AMAZING Travel Camps — We’re headed to Universal Studios! NEW Leadership Sessions! REGISTER EARLY before

sessions reach max capacity!

VIA WEST CAMPUS

Proudly working with children, teens, and adults www.viaservices.org • 13851 Stevens Canyon Road, Cupertino, CA 95014

Tours available for new families. Please contact Katie Gilbreth 408-243-7861 or kgilbreth@viaservices.orgEmployment and volunteer opportunities available. Please contact Lisa Hernandez 408-243-7861 or lhernandez@viaservices.org

2017–2018 Fall, Winter, & Spring Programs

Katie Gilbreth is the Community Relations Manager and is responsible for bringing all new families to Via West Campus as well as recruiting for our special needs science camps.

Dave Gilbreth is the Via West Executive Chef and Services Manager, and is responsible for all of our direct food services as well as culinary programs.

Irshad Fardan is the Director of Via West and is responsible for overseeing all of the programs and providing leadership, supervision, and management.

Lisa Hernandez is the Associate Director of Operations and Staff for Via West and is responsible for co-managing the sessions, staffing, volunteers, behavior management, and camp logistics.

Via West Staff

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Dear Families, Friends, and Supporters,

Via Services is proud to present the 2017-2018 Via West Fall, Winter, and Spring Program Registration Catalog. At press time, we are completing our 2016-2017 season with our highest enrollments ever. We are honored to work alongside you to continue to grow our programs and provide the utmost quality in services.

Just within the past year, we have made some vast improvements to the facilities at Via West Campus. In the fall of 2016, with the help of KaBOOM!, the Sharks Foundation, and Groupware Technology, we constructed a brand new accessible playground on our main lawn. In March, we cut the ribbon on the Linda L. Lester Equestrian Center, formerly the horse corral, thanks to the wonderful contributions of Linda Lester. Ms. Lester generously donated $50,000 to continue to fund the Linda L. Lester Equestrian Program, which provided therapeutic riding for over 600 participants in 2016 and will continue to fund field trips to trail ride through the Stevens Creek Foothills at nearby Garrod Farms. In May, we unveiled the Sobrato Center for the Performing Arts, formerly the Huckleberry, which is our new state-of-the-art facility that will be the home of our performing arts programs, sensory room, and tech center.

We are pleased to announce that we are expanding our Adventures in Leadership program to include a third offering — Continuing Adventures in Leadership. Adults who have completed both Beginning and More Adventures in Leadership will have the opportunity to shine as a program leader in front of their peers while gaining valuable vocational skills for the future.

At Via West, we welcome everyone with open arms. We have a scholarship fund available for our Via West and Altitude families who cannot afford our private pay or regional center (RC) supplemental daily rates. We are so fortunate to work with you, our families, and we hope that you continue to make Via your home away from home.

Thank you for continuing to spread the word about Via West Campus. Without you, we would be the Bay Area’s best kept secret. See you all very soon!

Leslie Davis Executive Director

Shama Marshall is the Director of Altitude, and is responsible for the intake process of new participants, managing the sessions, and preparing the wonderful curriculum for Altitude programs.

Chelsea Farrington is the Associate Director of Programs and Grants for Via West and is responsible for co-managing the sessions, preparing the wonderful curriculum, and coordinating the grants.

FALL, WINTER, AND SPRING PROGRAM DESCRIPTIONSAll of our sessions are supported by a number of generous donors, including the Sobrato Family Foundation, the Leo M. Shortino Family Foundation, the Sharks Foundation, the Farrington Historical Foundation, the Adams Legacy Foundation, Palo Alto Community Fund, Mentor Graphics, and the San Jose Mercury News Wishbook. We would like to extend our gratitude to these wonderful organizations for their continued support of Via West and Altitude.

Traditional Day & Overnight Programs (Adults) Traditional Day & Overnight Programs (Kids/Teens/Young Adults)Traditional day and overnight programs provide independent living skills and executive functioning,

all while having so much fun. Activities will be themed to each weekend and will include culinary arts —including farm to table education, hiking, music, sports and physical fitness, dramatic arts, creative arts, and more. Check-in is from 5:00-6:00pm on Friday, and check-out is from 1:00-3:00pm on Sunday. Day program is available on Saturday only from 9:00am-8:00pm.

