Handwriting Camp 2024

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Welcome to Summer Handwriting Camp! Our camp seamlessly blends games and playful activities with focused handwriting instruction over four exciting days. This dynamic approach will enhances your child's handwriting skills and foster confidence.

To register your child for this engaging experience, please complete the following questionnaire. Upon receiving the completed form, we will generate an invoice. Once the invoice is settled, your child's spot at camp will be secured. Please fill out a separate questionnaire for each participant. I'm eager to work with your child and make this summer a memorable learning adventure!

Camp runs Monday through Thursday and is $199/ session. Each camp is limited to 8 participants. Camp requires a minimum of four participants to proceed. Private tutoring is available.

Email *

I would like to register for the following camp: *

LETTER EVOLUTION July 8-11 9-10:30 a.m.

PRINTING SOLUTIONS July 8-11 11-12:30 p.m.

1 space left/ LETTER EVOLUTION July 15-18 9:00-10:30 a.m.

PRINTING SOLUTIONS July 15-18 11-12:30 p.m.

CURSIVE CONNECTIONS July 15-18 1:00-2:30 p.m.

I'm interested in private tutoring

CAMP CHOICE

Your child's first and last name. *

Your first and last name. *

Your child's date of birth *

YYYY

Child's Grade for the upcoming 2024 - 2025 school year *

Kindergarten

1st

2nd

3rd

4th

5th

6th

7th

Your address (include zip code) *

Your cell phone number *

COMMUNICATION PREFERENCES *

Cell Phone

Required

Please provide insights into your child's unique qualities! Share details about their special interests, strengths, and talents. Feel free to tell me anything noteworthy about your child. For instance, they might have a passion for creating, a fondness for Legos, a love for animals, an affinity for laughter, a talent for dancing, and so on. Your input will help tailor our interactions to create a positive and enriching experience for your child.

Emergency Contact Name, Relationship and Phone Number *

PHOTO RELEASE. Consent allows Mary Hackworth to use photos and/ or videos of registered child in camp promotional materials or in social media posts (Instagram/ Facebook) *

I GIVE consent to take photos or videos of my camper.

I DO NOT GIVE consent to take photos or videos of my camper.

My child has an IEP, IFSP or 504 plan. *

Yes

My child's IEP, IFSP or 504 plan addresses the following areas:

Medical history, check all that apply: *

Autism Spectrum Disorder

Apraxia

Speech Concerns

Language Impairment

Attention Deficit Disorder

Other:

Please check all that may describe your child: *

Overall, my child is developing in typical progression without any noted concerns.

My child may be slow to warm-up to new situations.

My child may have difficulty transitioning.

My child may have difficulty making friends.

My child may avoid activities that are perceived as too hard.

My child has difficulty processing sensory input.

My child has a history of trauma.

My child can be impulsive at times which can impact safety or ability to follow directions.

Other:

Required

My child has allergies and/ or asthma. *

Yes. Describe under "other."

My child has physical and/ or dietary restrictions. *

Yes. Describe under "other."

Has your child ever had a seizure?

Yes. Describe under "other."

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To ensure cultural sensitivity, kindly share any information about traditions, beliefs, or cultural background that I should be mindful of during your child's camp session.

I understand that Mary Hackworth will maintain my privacy to the highest standards. I understand that personal information provided through this registration questionnaire will only be shared with staff of the Summer Handwriting Camp to ensure the safety of my child and to ensure my child receives the support needed while attending camp.

Yes

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Other; Use this section to tell me anything else!

RELEASE OF LIABILITY (section two). I have read the liability information and agree to its contents. *

Yes

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