2020Registration

2024 Summer Camps
List All Potential Camp Weeks you are interested (June 17 - August 21):*

June 17- June 21June 24 - June 28July 1 - 3 (Monday-Wednesday only) $535July 8 - July 12July 15 - July 19July 22 - July 26July 29 - August 2August 5 - August 9August 12 - August 16August 19 - 21 (Monday-Wednesday only) $535SaturdaysOther
Preferred number of weeks you're interested in for the Summer 2024 (Enter # 1-10)
$885 per session. Includes $100 non-refundable administration fee that will be applied toward the cost of the group session. Group is non-refundable unless Friendship Explorations is required to cancel the group at the advice of public health officials. In the event Friendship Explorations is cancelled for any reason, the therapist will contact you to provide individual consultations for your child during the established camp or groups hours. In the case of extended cancellations due to weather, air quality, or other circumstances beyond our control, you may receive a credit towards future services.

As many of the locations do not have cell phone service, it may not be possible to reach the group leader if you are running late. Please note - the group will leave the meeting area 10 minutes after the group start time.

It is very important to be on time to pick up your child. If something happens and you are more than 5 minutes late to pick up your child, there is a $50 late fee. This is for the safety of the kids first and foremost, as well as to respect any other commitments that the Therapists may have scheduled after Friendship Explorations.

After registering your child, you will receive an invoice from Ready Set GO Therapy which you may pay by check, credit card, or through our online system.

If paying by check, please mail to: Ready Set GO Therapy, Inc. Gate 5 Road, Sausalito, CA 94965.
Check below if you are interested in these additional services:

Consultation with OT/SLP leaders: If you would like to discuss specific needs directly with the therapist who is leading your child's session, we offer consultation at $175/hour, 30 minute minimum.Summary Reports - $175 for a 2-3 page reportOne-to-One Aides: Some children benefit from individual day-to-day support from an aide. Please contact us directly and we can work collaboratively to determine the best solution for your child, or you are welcome to have your own aide accompany your child. If we find that your child requires additional support after camp has started, we will contact you to discuss best options.
Camper Information
Camper's Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade Entering
TK or kindergarten enter 0
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*

Area CodePhone Number
Home Number

Area CodePhone Number
Email*
example@example.com
Additional Parent's Email:
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Information

(Please list another individual, other than yourself, that we can contact in case we can't reach you.)
Emergency Contact's Name*

First NameLast Name
Relationship
Phone Number*

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Does this person have permission to pick your child up from camp?

YesNo
Please list anyone that is authorized to pick up your child from camp.*
What are your goals for your child during camp? Tell us a brief summary of your child's challenges.*
Please share any concerns you may have about your child's safety awareness or ability to stay with the group.*
Please describe your child's verbal and communication abilities.*
Tell us some wonderful aspects of your child.*
What is your child's t-shirt size?*
Who referred you to Friendship Explorations?
Please let us know of any other friends you'd like to have your child with in the same group:
Medical Information
Primary Physician's Name
Primary Physician's Phone Number
Health Insurance Company
Health Insurance Policy Number
Diagnosis (if any):
Has your child ever received occupational therapy or speech therapy?*

Occupational TherapySpeech TherapyNeither
Does your child have any allergies? If so, please list them.*
If there is any other important medical information, please elaborate.
I understand and agree that my child(ren)'s and/or my own health/medical insurance is primary and agree to be responsible for medical expenses.*

Yes, I agree.
Please upload any reports that you feel will support your child’s camp experience:

Browse Files

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Friendship Explorations Waiver

Outdoor play is integral to Friendship Explorations occupational therapy camp operated by Ready Set GO Therapy, Inc. We will make every effort to ensure the safety of your child. However, we do want you to be aware that it is possible for accidental injuries to occur in this environment. In addition, please be aware that physical contact with the therapist is common in this treatment setting.

I give permission for my child,
Child's Name*
to receive occupational therapy treatment at Friendship Explorations operated by Ready Set GO Therapy.

I hereby agree to indemnify and hold Ready Set GO Therapy, Inc., Friendship Explorations and all its officers, directors, employees, representatives and volunteers harmless from and against any and all liabilities for any injury which may be suffered by me or by my child(ren) arising out of or in any way connected with participation in Ready Set GO Therapy, Inc, and Friendship Explorations program. In the case of a medical or surgical emergency, I hereby give permission, to any medical personnel selected by the staff, to secure proper treatment. I give my full permission for my child(ren) to participate in activities, including but not limited to, hiking, running, climbing trees and playing in water. I acknowledge that group activities may contain an inherent risk of injury.

Any controversy or claim arising out of or related to my child(ren)’s participation in this group will be attempted to be settled by a professional mediation service, then by binding arbitration pursuant to the applicable rules of the American Arbitration Association.

I acknowledge that I understand that the group is non-refundable unless Friendship Explorations has been advised to cancel the group by public health officials. If a day needs to be cancelled, there may be a makeup day added at the end of the session or the pro-rated amount for the missed date may be applied to future services.

I acknowledge that I have reviewed Ready Set GO Therapy and Friendship Explorations Policies and Procedures for COVID-19 safety. I am comfortable with these policies and procedures and consent to my child's participation. I understand that these policies and procedures are in place to mitigate but do not elimitate the risk of acquiring Coronavirus and COVID-19. I accept the potential risk.

Ready Set GO Therapy and Friendship Explorations takes your health and safety very seriously and fully intend to protect and keep your child safe.
Do you consent to the previous statement?*

Yes, I consent.No, I do not consent.
Use of any pictures or videos of my child(ren) that may be used for camp advertising, promotion and are the sole property of Ready Set GO Therapy, Inc.
Do you consent to photo release?*

Yes, I consent.No, I do not consent.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature*

Clear
Date

MonthDayYear
Date
Should be Empty:

2024 Summer Camps

Medical Information