Travel Camp (Adults) Travel Camp (Kids/Teens/Young Adults)Travel camps give participants the chance to spend time exploring beyond their local community by experiencing overnight trips in a safe, nurturing environment. Check-in is from 7:00-8:00am on Friday, and check-out is from 5:00-6:00pm on Sunday. These opportunities are tailored to fit the needs of 3:1 participants. Those with a 2:1 ratio may be evaluated on a case-by-case basis to determine eligibility. There is no option for day program or for those requiring a 1:1 ratio.

Adventures in LeadershipLeadership programs are for 3:1 adults with developmental and/or physical disabilities who are ready to master relevant knowledge, skills, and attitudes for working at Via West in preparation for community work settings. Participants will engage in some of the typical camp activities as well as leadership specific activities wherein they will work on these specific skills. To enroll in Beginning Adventures in Leadership, participants must have completed at least two summer and/or weekend sessions within the past five years. To enroll in More Adventures in Leadership, participants must have completed at least one of the Beginning Adventures in Leadership programs. To enroll in Continuing Adventures in Leadership, participants must have completed both Beginning Adventures in Leadership and More Adventures in Leadership. Leadership sessions run concurrently with select traditional overnight programs. Check-in is from 5:00-6:00pm on Friday, and check-out is from 1:00-3:00pm on Sunday.

Golf Sports Clinic In collaboration with First Tee and due to a generous grant from the National Alliance for Accessible Golf, we are offering an 8-week sports clinic specializing in golf. Participation and teamwork will be emphasized. The point of this offering is to build everyone’s ability at a pace they are comfortable with and to the level that they are capable of. The most important factor will continue to be safety and learning, and of course, having fun! These programs are offered to all ages and ratios. Instructions and team building exercises will be integrated; however, the clinic itself will be separated by age groups. Lessons are offered either at 4:00pm or 6:00pm. We would like everyone to take advantage of this wonderful opportunity, and if transportation is an issue, please contact the Via West Admissions Manager at 408-243-7861, ext. 214 to arrange.

Older Teens and Young Adults WeekendBack by popular demand is our weekend designed specifically for older teens and young adults. This program focuses on establishing a network of friends, mastering life skills, and developing confidence in the adult world. We’ll create lasting bonds of friendship and camaraderie as we cook meals in small groups, plan an exciting theme-based dance, and master gardening skills. Check-in is from 5:00-6:00pm on Friday, and check-out is from 1:00-3:00pm on Sunday. Day program is available on Saturday only from 9:00am-8:00pm.

AltitudeAltitude is for participants who can function in a 3:1 ratio, have conversational language skills, are not currently struggling with any significant behavioral challenges, and are typically in a

main stream classroom setting. Check-in is at 5:00pm on Friday, and check-out is at 3:00pm on Sunday. Day program is available on Saturday only from 9:00am-8:00pm. Please note that for the February travel camp, check-in is from 7:00-8:00am on Friday, check-out is from 5:00-6:00pm on Sunday, and there is no opportunity for day program.

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FORE! VIA ACCESSIBLE GOLF CLINIC September 5, 12, 19, 26, 2017 AND October 3, 17, 24, 31 2017 In partnership with The First Tee of Silicon Valley, the golf clinic will provide eight 1.5 hour lessons at Rancho del Pueblo Golf Course. Lessons will be provided by First Tee instructors, most of whom have their PGA instructor card, and they’ll cover a general introduction to the game, golf swing, club variation, putting, driving, club usage/selection, rules of the game, and course play. Equipment, golf balls, range fees, and snacks are included. We can’t forget the most important part of learning a new game — having fun! Please select either the 4:00pm or the 6:00pm lesson time.

