/ “Sharing Our World with You”
Midwest Regional Disability Lifestyle
Conference and Expo

2007 Registration Form

I. Attendee Registration

Last Name / First Name
Professional Designation / Nickname for Badge
Company / School (for students)
Address
City / State / Zip Code
Phone (Primary) / Phone (Alternate) / Fax
eMail Address

Please check here if you require communication accommodations, alternative format
materials or special services. Please attach a written description of your needs.

  1. Personal Care Assistant Registration

One registration fee waived however the PCA must pay for lunch & reception.

Last Name / First Name
Professional Designation / Nickname for Badge

III. Conference Registration Fees

Registration (both days) / Fee /
Total
Members of Therapeutic Recreation Directory Newsletter / $75

Optional

/ Qty /
Total
Reception / $ 0
Box Lunch, Choice= / $ 0
Continuing Education Units / $ 10
Parking – OSU – Per Day / $ 3
TOTAL

Registration is limited to 200 applicants.

“Sharing Our World with You”

Midwest Regional Disability Lifestyle
Conference and Expo

Instructions

IV. Conference Schedule
Saturday September 29, 2007
8:00 – 9:15 / Vendors/Exhibitors Set-Up in Exhibit Hall (Davis Gymnasium)
9:30 /

Registration and Exhibit Hall Opens

10:00 – 10:15 / Rosemarie Rossetti -Opening Welcome Session
10:30 – 11:45 / Concurrent Breakout Sessions
A) Bill Kipp-Fast Defense
B) Debbie Clement – Rainbows Within Reach
C) Tom Fish & Jillian Ober – The Ohio Americorp Inclusion Project
12:00 – 1:15 / Box Lunch
Performances by Dancing Wheels \ Artist with Disabilities
1:30 – 2:30 / Adaptive Sports Demonstrations
A) Tennis (outdoor)
B) Bill Kipp - Fast Defense
C) Trey Bates - Wheelchair Basketball Gym court 1
D) Brett Harbage - Wheelchair Quad Rugby Gym court 2
2:45 – 4:00 / Concurrent Breakout Sessions
A) Mary Verdi: Fletcher-Dancing Wheels
B) Mary Hiland: Ski for Light-
C) Joe Szafarowicz – I-LIVE arts program and Nate Thomson - Photographic Project
4:15 – 5:15 / Adaptive Sports Demonstrations
A) Beep Baseball (outdoor)
B) Bill Kipp - Fast Defense
C) Trey Bates - Wheelchair Basketball Gym court 1
D) Brett Harbage - Wheelchair Quad Rugby Gym court 2
5:30 – 6:30 / Adjourn – Vendor Exhibit tear down
7:00 – 10:00 / Dr William Bauer PhD. - Reception at Ohio Stadium Huntington Club
Sunday September 30, 2007
10:00 – 11:15 / Concurrent Breakout Sessions
A) Patty Mitchell – Community Arts Programs
B) Brett Harbage & Andy Mollica Sled Hockey
C) Connie Goble & Nicola Eyre-Winning 4-H Plan
11:30 – 1:00 / Lunch – On Your Own
1:00 – 2:15 / Concurrent Breakout Sessions
A) Nutrition
B) Gary Russell & Krysta Rife – GOLF
C) LaWonda Cook – ALL WORK & NO PLAY – NO WAY
2:15 – 2:30 /
Break
2:30 – 3:45 / Concurrent Breakout Sessions
A) Dr. Bill Bauer – Competitive Swimming: An Inclusive Sport
B) Jill McQuaid –Changing Lives of Families Through Adapted Fitness & Recreation
C) Bill Martell –Exercise & Disabilities
4:00 / Adjourn

Please number the breakout sessions you will attend in order of preference.

“Sharing Our World with You”

Midwest Regional Disability Lifestyle
Conference and Expo

Instructions

Conference Registration Instructions ( Be sure to complete both pages of the registration form.)

I Attendee Registration

  1. Please print all information.
  2. Use separate form for each attendee (except for personal assistant)
  3. Please check if you require communication accommodations, alternative format materials or special services.
  4. Please attach a written description of the special accommodations to the registration form.

II Personal Care Assistant Registration

  1. Only one (1) Personal Care Assistant registration fee will be waived per attendee.
  2. The Personal Care Assistant must pay for lunch and the reception.

III. Conference Registration Fees

  1. Registration is not complete without payment
  2. Special Recreation Therapy Registration fee is $75.
  3. Please indicate box lunch choice of Beef, Ham, Turkey or Vegetarian
  4. Registration is limited to 200 applicants.
  5. Continuing Education Units are available for an additional $10.00 fee.
  6. OSU parking passes are required of all vehicles to park on OSU campus.
  7. Payment must be in US dollars, checks or money orders.
  8. Payment may be made by check payable to “Friends of Therapeutic Recreation”
  9. NO refunds on registration cancellations made after Sept. 14, 2007.

IV. Conference Schedule

  1. Please number the breakout sessions you wish to attend in order of preference. (Please place a number to the left of the session selected)
  2. Some sessions may be limited in number of attendees.

Send Completed form to The conference is being held at


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