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Camp Registration
Event Timing:
June 3-7, 2024
Time:
9:00 am - 2:00 pm
Event Address:
Phoenix Academy Day School 1110 N 66th St Omaha 68132
Contact us at :
sherita@socialkidsomaha.org
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Email
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Student Name, Grade, School
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Verified Disability?
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Yes
No
Not Diagnosed
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If Yes, What is the disability?
Your answer
Has your student every had behavioral problems? Please explain.
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Will your student need medication while at camp? If yes, what is the medication?
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Allergies? If yes, what?
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Parent Name, Address, Phone
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Parent Email
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Emergency Contact Name and phone number
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Are you interested in applying for a scholarship? (Summer Only) Camp cost $150 for the week.
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Not sure
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