Adults ages 18+SPORTS AROUND THE BAYBEGINNING ADVENTURES IN LEADERSHIPSeptember 22-24, 2017 (FRI-SUN)Hello sports fans, have we got the session for you! This weekend has it all — football, baseball, swimming, cheerleading, soccer, and an extra special tribute to the San Jose Earthquakes. We’ll take a field trip to watch San Jose

State beat Utah State, and we’ll make our own tailgate foods to bring with us! Everyone will get an instant camera to take pictures at the game so that we can create our own sporting scrapbooks to bring home, along with handmade sports pennants. We’ll also make our own Giants baseball cards, decorate Warriors shirts, and go on a 49ers scavenger hunt.Field Trip: San Jose State Football Game

Adults ages 18+MUMMIES AND ZOMBIES

October 13-15, 2017 (FRI-SUN)Things are getting spooky at Via West! Come join us for a creeptacular Halloween weekend full of mummies, zombies, and of course, pumpkins! We’ll take a field trip to a local pumpkin patch and then carve our spooky jack-o-lanterns back on campus. We’ll have a mummy wrapping contest AND a costume contest – will you go for scary, funny, or just plain awesome? We’re going to make haunted broccoli forests and zombie surprise treats as well as cardboard mummies, zombie protection serum, and monster puppets. Halloween wouldn’t be complete without a trip through the Haunted House and trick-or-treating throughout campus.Field Trip: Pumpkin Patch

Adults ages 18+HEADING TO HOLLYWOOD TRAVEL CAMPNovember 3-5, 2017 (FRI-SUN)Who is ready for the red carpet treatment? We’re going to load the Via vans and head on down to Tinseltown! After checking into our hotel for the weekend, we’ll go explore the Hollywood Walk of Fame, the Dolby (formerly the Kodak) Theatre, and more. On Saturday, it’s time for Universal Studios — home to the Despicable Me minions, Jurassic Park dinos, and of course, The Wizarding World of Harry Potter! After we’ve had our fill of butterbeer and pumpkin juice, we’ll go out to a fancy breakfast before heading back up to Via West on Sunday.

Adults ages 18+CARNIVAL CRUISE THANKSGIVINGMORE ADVENTURES IN LEADERSHIPNovember 17-19, 2017 (FRI-SUN)Climb aboard the S.S. Via West for our special Thanksgiving cruise adventure! We’ll have all of the makings of a traditional Thanksgiving celebration — making stuffing from scratch, stuffing, baking, and carving our own turkeys, learning how to make healthy pumpkin pie, and of course, some cheerleading and friendly games of football. We’ll also be the judges for a very special mashed potato cook-off between Chef Anthony and Chef Dave. We’ll bask in the cruise lifestyle with some spa time, cruise ship gym workouts, and an epic carnival. We’ll make and take home felt cruise ships, leis, and, of course, some hand turkeys.

Adults ages 18+HOLIDAYS AROUND THE WORLDDecember 8-10, 2017 (FRI-SUN)Felices fiestas, joyeuses fêtes, and happy holidays from around the world! This seasonal favorite session is sponsored by the Rotary Club of Cupertino and it has it all — decorating and exchanging cookies, stuffing stockings for a local shelter, making wreaths, live music, presents from Santa, you name it! We’ll also make and take home our own personal passports that we’ll use to go caroling around the Via West world. We’ll learn how to create Henna art, Japanese lanterns, St. Lucia wreaths with candles, poinsettias, and more.

Older Teens and Young Adults ages 16-39JUMANJI: VIA WEST STYLECONTINUING ADVENTURES IN LEADERSHIP

January 26-28, 2018 (FRI-SUN)Roll the dice and unleash the excitement of Jumanji! We’ll hike on the accessible trail to search for animals — steer clear of the monkeys! We’ll hop on horseback to try and avoid the wild animal stampede. We’ll also make animal puppets, safari hats, terrariums, and our own version of the classic board game to take home. We’ll cook up some delicious animal food snacks and some lion pita pizzas. We’ll also spend some time in the garden with our friends and plan a wild jungle ball.

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Adults ages 18+GUARDIANS OF THE GALAXYBEGINNING ADVENTURES IN LEADERSHIPFebruary 9-11, 2018 (FRI-SUN)Join Star Lord, Groot, Rocket, and your favorites as we zoom around the galaxy! We’ll build our own rocket ships like the Milano and fly to space to collect moon rocks. We’ll learn about the stars on our field trip to the planetarium (with a stop at the Euphrat Museum of Art) and then put our knowledge to the test when we make our own solar system mobiles. We’ll also make galaxies in jars, groot planters, and rocket ship fruit kabobs. We’ll jam out to some of the classic tunes from the soundtrack at our Galactic Galaxy dance.Field Trips: Planetarium and Euphrat Museum of Art at De Anza College

Adults ages 18+PIRATES AND PRINCESSESMORE ADVENTURES IN LEADERSHIPMarch 2-4, 2018 (FRI-SUN)Avast me hearties and shiver me timbers — it’s pirate time at Via West! We’ll make our own fake gold booty and then embark on a treasure hunt throughout campus to find more. Our royal princesses will create fancy jewels and crowns,

but watch out for pirates — they’ll have their own homemade pirate ships! We’ll bake some yummy hidden treasure pitas and then make and take home Captain Hook hooks, royal emblems, and treasure chests. We’ll also have some fun riding horses!

