɛ ŽŵƉĞŶƐĂƟŽŶ
:ŽŝŶƚ ZĞƉůĂĐĞŵĞŶƚ KƌƚŚŽƉĂĞĚŝĐ ŽŶĚŝƟŽŶƐ WŽƐƚ ĂƌĚŝĂĐ ^ƵƌŐĞƌŝĞƐ ^ƚƌŽŬĞͬ s &ƌĂĐƚƵƌĞƐ ĚĞŵĂ DĂŶĂŐĞŵĞŶƚ WĂŝŶ DĂŶĂŐĞŵĞŶƚ EĞƵƌŽůŽŐŝĐĂů ŽŶĚŝƟŽŶƐ EĞƵƌŽƉĂƚŚLJ DƵůƟƉůĞ ^ĐůĞƌŽƐŝƐ ŵƉƵƚĂƟŽŶ ^LJƐƚĞŵŝĐ sĂƐĐƵůĂƌ ŝƐĞĂƐĞ ƌƚŚƌŝƟƐ LJƐƉŚĂŐŝĂ ;^ǁĂůůŽǁŝŶŐͿ 'ĞŶĞƌĂůŝnjĞĚ tĞĂŬŶĞƐƐ ĞŵĞŶƟĂ ĂƌĞ
&HOHEUDWH 5HWLUHPHQW (QJDJH /LIH
0HGLFDUH &RYHUDJH L Q 6 KR U W WH U P 5 HKD E LOLWD WLR Q ŽŶƚĂĐƚ ƵƐ ĨŽƌ ŝŶĨŽƌŵĂƟŽŶ ŽŶ ŚŽǁ dƌĂĚŝƟŽŶĂů DĞĚŝĐĂƌĞ ĂŶĚ DĞĚŝĐĂƌĞ ƌĞƉůĂĐĞŵĞŶƚ ƉůĂŶƐ ĐĂŶ ĂƐƐŝƐƚ ŝŶ ƉƌŽǀŝĚŝŶŐ ĐŽǀĞƌĂŐĞ ĨŽƌ LJŽƵƌ ƐƚĂLJ͘
>ŝŶĚĂ ƌŶŽůĚ͕ ĚŵŝŶŝƐƚƌĂƚŽƌ ϮϲϬ͘ϱϴϵ͘ϯϭϳϯ ůŝŶĚĂĂƌΛƐǁŝƐƐǀŝůůĂŐĞ͘ŽƌŐ
ŚƌŝƐƟŶĞ ĂŝůĞLJ͕ ĚŵŝƐƐŝŽŶƐ ŽŽƌĚŝŶĂƚŽƌ ϮϲϬ͘ϱϴϵ͘ϯϭϳϯ ĐŚƌŝƐƟŶĞďΛƐǁŝƐƐǀŝůůĂŐĞ͘ŽƌŐ
^ǁŝƐƐ sŝůůĂŐĞ ZĞƟƌĞŵĞŶƚ ŽŵŵƵŶŝƚLJ ĚŽĞƐ ŶŽƚ ĚŝƐĐƌŝŵŝŶĂƚĞ ŽŶ ƚŚĞ ďĂƐŝƐ ŽĨ ƌĂĐĞ͕ ĐŽůŽƌ͕ ƌĞůŝŐŝŽŶ͕ ŶĂƟŽŶĂů ŽƌŝŐŝŶ͕ ƐĞdž Žƌ ŚĂŶĚŝĐĂƉƐ͘
: 0DLQ 6WUHHW %HUQH ,1 ZZZ VZLVVYLOODJH RUJ
+($/7+
5(+$%,/,7$7,21
7KHUDS\ *HWV <RX %DFN WR /LYLQJ dŚĞ ƌĞŚĂďŝůŝƚĂƟŽŶ ƚĞĂŵ Ăƚ ^ǁŝƐƐ sŝůůĂŐĞ ŝƐ ĐŽŵŵŝƩĞĚ ƚŽ ŚĞůƉŝŶŐ LJŽƵ ĂĐŚŝĞǀĞ LJŽƵƌ ƌĞĐŽǀĞƌLJ ŐŽĂůƐ͘ KƵƌ ŐŽĂů ŝƐ ƚŚĞ ƐĂŵĞ ĂƐ LJŽƵƌƐ͙ĨŽƌ LJŽƵ ƚŽ ŚĂǀĞ ƚŚĞ ŵŽƐƚ ĐŽŵƉůĞƚĞ ƚŚĞƌĂƉLJ ĨŽƌ Ă ĨƵůůĞƌ ĂŶĚ ĨĂƐƚĞƌ ƌĞĐŽǀĞƌLJ͘
+HDOWK 5HKDELOLWDWLRQ DW
^ǁŝƐƐ sŝůůĂŐĞ ZĞƟƌĞŵĞŶƚ ŽŵŵƵŶŝƚLJ ŝƐ Ă ŶŽƚͲĨŽƌͲƉƌŽĮƚ ĐŽƌƉŽƌĂƟŽŶ ĐŽŵŵŝƩĞĚ ƚŽ ƉƌŽǀŝĚŝŶŐ ƋƵĂůŝƚLJ ƐĞƌǀŝĐĞƐ ĂŶĚ ĂīŽƌĚĂďůĞ ĨĂĐŝůŝƟĞƐ ŝŶ Ă ŚƌŝƐƟĂŶ ĞŶǀŝƌŽŶŵĞŶƚ ƚŚĂƚ ĞŶŚĂŶĐĞƐ ůŝĨĞ ǁŝƚŚ ĚŝŐŶŝƚLJ͕ ŵĞĂŶŝŶŐ͕ ĂŶĚ ŽƉƉŽƌƚƵŶŝƟĞƐ ĨŽƌ ŐƌŽǁƚŚ͘ tĞ ƚĂŬĞ ƉƌŝĚĞ ŝŶ ƐĞƌǀŝŶŐ ŽƵƌ ĐŽŵŵƵŶŝƚLJ͕ ĂŶĚ ĂƌĞ ĐŽŵŵŝƩĞĚ ƚŽ ŽīĞƌŝŶŐ ƚŚĞ ĐĂƌĞ ĂŶĚ ƐƵƉƉŽƌƚ LJŽƵ ŶĞĞĚ ƚŽ ĂĐŚŝĞǀĞ ƚŚĞ ŵŽƐƚ ĐŽŵƉůĞƚĞ ƌĞĐŽǀĞƌLJ ƉŽƐƐŝďůĞ͘
