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Pioneer Program Registration Form Oak Brook Park District


www.obparks.org | (630) 645-9590 | registration@obparks.org Winter & Spring 2017 Registration | Separate households require separate forms. Part 1 Household Information


Names _____________________________________________________________________Birthdate (required):_______________________________ Address_____________________________________________________________________________________________________________________ City_________________________________________State____________________________Zip Code______________________________________


Phone_______________________________________Email Address__________________________________________________________________ (to receive email confirmations)


**Please indicate if a registrant has any dietary needs or requires any special accommodation or assistance for enjoyment of programs. Any request needs to be made at registration. _____________________________________ ____________________________________________________________________________________________________


Part 2 Program Registration Code


(please circle) 6661


6663 6669


6689 6760


6662 6751 6659 6748


6693 6749 6767 6648


6649 6660 6650


6651 Activity Brain Games


Second Thursday Bingo Rules Of the Road


AARP Smart Driver Course Museum of Broadcast “My Way”


Choose: Mediterranean Tilapia / Pepper Steak


“Saturday Night Fever” Choose:


Pecan crusted Tilapia Mulligan Stew


Macy’s Spring Flower Show


Choose: Oven Baked Meatloaf / Chicken Pot Pie / Caramelized Salmon


“South Pacific” at Fireside “My Fair Lady” at Lyric Opera “Relativity” at Northlight Theatre Movie Matinee Lady In the Van


Movie Matinee McFarland, USA Movie Matinee Brooklyn


Movie Matinee The Dressmaker


Movie Matinee Hello, My Name is Doris


Form continues on the back 4/5


4/20 5/10 6/7


1/26 2/23 3/23


4/27 5/25


$50/$56 Depart: Tennis Center Parking Lot.


$108/$114 Depart: Tennis Center Parking Lot. $90/$96


$100/$106 Depart: Tennis Center Parking Lot. FREE


FREE FREE FREE


FREE


Canterberry Room Canterberry Room Canterberry Room


Canterberry Room Canterberry Room


Total Fees Paid Roast Turkey / Date 3/6, 3/13, 3/20


1/12, 2/9, 3/9, 4/13, 5/11


2/17


2/28 & 3/1 1/11


2/15 2/22 3/14


R/NR Fee


FREE FREE


FREE $20


$67/$73 $83/$89 $54/$60 $77/$83


Location


Canterberry Room Canterberry Room


Canterberry Room Canterberry Room


Depart: Tennis Center Parking Lot. Depart: Tennis Center Parking Lot. Meet at Drury Lane Theatre Depart: Tennis Center Parking Lot.


Fees Paid


Depart: Tennis Center Parking Lot.


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