Adults ages 18+TIME TRAVEL THROUGH THE DECADESCONTINUING ADVENTURES IN LEADERSHIP March 23-25, 2018 (FRI-SUN)Now that we’re well into the 21st century, let’s take a step back and explore some of our favorite decades from the past! We’ll start in the ‘50s by decorating records, making milkshakes, and having an old school beach party, complete with rockin’ surfer tunes. We’ll groove into the ‘70s with homemade dream catchers and some far out tie dye. Who can forget the ‘90s with Nickelodeon and getting slimed? We’ll also make shell creatures and pet rocks, and we’ll learn to do the hand jive at our dance.

Adults ages 18+STREETS OF SFApril 20-22, 2018 (FRI-SUN)Let’s have fun exploring our very own City by the Bay! We’ll put on our tourist hats and explore the Museum of Modern Art and the Yerba Buena Gardens. Back on campus, we’ll make our own famous sourdough bread from scratch —don’t worry, we’ll send the recipe back home! We’ll create our own maps of the fun spots in San Francisco – Chinatown, Fisherman’s Wharf, Alcatraz – and follow them around campus during our scavenger hunt. We’ll also make Golden Gate Bridge water color art, aquariums, and seal puppets.

Field Trips: Yerba Buena Gardens and Museum of Modern Art

Adults ages 18+SOUTH OF THE BORDERMay 4-6, 2018 (FRI-SUN)Hola amigos! Let’s travel south of the border for a fun-filled Mexican style weekend! We’ll kick off the summer with a poolside fiesta, complete with piñatas, our own homemade maracas, and a mariachi band. We’ll go check out the Frida Kahlo exhibit at the San Jose Museum of Art, and then we’ll make our own portraits back on campus. We’ll also learn how to make delicious salsa and enchiladas, and we’ll have a FIFA World Cup style soccer tournament!Field Trip: San Jose Museum of Art

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All Ages 5+FORE! VIA ACCESSIBLE GOLF CLINICSeptember 5, 12, 19, 26, 2017 AND October 3, 17, 24, 31 2017In partnership with The First Tee of Silicon Valley, the golf clinic will provide eight 1.5 hour lessons at Rancho del Pueblo Golf Course. Lessons will be provided by First Tee instructors, most of whom have their PGA instructor card, and they’ll cover a general introduction to the game, golf swing, club variation, putting, driving, club usage/selection, rules of the game, and course play. Equipment, golf balls, range fees, and snacks are included. We can’t forget the most important part of learning a new game — having fun! Please select either the 4:00pm or the 6:00pm lesson time.

Kids, Teens, and Young Adults ages 5-22MARIO, PEACH, AND FRIENDSSeptember 29-October 1, 2017 (FRI-SUN)It’s-a me, Mario! Hop into your cart and come with us to Bowser’s Castle, Rainbow Road, and more! We’ll make our own cardboard racer cars as well as Mario hats and Peach crowns. We’ll go on a scavenger hunt through campus to search for power up boxes to give us extra boosts! We’ll make Yoshi piñatas, piranha plants, and toadstool cupcakes, and we’ll enjoy a drive-in movie, pool time (weather permitting), and horseback riding.

