2023 Fall Mud Kitchen Kids & Loose Parts Play Registration
Hello Muddy Buddies!Ā Ā 

Thank you so much for your interest in our Fall "Mud Kitchen Kids and Loose Parts Play" enrichment.Ā Ā 

šŸ‘€ PLEASE READ ALL THE DETAILED INFORMATION BELOW

šŸ›‘ UPDATE: 4-6 pm class has been filled, please add your name to waitlist belowĀ 

We are super excited to announce we have partnered with the College of Western Idaho (CWI) to support their fieldwork, level I occupational therapy assistant (OTA) program.

šŸ¤øā€ā™€ļø This is an exciting opportunity to provide support and mentorship to the future OTA's in our community.

šŸ¤“In addition to all groups being led and designed by a pediatric OT, they will also be supported by dedicated OTA students.

Class Details:Ā 

ā—˜ Ages 4 - 7Ā 
ā—˜ Class is a drop off class -Ā If your child needs more one to one adult care or is unable to transition independently from caregiver, a child/caregiver class would be better suited for your needsĀ 
ā—˜ Class needs a minimum of 6 children to initiateĀ 
ā—˜ "Mud Kitchen Kids and Loose Parts Play" enrichment is NOT considered physician referred, occupational therapy - this is an open enrichment class
ā—˜ If you are registering multiple children, please fill out multiple forms.
ā—˜ Children must be potty trained ( we have a portable potty on site in a private tent)
ā—˜Ā Enrichment classes meet rain or shine (we have overhead shade/protection).
ā—˜Ā Once deposit/payment has been received, there are no refunds.
ā—˜Ā There are no refunds for missed sessions due to limited schedule to create make-ups.Ā 
ā—˜ If a class must be canceled for an unforeseen event/weather, a make up class will be provided on Sat. Oct. 14th
ā—˜Ā Once this form is completed, we will email in-take paper work and a link from SquareĀ 
ā—˜Ā If class fills, we will put you on a waitlist and keep you updated as things shift.Ā 

šŸ Our 2023 fall sessions will be every FridayĀ Ā 

ā—˜ Sept 8, 15, 22, 29, Oct. 6, 13
ā—˜ Each class is a 2 hour session
ā—˜ Located in Garden City, where 40th street meets the GreenbeltĀ 

ā¶Ā  Class A: 1:00 pm - 3:00 pm
ā·Ā  Class B: 4:00pmĀ  - 6:00 pmĀ  - CLASS FILLED ADD NAME TO WAITLIST BELOWĀ 

Tuition Total = $275Ā 

If you have any questions, concerns, or curiosities please email Daniele at:Ā  boiseoutdoorot@gmail.com

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Email *
Are you a returning family?Ā  *
Due to the nature of this group dynamic being "child-led" adult participation is capped to our lead occupational therapist and field-work students. Child must be able to attend group independently. Parents are welcome to hang around in the beginning to support transitions.Ā 
 *
Which fall class are you registering for?Ā  *
Required
Child's name *
Child's Age *
Child's D.O.B *
Child's grade *
Gender
Primary caregiver's first and last name *
Primary caregivers contact # *
Emergency contact Ā and phone number *
Please list caregivers granted permission to pick child up from enrichment. *
Due to teacher/student ratio, children must be fully potty trained. Mud Kitchen Kids provides a pop up potty in a privacy tent. Is your child able to complete toileting tasks independently?Ā  *
Please note any medical diagnosis, delays or history of seizures. If none, please note n/a. *
Please list allergies and intervention if necessary. If none, please note n/a. *
Please note any medications your child is currently taking. If none, please note n/a. *
What brings your child joy? *
What are your child's strengths? *
What are your child's challenges? *
Are you aware of any sensory challenges your child often experiences?Ā  *
Has your child / does your child utilize the support of an 1:1 aide? *
Does your child have a history of elopement (fleeing, running off/away from caregivers)? If so, due to teacher ratio and the open environment, this group session would not be a best fit. A 1:1 teacher ratio wouldĀ  supportĀ  needed safety.Ā  *
Do you anticipate any behavioral needs and/or challenges?Ā 

 *
Please list anyĀ  additional information and/or history you think would be helpful for Boise Outdoor OT to know about your child.
 *
I understand the followingĀ challenges need one-to-one support and will not be a best fit for the open environment, teacher ratio, and group dynamic.Ā 

ā€¢ aggression toward teachers, others or self
ā€¢ destruction of environment
ā€¢ fleeing the area/running away outside of given perimeter
ā€¢ repeated verbal disrespect towards others or teachers
ā€¢Ā an extreme aversion to bugs or the outdoors

Staff has the right to terminate participation at any time should these or other challenging behaviors occur. Refunds will not be issues in these circumstances.Ā 
 *
Required
I understand that "Mud Kitchen Kids and Loose Parts Play" enrichment is an enrichment class; it is NOT physician referred occupational therapy services.Ā  But If your child has specific goals we would love to help support these during our groups.Ā  *
Required
Once we receive your registration and we fill the class, you will receive additional intake paperwork and a link for payment via email. If classes become filled, you will receive an email notifying you are on our waitlistĀ  *
Please share which level of privacy you would like to request in regards to photos taken of your child during "Mud Kitchen Kids and Loose Parts Play" Enrichment. *
How did you hear about "Mud Kitchen Kids and Loose Parts Play" enrichment?Ā  *
Required
Do you want to add anything or have any questions ?Ā 
A copy of your responses will be emailed to the address you provided.
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