Camp Registration Form
Thank you so much for your interest in our camp! We'll be in touch by June 14 to let you know whether we are able to offer a spot to your camper! If you don't receive an email from us, please don't hesitate to contact us at tmerrick@fhfnola.org (unfortunately, our emails sometimes go to spam). The camp cost is $250 per week. A two-week-long summer camp from 10 a.m. to 3 p.m. and we focus on disability justice, celebrating neurodiversity, and simply encouraging everyone to explore and have fun in a safe, supportive environment! We welcome all applications. This 10-day camp is designed for neurodiverse individuals to have an opportunity to explore coding with Texas Instruments Technology. Activities include daily competitions involving games, robotic vehicles, microcontrollers, calculators, and PYTHON programming. We aim to create a low-pressure, sensory-friendly environment that supports all types of communication.
Email Address
example@example.com
Camper Name
*
First Name
Last Name
Camper Birth Date
Please select a month
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Day
Please select a year
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Year
Camper Race
*
Home Phone Number
*
Mobile Number
*
Desired Name Tag
*
Camper Primary Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Select Camp shirt size
*
Small
Medium
Large
Extra-large
XXL
XXXL
Please provide any medical or dietary restrictions you have
Please list any allergies or food allergies
Please list current medications
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Important Information
What types of neurodiversity (if any) does your child have? (For example: autism, ADHD, sensory processing differences, learning or cognitive disabilities, speech conditions, etc.) Please feel free to list any conditions that you believe your child has even if they do not have a formal diagnosis.
Which methods does your child usually use to communicate (please select any that apply)
Spoken phrases or sentences that are understandable to strangers
Spoken sentences or phrases that have a special meaning to the child (for example, reciting portions of favourite books or TV shows)
Single words in combination with gestures
AAC devices and/or pointing to pictures or letters
Sign language and/or gestures
Other nonverbal method of communication
Other
How does your child usually show happiness and/or feelings of connection?
How does your child usually show that they are feeling overwhelmed, frustrated, or anxious?
Are there any safety concerns that you would like us to know about? (For example, medical concerns, a tendency to run/wander away, or self-injurious behaviours.) If so, how can we best support your child's safety? We are happy to work with campers to accommodate any safety concern-- this question is purely used to ensure we have the correct amount of aid or assistance ready for every child at camp.
If there are phrases in a language other than English that would be helpful for us to know in order to better communicate with your child, feel free to include them here. Likewise, if your child has specific gestures or gestalts/memorized phrases with a special meaning, feel free to describe them here.
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School Information
School Name
School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Family Information
Parent/Guardian's Name
First Name
Last Name
Contact Phone Number
E-mail Address
example@example.com
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Transportation
Transportation Type
Car Drop off/Pickup
Walking
Bus
Uber/Lyft
Driving
Bike
Other
Authorized Pick Up Contact Name
*
First Name
Last Name
Relationship to Camper
Authorized Pick Up Contact Name
*
First Name
Last Name
Relationship to Camper
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Emergency Contact Information
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Relationship to Camper
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Relationship to Camper
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In 300 words or less, any additional questions or comments
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