2024 Summer Camp Interest Form
The Social Motion program is offering a Summer Camp for students ages 12-15. The first session is June 3-27. The second session is July 8-August 1. If your child is interested in attending, please complete the following form. We will be in touch with more details!
Student's Name:
*
First Name
Last Name
Student's DOB:
*
-
Month
-
Day
Year
Date
Student's Grade:
*
Parent/Caregiver Name:
*
First Name
Last Name
Parent/Caregiver Email:
*
example@example.com
Parent/Caregiver Phone Number:
*
Please enter a valid phone number.
Zip Code:
*
What program dates would you prefer?
*
Please Select
June 2024
July 2024
Both June & July 2024
Which location would you prefer?
*
Please Select
East End
Sharpstown
What topics would you be interested in for your child?
*
Activities of Daily Living Skills (housekeeping, cooking, etc.)
Pre-vocational skills
Social Skills
Volunteering
Executive functioning skills
Physical activities
Mindfulness activities
Yoga
Other
If other, please describe below:
Are you a current Social Motion student?
*
Please Select
Yes
No *All new students are required to do an intake.
The cost for the summer program is $1700 per 4-week session ($3400 to attend both sessions.) Will you need partial or full scholarship assistance to attend?
*
No scholarship needed
Full scholarship needed
Partial scholarship needed
Thank you, our Social Motion team will be in touch with you soon!
Submit
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