Kids, Teens, and Young Adults ages 5-22GREAT PUMPKIN CHARLIE BROWN October 20-22, 2017 (FRI-SUN)Join Charlie Brown, Linus, Lucy, and Snoopy as we search for the Great Pumpkin! We’ll take a field trip to a local pumpkin

patch and then carve our jack-o-lanterns back on campus. We’ll have a mummy wrapping contest AND a costume contest — will you go for scary, funny, or just plain awesome? We’ll make graveyard pudding, Great Pumpkin pie, haunted Snoopy dog houses, and ghost puppets. Halloween wouldn’t be complete without a trip through the Haunted House and trick-or-treating throughout campus.Field Trip: Pumpkin Patch

Kids, Teens, and Young Adults ages 5-22HOLIDAY HAPPY FEETDecember 1-3, 2017 (FRI-SUN)Operation Snowflake is back again and sponsored by the Rotary Club of Cupertino! Feel the magic in the air as campus is transformed with tons of snow for an unforgettable afternoon of sledding, snowman building, caroling, cookie decorating, stocking stuffing, wreath making, and more! We’ll make and take home our own happy feet penguins and learn how to dance just like Mumbles! Santa will also make a very special appearance on Sunday to deliver gifts and spread holiday cheer to all!

Kids, Teens, and Young Adults ages 5-22WALK AMONGST DINOSAURS

January 19-21, 2018 (FRI-SUN)Join us as we travel back to the Jurassic period and walk amongst the dinosaurs! We’ll uncover the secrets of prehistoric mammoths at the Children’s Discovery Museum. Back on campus, we’ll make and search for fossils and go on a scavenger hunt for dinosaur eggs. We’ll work out like cavemen in the Via West gym, play T-Rex tag, and rock out at the Brontosaurus Ball. We’ll also make dinosaur egg oatmeal, ceramic pottery, and pterodactyl mobiles. Field Trip: Children’s Discovery Museum

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Older Teens and Young Adults ages 16-39JUMANJI: VIA WEST STYLEJanuary 26-28, 2018 (FRI-SUN)Roll the dice and unleash the excitement of Jumanji! We’ll hike on the accessible trail to search for animals — steer clear of the monkeys! We’ll hop on horseback to try and avoid the wild animal stampede. We’ll also make animal puppets, safari hats, terrariums, and our own version of the classic board game to take home. We’ll cook up some delicious animal food snacks and some lion pita pizzas. We’ll also spend some time in the garden with our friends and plan a wild jungle ball.

Kids, Teens, and Young Adults ages 5-22HEADING TO HOLLYWOOD TRAVEL CAMPFebruary 9-11, 2018 (FRI-SUN)Who is ready for the red carpet treatment? We’re going to load the Via vans and head on down to Tinseltown! After checking into our hotel for the weekend, we’ll go explore the Hollywood Walk of Fame, the Dolby (formerly the Kodak) Theatre, and more. On Saturday, it’s time for Universal Studios — home to the Despicable Me minions, Jurassic Park dinos, and of course, The Wizarding World of Harry Potter! After we’ve had our fill of butterbeer and pumpkin juice, we’ll go out to a fancy breakfast before heading back up to Via West on Sunday.

Kids, Teens, and Young Adults ages 5-22POWER RANGERSFebruary 16-19, 2018 (FRI-MON) Special President’s Day RespiteJoin us for a special extended President’s Day weekend session and Go Go Power Rangers! We’ll do some LARPing (Live Action Role Playing) as our favorite Red Ranger, Yellow Ranger, Black Ranger, Pink Ranger, and Blue Ranger to take on the evil Rita Repulsa! We’ll undergo official Power Rangers training camp to get ready for our mighty obstacle course and horseback riding. We’ll also make our own protein bars, water bottles, morphing masks, and power coins.

Kids, Teens, and Young Adults ages 5-22CLASH, CLASH, BANG!March 9-11, 2018 (FRI-SUN)Turn it up and make some noise for this fun-filled musical weekend! We’ll create our own music skits to perform for our friends, and we’ll hit the road (through campus) to tour as a rock n roll band. We’ll make and take home glow-in-the-dark

microphones, ukuleles, kazoos, and band t-shirts. We’ll bake some delicious keyboard cake and tromboney macaroni. Visitors abound as we have a DJ at the dance and a special musical guest appearance at our closing camp ceremonies on Sunday.

Kids, Teens, and Young Adults ages 5-22WHERE THE WILD THINGS ARE

April 6-8, 2018 (FRI-SUN)Let the wild rumpus start! Join Max, the king of all wild things, for a monstrously good weekend! We’ll use night vision goggles to go on a night hike through campus to see if we can spot Carol, Alexander, or Ira. We’ll learn how to identify animal tracks, and we’ll act out our favorite parts of Where the Wild Things Are. We’ll make and take home monster puppets, UV bracelets, hand sewn wild thing burlap hats, and monster mouth snacks. Of course, the weekend wouldn’t be complete without a wild rumpus dance!

