Summer Camp 2025 Registration
Read and fill out the form carefully for registration. If any questions, please Call 561-295-4159 or Email: Info@speakreadgrow.com
Parent Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Student Name
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First Name
Last Name
Student's Age
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School and grade entering in the fall
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Does your child have a learning, medical, or neuropsychological diagnosis? If any apply, Please list.
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What are some of your child's likes/favorite things?
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What are some of your child's dislikes/fears/sen-sitivities?
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Does your child have any allergies or medical conditions?
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Please check which camp or camps your child would like to attend
Speak Read Grow - Game On! Reading Camp Week 1 (entering 2nd to entering 5th graders). Monday through Thursday July 7-10, 9:00-12:30. $375. 10% discount for Registered Siblings
Speak Read Grow - Level Up! Reading Camp Week 2 (entering 2nd to entering 5th graders). Monday through Thursday July 14-17, 9:00-12:30. $375. 10% discount for Registered Siblings
Speak Read Grow- OT Handwriting Camp! Mon, Tues, Wed, July 28,29,30. 9:00-12:00. Entering 1st through Entering 3rd Graders (should have letter recognition skills to participate). $275. 10% discount for Registered Siblings.
Sometimes treats are allowed in sessions to teach a specific concept or to reward a child for reaching his/her goals (ex. small lollipops, small portion of chocolate, etc). Please let us know if this is allowed for your child.
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Yes
No
I understand that I will receive an invoice within 7 days of my registration of which I must submit payment through the HIPAA safe platform Simple Practice sent via Speak Read Grow to confirm my registration.
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Yes
No
I understand that I have 30 days to cancel registration, and after that I may receive a 50% refund for cancellation up until June 15th. After June 15th no refund may be given.
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Yes
No
I understand that while Speak Read Grow supports every child's opportunity to learn and grow, Speak Read Grow does not have behavioral support on staff for children who have behavioral goals/needs. If my child has behavioral needs/goals, I must provide a certified ABA specialist that is trained to assist with my child's needs and notify Speak Read Grow in advance.
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Yes
No
I understand that my child needs to bring a couple of healthy snacks and a re-fillable water bottle every day. I understand lunch will not be during camp.
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Yes
No
I understand I can drop off my child no earlier than 8:45 a.m. and must pick up by 12:30 p.m. for Reading camp and 12:00 for OT Handwriting camp. Prompt pickups are necessary as our specialists also have clinic appointments after camp.
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Yes
No
Please leave any questions or concerns here.
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