ITS Summer Speech-Language Camp Registration Form
Thank you for your interest in an Individualized Therapy Solutions summer camp! Please complete all of the information in the form below regarding your child.

Camps will involve arts and crafts, music, story time, sensory activities, movement activities, and functional play indoors and outdoors.

Camps are 4 days in length, Monday through Thursday from 9-10:30 AM, and will run for 3 total weeks in June 2021.

Available dates:
June 21-24

Cost: $179 / week

In-person camps will be located at 11 Municipal Dr Suite 200, Fishers, IN 46038.

Outdoor activities will be dependent on the weather and will be guided by staff on grassy areas near the Nickle Plate Amphitheatre and at Roy G. Holland Memorial park. Staff will safely walk all students the .05 miles to Nickel Plate Amphitheatre area and .4 miles to Roy G. Holland Memorial Park.

Precautions for COVID-19 will be taken, including but not limited to small group sizes, appropriate sanitization, mask-wearing for all camp staff, temperature checks, social distancing, individual bins of activity materials for each child, and acknowledgements signed by all participating families indicating no exposure nor symptoms of COVID-19 in their home in the past 14 days.

If you wish to share relevant information such as IEPs, behavior plans, and evaluation reports, please email them to Contact@IndividualizedTherapySolutions.com after registering.

If you or anyone you know are an SLP, OT, PT, related assistants, teachers, or students who would be interested in helping with summer camps, please send us an email stating your interest.

Email us at contact@individualizedtherapysolutions.com with any questions or comments! Feel free to call us at (317)537-7698 or visit our website at https://IndividualizedTherapySolutions.com for more information.
Sign in to Google to save your progress. Learn more
Child's Name *
Child's Date of Birth (if you have more than one child who you would like to attend a camp, please complete separate registration forms - one for each child) *
MM
/
DD
/
YYYY
Child's Gender
Clear selection
Primary language(s) spoken in the home
Parent/Guardian 1 Name *
Parent/Guardian 1 Email Address *
Parent/Guardian 1 Phone Number *
Able to use text for communication? *
Parent/Guardian 2 Name
Parent/Guardian 2 Email Address
Parent/Guardian 2 Phone Number
Able to use text for communication?
Clear selection
Home Address
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Relationship *
Emergency Contact Authorized to Drop off/Pick up? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of individualizedtherapysolutions.com. Report Abuse