KƵƌ ƚŚĞƌĂƉŝƐƚƐ ĂƌĞ ƚŚĞ ĞdžƉĞƌƚƐ ŝŶ ĂĚƵůƚ ƌĞŚĂďŝůŝƚĂƟŽŶ ĂŶĚ ǁŽƌŬ ǁŝƚŚ LJŽƵ ŽŶĞͲ ŽŶͲŽŶĞ ǁŝƚŚ Ă ƚƌĞĂƚŵĞŶƚ ƉůĂŶ ĚĞǀĞůŽƉĞĚ ďLJ LJŽƵƌ ƉŚLJƐŝĐŝĂŶ ƚŚĂƚ ĨŽĐƵƐĞƐ ŽŶ LJŽƵƌ ƐƉĞĐŝĮĐ ĐŽŶĚŝƟŽŶ͘
([FHOOHQFH LQ 5HKDELOLWDWLRQ
WƌŝǀĂƚĞ ZĞŚĂď ^ƵŝƚĞƐ ĚĞƐŝŐŶĞĚ ĨŽƌ ďĞƩĞƌ ŵŽďŝůŝƚLJ ^ĞƉĂƌĂƚĞ ĚƌŝǀĞͲƵƉ ƌĞŚĂď ĞŶƚƌĂŶĐĞ ĂŶĚ ƉĂƌŬŝŶŐ ůŽƚ ĂƐLJ ĂĐĐĞƐƐ ƚŽ ƐĞƉĂƌĂƚĞ ƚŚĞƌĂƉLJ ŐLJŵ ŶĞdžƚ ƚŽ ƌĞŚĂď ĐĞŶƚĞƌ >ĞĂĚŝŶŐ ƚŚĞƌĂƉLJ ƚĞĐŚŶŽůŽŐLJ ĚĞƐŝŐŶĞĚ ƚŽ ĞůŝŵŝŶĂƚĞ ƉĂŝŶ͕ ŝŶŇĂŵŵĂƟŽŶ ĂŶĚ ƐƉĞĞĚ ƵƉ ŚĞĂůŝŶŐ
ϭϰ WƌŝǀĂƚĞ &ƵƌŶŝƐŚĞĚ ZĞŚĂď ^ƵŝƚĞƐ
&ůĂƚ ^ĐƌĞĞŶ ds͕ ĐĂďůĞ ĂŶĚ ƉŚŽŶĞ tŝͲ&ŝ
WƌŝǀĂƚĞ ďĂƚŚ ǁŝƚŚ ǁĂůŬͲŝŶ ƐŚŽǁĞƌ
(YLGHQFH EDVHG 7UHDWPHQW
WƌŝǀĂƚĞ ĞŶƚƌĂŶĐĞ ĂŶĚ ƉĂƌŬŝŶŐ
ZĞƐƚĂƵƌĂŶƚͲƐƚLJůĞ ĚŝŶŝŶŐ ŝŶ ƉƌŝǀĂƚĞ ĚŝŶŝŶŐ ƌŽŽŵ
dƌĂŶƐƉŽƌƚĂƟŽŶ ŽŽƌĚŝŶĂƚŽƌ
KƵƌ ƚŚĞƌĂƉŝƐƚƐ ƵƐĞ ƚŚĞ ŵŽƐƚ ƌĞƐĞĂƌĐŚĞĚ ĂŶĚ ƐƵĐĐĞƐƐĨƵů ƚŚĞƌĂƉĞƵƟĐ ŝŶƚĞƌǀĞŶƟŽŶƐ ƚŽ ƚƌĞĂƚ LJŽƵƌ ƐƉĞĐŝĮĐ ĐŽŶĚŝƟŽŶ͘ ^ǁŝƐƐ sŝůůĂŐĞ ƚŚĞƌĂƉŝƐƚƐ ƵƐĞ ƉƌŽǀĞŶ ƉƌĂĐƟĐĞƐ ŝŶ ŽƌƚŚŽƉĂĞĚŝĐ͕ ŶĞƵƌŽůŽŐŝĐĂů͕ ĂŶĚ ĐĂƌĚŝĂĐ ĐĂƌĞ͕ ŵĂŶƵĂů ƚŚĞƌĂƉŝĞƐ ĂƐ ǁĞůů ĂƐ ƚŚĞ ůĂƚĞƐƚ ŝŶ ƌĞŚĂď ƚĞĐŚŶŽůŽŐLJ ĂŶĚ ĞdžĞƌĐŝƐĞ ĞƋƵŝƉŵĞŶƚ͘
dƌĂŶƐƉŽƌƚĂƟŽŶ sĂŶ ĂĨĠ ^ƵŝƐƐĞ ƐĞƌǀŝŶŐ ƐƉĞĐŝĂůƚLJ ĐŽīĞĞƐ͕ ƐĂŶĚǁŝĐŚĞƐ ĂŶĚ ƐŶĂĐŬƐ
6DIH 7UDQVLWLRQLQJ
ϵϬй
KƵƌ ƌĞŚĂď ĐůŝĞŶƚƐ ƌĞƚƵƌŶ ŚŽŵĞ ĨĂƐƚĞƌ ĂŶĚ ƐƚƌŽŶŐĞƌ ƚŚĂŶ ƚŚĞ ŶĂƟŽŶĂů ĂŶĚ ƐƚĂƚĞ ĂǀĞƌĂŐĞ͘
ϳ
z^
KƵƌ ƚŚĞƌĂƉŝƐƚƐ ĂƌĞ ƚŚĞ ĞdžƉĞƌƚƐ ŝŶ ƚƌĞĂƟŶŐ ŽƌƚŚŽƉĂĞĚŝĐ͕ ŶĞƵƌŽůŽŐŝĐĂů ĂŶĚ ĐĂƌĚŝĂĐ ĐŽŶĚŝƟŽŶƐ ĞīĞĐƟŶŐ ŽůĚĞƌ ĂĚƵůƚƐ͘ /ŶƉĂƟĞŶƚ ĂŶĚ ŽƵƚƉĂƟĞŶƚ ƚŚĞƌĂƉLJ ŝƐ ƉƌŽǀŝĚĞĚ ϳ ĚĂLJƐ Ă ǁĞĞŬ͘
