Summer 2026 Program Registration

Comments

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Order #

Which summer program(s) would you like to register for? (Pick one)(Required)

Parent Infant Week: Ages 0-2 years, June 22-25, 9am-12pm ($100 per child)

Teen Summit: Middle and High School ages, June 29-July 1, 12pm-3:30pm ($100 per child)

Summer Camp: Ages 3-11 years, June 15-19, 9am-3pm ($300 per child)

Consent(Required)

I understand that this week requires parent involvement and attendance onsite from 9am-12pm each day

Consent(Required)

I understand that my child must be fully potty trained and able to use the restroom independently before the start of camp.

Please note that children attending in-person programs must be potty trained at the time of attendance.

T-Shirt Size (Child): (select one)(Required)

Interested in staying for parent classes and/or support group? (select one)

Yes- Parent Classes (Parent Class and Support Groups will be between 9am-12pm)

Yes- Support Group

Yes- Both

Not at this time

Child's Name(Required)

First Last

Preferred Name(Required)

Date of Birth(Required)

Age(Required)

Grade Fall

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent/Guardian Name(Required)

First Last

Relationship to Child(Required)

Home Language(Required)

Other Language(Required)

Untitled

Yes, I would like interpretation/support in Spanish

Phone (Cell)(Required)

Email(Required)

Second Parent Name

(Optional)

First Last

Phone (Cell)

Email

Emergency Contact/Relation to Child(Required)

Phone(Required)

Relation to Child(Required)

How did you hear about us?(Required)

School

Audiologist

Speech Therapist

Social Media

Friend/Family Referral

Website

Returning Family

Other

Untitled(Required)

Allergies(Required)

food, medication, environmental

Medical Conditions(Required)

asthma, seizures, diabetes, etc.

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Summer Program Registration

Please note that children attending in-person programs must be potty trained at the time of attendance.