Registration for 2017 Summer

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