Registration
form* for Children’s Special Services, LLC 2017 Camps
*At the time of Registration a 50% non refundable deposit is
required.
Name
of Student______________________________________________
Name
of Parent________________________________________________
Address_______________________________________
Zip
code_________________
Phone
Contact#__________________________________
The
Camp(s) I am registering for:
**S.H.I.N.E.™ 3 day weekend camp June 2-3-4 th 9-AM-12 PM_____________($375 total ~ $187.50 due at registration)
**Sensory Social Skills/POP™ Personal
Options and Preferences ™ June 13,14,15, 16 9-11:45 AM
Temple Emanuel Dunwoody ____________($350 total $175 due at
registration)
Camps at
PACE Academy
Parents must
register directly with Pace Academy
WIN™ Write
Incredibly Now™
Pace
Academy Go the the PACE Academy Website
and register with them on line or call Beth Singleton at Pace Academy
information provided below.
June
19-20-21-22
Or
July
10-11-12-13
Buckhead
9
AM-12 PM
12
hour program at $46/hour
CALL
BETH SINGLETON AT PACE ACADEMY TO REGISTER OR GO TO THEIR WEBSITE www.paceacademy.org
404-240-7412
POP™ Sensory
Social Skills
Sensory
Social Skills/POP™ Personal Options and Preferences ™
Learning exploration, curiosity, creativity, sharing,
organization, sharing space and materials.
Registered Music Therapist , Occupational Therapy and
Pediatric Yoga integrated into the programs.
Children ages 2-8
Sensory regulation techniques, sharing, delayed gratification/,
motor skills both through crafts, music therapy and pediatric yoga, listening
skills, social responses, and MORE!!
Pace Academy
June 26-27-28-29
9 AM-Noon
Sensory Social Circles/POP™ $37/hour
CALL BETH SINGLETON AT PACE ACADEMY TO REGISTER OR GO TO THEIR
WEBSITE www.paceacademy.org 404-240-7412
WIN™ Write Incredibly Now™ LABORED
TO legible in just 12 hours ~sensory handwriting utilizing games, crafts and
sensory experiences in a fun fast way to legible handwriting -grades 5-12
—addressing motor control, grasp, organization and appropriate penmanship . FUN
Craft oriented doing/feeling and creating!
The Cottage School
Roswell
July 17, 18, 19, 20
9 AM-12 PM
12 hour program at $46/hour
Email_________________________________________________
Visa
or MC #________________________________
Exp.Date_________
Code____________________________
(please
note that a CC# is required even when paying by check)
OR
Check
#_________________________________*
If paying by voucher, parents are responsible for applying for
and obtaining the money in advance from the GA Voucher Program. Children’s Special Services, LLC cannot apply
for you. You can get the Individualized Family Support Application by email from Children's Special
Services, LLC : susanorloff@chidlrens-services.com.
Those
choosing to pay by credit card are advised that a 4% charge is added to cover processing —
Checks*
should be made payable to (Please note there is a
$35 returned check fee)
Children’s
Special Services. LLC
7501
Aduen Trail
ATL GA 30350