test

Camper's Full Name
Age
School
Home Address
Home Phone Number
Mom's Cell
Dad's Cell
Email

Diagnoses
Feeding instructions/ restrictions
Seizures/ current medication/G-tube instruction
Any additional information regarding your child's home routine during program hours that would be helpful to know
I need transportation home from the program for $10/day.

My child needs a 1:1 staff for an additional $25/day.

captcha