Fall2025 Registration
Important:
After you submit a form for registration, we will send you an email confirming attendance, there is no longer a requirement for a $20 deposit to hold an attendee's spot. Acceptance into classes is based on open availability in the class. Confirmation emails will take about 24-48 hours after registration submission. Classes will be taken at our center at 811 Ridge Rd. Webster, NY 14580. Please note that if your child requires high support we may ask for adult support during classes to ensure safety.
Student Information
Guardian Information
Guardian Full Name (If same as participant's name please list participant's name)
*
First Name
Last Name
E-mail
*
Contact Number
*
-
Area Code
Phone Number
Student Information
Full Name
*
First Name
Last Name
Age
*
Birthdate
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Month
-
Day
Year
Date
Disability
If applicable and you would like to share.
Support From Adults
Please Select
Low Support
Medium Support
High Support
Support from adults needed to be successful in class setting.
Will payment for classes be private pay or OPWDD Self Direction Budget?
Self Direction Agency
If applicable.
Emergency Contact
Some likes and dislikes (so that we can best create relationships with the student):
Health Concerns
Please click the classes you'd like to register your child for:
Social Skills for 6-10 year olds
Social Skills for 11-15 year olds
Social Skills for Adults (16+)
Comments or Questions:
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