Kids, Teens, and Young Adults ages 5-22BEETLES, BUGS, AND BUTTERFLIES

April 27-29, 2018 (FRI-SUN)Things are getting creepy crawly at Via West this weekend! We’ll learn all about caterpillars and butterflies on our field trip to the Butterfly Garden, and back on campus, we’ll go on a scavenger hunt to collect and pin insects. We’ll make butterfly nets, beetle juice, bug jars, and very hungry caterpillars. We’ll also make some healthy backyard bug snacks to bring home and share with our families, and we’ll have a campus wide Beetles vs. Butterflies competition.Field Trip: Butterfly Garden

Kids, Teens, and Young Adults ages 5-22UNDER THE SEAMay 18-20, 2018 (FRI-SUN)The Via West pool is open for the summer, so come join us under the sea! It’s our last session of the spring before summer kicks off, and we’re going to go water crazy! We’ll compete with our lodges in water balloon contests and swimming races. We’ll go on a scavenger hunt through campus to collect seashells. We’ll make and take home footprints in the sand, sea shell crab art, and jellyfish mobiles. We’ll make and eat Jell-O aquariums and starfish cookies.

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Kids and Teens entering 6th through 12th gradeTRAVEL BACK IN TIMENovember 3-5, 2017 (FRI-SUN)This weekend is geared for all — Altitude returners as well as new friends! Our time travel weekend is the perfect way to explore and experience the ways in which Americans have lived and bonded through the centuries. Participants will utilize their problem-solving and negotiation skills through exciting team building activities. We’ll have tons of fun while participating in centuries-old activities like archery, candle making, butter churning, and so much more! Our goal is to provide opportunities for participants to gain friendships through “team” experiences by building trust and having a common understanding. Everyone will leave with the

“Altitude Gratitude” mentality as we’ll have learned to appreciate each other and our modern lifestyles.

Kids, Teens, and Young Adults ages 5-22 HEADING TO HOLLYWOOD TRAVEL CAMP February 9-11, 2018 (FRI-SUN)Who is ready for the red carpet treatment? We’re going to load the Via vans and head on down to Tinseltown! After checking into our hotel for the weekend, we’ll go explore the Hollywood Walk of Fame, the Dolby (formerly the Kodak) Theatre, and more. On Saturday, it’s time for Universal Studios – home to the Despicable Me minions, Jurassic Park dinos, and of course, The Wizarding World of Harry Potter! After we’ve had our fill of butterbeer and pumpkin juice, we’ll go out to a fancy breakfast before heading back up to Via West on Sunday.

Kids and Teens entering 4th through 11th gradeTASTE OF ALTITUDE April 13-15, 2018This is an opportunity for everyone! It’s a fabulous reunion opportunity for our summer campers and a great way for new and prospective campers to get a taste of the

“Altitude Attitude”! Activities will include a wide variety of sports, arena horseback riding, stimulating arts and crafts, hiking, s’mores, and movie night! Parents, siblings, and other important family members are strongly encouraged to attend the “family fun day” on Sunday where they can follow their campers through a few short activities and participate in a small carnival and barbeque. It’s a great way for family members to catch the Altitude Attitude, too!!!

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REGISTRATION DEPOSIT FORMReturn to Via Services, Inc.Mailing address: 2851 Park Ave. • Santa Clara, CA 95050 Attn. Via West Admissions Manager www.viaservices.org • Phone: 408-243-7861 • Fax: 408-243-0452Please make a copy for your records, and mail in the following forms to register.

PARTICIPANT’S NAME PARENT/GUARDIAN NAME

NUMBER OF SESSIONS SELECTED X $100 =

REGISTRATION DEPOSIT

REGISTRATION DEPOSIT TOTAL

PAYMENT DATE: PAYMENT AMOUNT:

PAYMENT TYPE: VISA MASTERCARD AMEX CASH CHECK NO.