ĞĨŽƌĞ ƌĞƚƵƌŶŝŶŐ ŚŽŵĞ͕ Ă ŚŽŵĞ ƐĂĨĞƚLJ ĂŶĂůLJƐŝƐ ŝƐ ƉĞƌĨŽƌŵĞĚ ƚŽ ĞŶƐƵƌĞ ƚŚĂƚ ĞĂĐŚ ƉĞƌƐŽŶ ƐƚĂLJƐ ƐĂĨĞ ĂĨƚĞƌ ůĞĂǀŝŶŐ ŽƵƌ ĐĂƌĞ͘ ƚ ƚŚŝƐ ƚŝŵĞ͕ LJŽƵƌ ƚŚĞƌĂƉŝƐƚ ŵĂLJ ƌĞĐŽŵŵĞŶĚ ŚŽŵĞ ĞdžĞƌĐŝƐĞƐ͕ ŽƵƚƉĂƚŝĞŶƚ ƚŚĞƌĂƉLJ ĂŶĚ ǁĞůůŶĞƐƐ ƉƌŽŐƌĂŵƐ ƚŽ ŬĞĞƉ LJŽƵ ƐƚƌŽŶŐ ĂŶĚ ƚŽ ƉƌĞǀĞŶƚ ĨƵƚƵƌĞ ŝŶũƵƌŝĞƐ͘ ^ǁŝƐƐ sŝůůĂŐĞ ŵĂŝŶƚĂŝŶƐ ƚŚĞ ŚŝŐŚĞƐƚ ƐƚĂŶĚĂƌĚƐ ǁŝƚŚ ƌĞƐƉĞĐƚ ƚŽ ƐĂĨĞƚLJ͕ ĐůĞĂŶůŝŶĞƐƐ ĂŶĚ ƚƌĂŝŶŝŶŐ ŽĨ ŽƵƌ ĞdžƉĞƌŝĞŶĐĞĚ ĂŶĚ ĚĞĚŝĐĂƚĞĚ ƐƚĂĨĨ͘ Ɛ Ă ƌĞƐƵůƚ͕ LJŽƵ ĐĂŶ ďĞ ƐƵƌĞ ƚŽ ƌĞĐĞŝǀĞ ĞdžĐĞƉƚŝŽŶĂů ĐĂƌĞ ĨƌŽŵ ĚĞĚŝĐĂƚĞĚ ĂŶĚ ĐŽŵƉĂƐƐŝŽŶĂƚĞ ŚĞĂůƚŚ ĐĂƌĞ ƉƌŽĨĞƐƐŝŽŶĂůƐ͘
• High / Low Impact Cardio • Relaxation / Stretching • Toning / Conditioning • Water Aerobics / Water Walking • Water Arthritis “Swiss Village’s Community Wellness Center exists to improve the quality of life experience for all members by providing the facilities, equipment, programs, and staff to nurture wellness.”
Changing lives now!
• Balance
S
F ree F i tne s s C l asses
Pa ® w s No eaker Sn er v l i
1:00 p.m. - 5:00 p.m.
P
Sunday
in er ss ne t i F
7:00 a.m. - 4:00 p.m.
n rt
Saturday
am
5:00 a.m. - 6:00 p.m.
gr ro
Friday
th
Monday - Thursday 5:00 a.m. - 9:00 p.m.
Wi g
O p e rat i on
(260) 589.4496 • www.swissvillage.org • 1201 Emmental Drive • Berne, Indiana 46711
of
Non-Profit Organization U.S. Postage Paid Berne, IN 46711 Permit No 71
H ours
Arthur & Gloria
Muselman
Wellness Pavilion
Swiss Village, Inc. Berne, Indiana (260) 589-4496 www.swissvillage.org
A menit i e s
