Specialized April Vacation Camp 
Tuesday - Friday 9:00-12:00 (4/16/24 - 4/19/24)
$120 a day or $480 for the week
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Parent Name and Email *
 Home Address  *
Phone Number *
Emergency Contact  *
Health concerns ( allergies) Medication ext. 
Child's Full Name *
Childs Age *
 Contact information: Please include address, parent phone numbers  and any health concerns Emergency contacts, * New students only*
What days will your child be attending AAC Camp *
Required
Explain more about your Childs ( disability/needs)
Explain how your child show the various emotions :
 Happy- Sad- Mad- Angry- Scared. Please add any additional information if necessary  i.e.. ( triggers, visuals needs, sensory breaks ext..)
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