CARDHOLDER NAME CONTACT PHONE NUMBER

CARD NUMBER CARD EXPIRATION DATE

PROMO CODE

Please note that your registration will not be processed without the $100.00 registration deposit (per session). This means that if you are registering by phone, fax (if you fax your registration, please call the main office at 408-243-7861 to confirm receipt), or email, you must pay the registration deposit via credit card at the time of registration.Please note that the deposit will be applied to the balance of your program regardless of payment method.In planning for each participant’s stay at Via West and Altitude, costs are incurred in advance. Therefore, if you cancel within 31 days of your scheduled session, for whatever reason, your $100.00 registration deposit will be retained to help cover lost expenses.

I have read and understood the policies regarding the Registration Deposit

SIGNATURE DATE

Registration

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Scholarship money is greatly needed. Help someone like Matthew attend camp!

Help a family in need send their child/adult to THEIR favorite weekend of the year.

Please accept this donation in the amount of $ .

(Check one) Please charge this amount to my credit card above I have enclosed a check in this amount.

Meet Matthew. He has been coming to Via West with the help of scholarships since he was 5. His mom writes: “I, as a parent, really appreciate that Matthew can get his time away from home with other kids and peers that understand him for who he is, and I get to take a break and not have to worry about him.” Without our scholarship fund, Matthew would not be able to attend his favorite weekend of the year.

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PP= Private Pay • RC= Regional Center

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2017–2018 FALL, WINTER, & SPRING REGISTRATION FORMReturn to Via Services, Inc. Mailing address: 2851 Park Avenue, Santa Clara, CA 95050 Attn. Via West Admissions Manager • www.viaservices.org • Phone: 408-243-7861 • Fax: 408-243-0452

WHICH REGIONAL CENTER PROVIDES YOUR FUNDING?

PARTICIPANT’S LAST NAME FIRST NAME MIDDLE

AGE BIRTHDATE GENDER PARENT/LEGAL GUARDIAN NAME

HOME ADDRESS (WHERE YOU WOULD LIKE TO RECEIVE THE CONFIRMATION PACKET) STREET / CITY / STATE / ZIP

TELEPHONE EMAIL ADDRESS

WHAT IS THE PARTICIPANT’S DISABILITY? RATIO? 1:1 2:1 3:1 UNCERTAIN

IS THE PARTICIPANT NEW TO VIA WEST? YES NO IF YES, HOW DID YOU LEARN ABOUT OUR PROGRAM?

IF HE/SHE IS NOT NEW, DID THEY ATTEND SUMMER 2017 OR FALL/WINTER/SPRING 2016–2017

I WOULD LIKE TO REGISTER MY PARTICIPANT FOR THE FOLLOWING SESSION(S):Please check the session(s) below, and indicate how the session will be funded.

Via West Adults (18+) Traditional Day and Overnight Programs Sept 22–24, 2017 PP RC Day Overnight

Oct 13–15, 2017 PP RC Day Overnight

Nov 17–19, 2017 PP RC Day Overnight

Dec 8–10, 2017 PP RC Day Overnight

Feb 9–11, 2018 PP RC Day Overnight

Mar 2 –4, 2018 PP RC Day Overnight

Mar 23–25, 2018 PP RC Day Overnight

Apr 20–22, 2018 PP RC Day Overnight

May 4–6, 2018 PP RC Day Overnight

Via West Kids, Teens, Young Adults (5–22) Traditional Day and Overnight ProgramsSept 29–Oct 1, 2017 PP RC Day Overnight

Oct 20–22, 2017 PP RC Day Overnight

Dec 1–3, 2017 PP RC Day Overnight

Jan 19–21, 2018 PP RC Day Overnight

Feb 16–19, 2018 PP RC Special President’s Day Respite Day Overnight

Mar 9–11, 2018 PP RC Day Overnight

Apr 6–8, 2018 PP RC Day Overnight

Apr 27–29, 2018 PP RC Day Overnight

May 18–20, 2018 PP RC Day Overnight

Via West and Altitude Kids, Teens, Young Adults (5-22) Travel Camp Feb 9–11, 2018 PP RC

Altitude

Nov 3–5, 2017 PP RC Day Overnight

Feb 9–11, 2018 PP RC Apr 13–15, 2018 PP RC Day Overnight

Sports Clinics (All ages 5+)GOLF: September 5, 12, 19, 26, 2017 AND October 3, 17, 24, 31 2017 4pm 6pm PP RC

