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Social Butterflies Interest Form
Social skills group for children ages 7-10 years with ASD
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* Indicates required question
Email
*
Your email
Parent Name
*
Your answer
Phone number
*
Your answer
Group location (choose one)
*
Surrey (South)
Okanagan (TBA)
Child name
*
Your answer
Child's date of birth
*
MM
/
DD
/
YYYY
What type of group are you interested in (check all that apply)?
*
1 week summer camp (2 hours/day)
10 week after school club (2 hours/week)
10 week weekend club (2 hours/week)
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