Social Skills Group Registration
Friend Connections will meet on Wednesdays from 4:30 to 5:30 at our Summit Center For Child Development- South Location. This is an eight week program beginning April 21 through June 16. Current age range is pre-teens and teens.
Sign in to Google to save your progress. Learn more
Child's Name:
Date of Birth:
MM
/
DD
/
YYYY
Parent Name:
Address:
City, State, Zip:
Phone number:
Email address:
I understand there is a tuition cost of $250 for the program. (Invoice for $125 will be emailed to family once form is submitted.  Payment ensures spot in program and is due before program starts.)
I understand the additional $125 will be due half way through the program (4 weeks in)
I understand attendance is required to full program to maintain a “group” atmosphere.
I would prefer for my child to attend the group
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Summit Speech & Language. Report Abuse
Google Forms