Summer Sessions at Blossom Educational Therapy
Thank you for filling out this form. This will help us with planning for summer schedule. Summer sessions will begin July 1st-August 8th.
Student Information
Student Name
First Name
Last Name
Grade going into:
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent(s)/Guardian(s) Information
Please list in order of whom to contact first
*
Emergency Information
Name
First Name
Last Name
Relationship
Phone Number
Health Information
Please let us know if this child have any allergies
*
Summer Program Options
Summer is a great time for students to practice skills and set them up to start for a successful start to the upcoming school year! For our summer program options, we have two options available: 1: one-on-one sessions 2: Spanish Group Camp for students Please choose the one that works best for your child.
Option 1: One on One specialized instruction to support with academics or executive function skills. (July 1st-August 8th)
Session with Lead Educational Therapist Professional ET/P (Lizeth)
Session with Associate Educational Therapist
Session with Learning Specialist in Reading, Executive Function, or Math
Summer Sessions will take place Monday-Thursday. We will do our best to accommodate student schedule. Please indicate which days and times might work for you.
Monday
Tuesday
Wednesday
Thursday
10:00am-11:00pm
11:00pm-12:00pm
12:00pm-1:00pm
1:00pm-2:00pm
2:00pm-3:00pm
3:00pm-4:00pm
4:00pm-5:00pm
Please let us know if there are any time restrictions/considerations to take into account when scheduling.
Option 2: Spanish Camp Group Sessions: Spanish group sessions will be a fun interactive, engaging, and multi-sensory way of students practicing their spanish skills in vocabulary development, decoding, and comprehension. Sessions will include all materials needed for creative projects!
Summer Camp Group 2x/week: Tuesdays and Thursdays 5:00pm-6:00pm
Summer Contract
After scheduling session, we will send out a new contract for summer sessions.
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