M em b e r sh i p O pportunities
• Aquatic Facility w/ Jacuzzi
Monthly Membership (with yearly contract agreement, no sign-up fee)
• Billiards • Cardio Fitness, Precor Tredmills, Ellipticals, AMTs, Recumbent Bikes, Nu-Steps
Adult Membership
$45.00
Family Membership (Household)
$65.00
• Coffee Bar
Monthly Membership
• Fitness Classes
S e r vice s
• Locker Rooms w/ Showers
• Child Watch
• Multi-Use Room w/ Kitchen (additional charge) • Nintendo Wii & Tag Free Weights
Adult Membership
$50.00
Family Membership (Household)
$80.00
• Body Assessments • Health Education
• Strength Training, Paramount Strength Machines
(without yearly contract agreement, no sign-up fee)
• Massage Therapy / Treatments
Daily Rates Individual Non-Members
Family Non-Members (Household) $10.00
• Personal Training Sessions • Swim Lessons, American Red Cross Certified • Weekly Blood Pressure Checks • Weight Loss Programs
$7.50
Membership Discounts Swiss Village Residents
Free
Swiss Village Employees
50% off
One Personal Training Session Free Fitness Classes
Free
SilverSneakers® Fitness Program “Exercise is like a savings account. The more you put in, the more you are going to get out of it.”
-Ron Ekovich
For Registration Information Visit www.swissvillage.org Monthly memberships paid via EFT are withdrawn on the first business day of the month. Monthly membership paid by check or cash require an additional $5.00 processing fee. ***