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Summer Social 2024
This form is for registering your child for our 2024 Summer Social. Please complete all that applies and feel free to email us if you have any questions that come up as you fill it out.
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* Indicates required question
Email
*
Your email
Child's Name:
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Your answer
Gender:
*
Choose
Male
Female
Grade (School Year 2024-2025):
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Choose
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Parent/Caregiver Name:
*
Your answer
Parent/Caregiver(s) Cell phone (Please enter all important numbers, i.e. Mom, Dad, Grandma, etc)
Your answer
Parent/Caregiver(s) Email Address:
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Your answer
Current School and District:
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Your answer
Child's Disability/Disabilities (As stated on current IEP):
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Your answer
Does your child have a Behavior Intervention Plan (BIP)?
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Yes
No
When at school, does your child travel to and from classes independently or requires support? (Please provide details):
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Your answer
Does your child elope, wander or walk away from where he/she is supposed to be?
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Yes
No
I understand that there will be NO behavior support provided other than standard safety adult supervision during Summer Social?
Choose
Yes
I understand I am required to provide a current copy of my child's IEP and Behavior Intervention Plan if applicable in order to complete registration.
*
Choose
Yes
I understand I am registering for Summer Social: Every Tuesday, June 11-July 16 for the following times:
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High School 9am-12noon
Middle School 1pm-4pm
I understand I can cancel at least 7 days in advance via email and will receive a refund LESS $39 non-refundable room fee per session cancelled (So you will receive a refund of $61 dollars if you cancel 7 days in advance).
*
Choose
Yes
Anticipated Missed Dates (Summer Social will run every Tuesday beginning June 11-July 16, 2024):
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Your answer
Please email your documents (IEP and BIP) to the following email:
Hello@SocialSeasons.Net
We will review your information and documents then reach out to you via email within 48 hours with next steps to complete and confirm your registration.
Please enter your full name below which serves as your signature indicating you have emailed your documents.
*
Your answer
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