Via West Adults (18+) Travel Camp Nov 3–5, 2017 PP RC

Via West Adults (18+) Adventures in Leadership Sept 22–24, 2017 PP RC

Nov 17–19, 2017 PP RC

Jan 26-28, 2018 PP RC

Feb 9–11, 2018 PP RC

Mar 2–4, 2018 PP RC

Mar 23–25, 2018 PP RC

Via West Older Teens & Young Adults (16–39)

Jan 26–28, 2018 PP RC Day Overnight

Registration & D

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REGISTRATION PROCEDURES:Registration is now open for all fall, winter, and spring sessions. We are not restricting any spaces in our regular programs, however we do still have a maximum capacity. Spaces are available on a first come, first served basis with deposit to secure reservation. We strongly encourage you to email, fax, or mail your registration forms as soon as possible. We encourage attendance at multiple sessions as our enhanced thematic programming will be very different each session.If you do not have enough respite hours to cover the full program, then you will be responsible for the Private Pay balance due. In order for your participant to be marked down as paid, we require:1. An Authorization to Purchase Services (not a Request for Purchase of Services) to be sent to the Via office before the start date of the session.2. The payment of the private pay or supplemental daily rate in full.If payment is not received from the regional center as authorized, you will be responsible for the remainder of the payment due at the private pay rate.

3:1 2:1 1:1

TRADITIONAL DAY & OVERNIGHT PROGRAMS AND LEADERSHIP SESSIONSRegional Supplemental Daily Rate: $82 per day ($164 per weekend)Private Pay Rates: $595 $655 $705

Day Rates (Saturday only): $195 $205 $275

PRESIDENT’S DAY SESSIONRegional Center Supplemental Daily Rate: $82 per day ($246 per weekend)Private Pay Rates: $885 $955 $1025

Day Rates (Saturday and Sunday Only) $195 $205 $275

TRAVEL CAMPRegional Supplemental Daily Rate: $290 per day ($580 per weekend)Private Pay Rates: $850 $975** N/A

Day Rate: N/A N/A N/A

**Limited spacing for 2:1 evaluated on case-by-case basis

SPORTS CLINICRegional Center Supplemental Daily Rate: $135 per clinicPrivate Pay Rates: $259 $349 $429

PRICING

ALTITUDERegional Center Supplemental Daily Rate: $82 per day ($164 per weekend) Private Pay Rates: $650 N/A N/A

Day Rates (Saturday Only) $195 N/A N/A

Travel Camp Regional Center Supplemental Daily Rate: $290 per day ($580 per weekend)Travel Camp Private Pay Rates: $850 N/A N/A

VIA SPECIAL EVENTS:

Fall FestivalCome join us at the 5th annual Fall Festival at Via West Campus. Entrance will again be free and tickets will be available to purchase to use towards delicious food and fun and games. Back by popular demand will be the haunted house, pumpkin patch, petting zoo, and much more! For

more information, please visit www.viaservices.org

Saturday, October 7, 2017 • 11am–3pm

Poker Tournament May 3, 2018 Via Services will host its second annual Poker Tournament. All of the proceeds will benefit the programs of Altitude, First Step, and Via West.

For more information, please visit www.viaservices.org

ViaPoker

Tournament

The 23rd annual Via Ball will take place on February 24, 2018. 100% of the proceeds will benefit the programs of Altitude, First Step, and Via West. For more information, please visit www.viaservices.org

February 24, 2018

6Via Services – Via West Campus2851 Park Avenue, Santa Clara, CA 95050-6006(408) 243-7861 • www.viaservices.org

PRESORT

FIRST CLASS

U.S. POSTAGE PAID

SAN JOSE, CA

PERMIT NO. 419

PRESORT

FIRST CLASS

U.S. POSTAGE PAID

SAN JOSE, CA

PERMIT NO. 419

Sobrato Center for the Performing Arts — the newest addition to our campus!

VIA WEST2017–2018 Fall, Winter, &

Spring Programs

VIA BALLVIA BALL

T H E 2 3 R D A N N U A L

“Positive staff to client ratio allowed for safety and fun!”

“The joy on his face was something indescribable!”

“He had a great time and asked to go back!”

“She didn’t want to leave at the end of the day!”

“She loves everyone at camp and talks about her friends there!”

“I like that he tries new foods at camp!”