Handwriting Summer Camp Application Form

Name*

First NameLast Name

Entering Grade*

*NOTE: This camp is only for students entering the 1st grade through 5th grade.

School Last Attended*

School Attending for 2025-2026 school year

Gender*

Date of Birth*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Student has an IEP?*

YesNo

Does your child have any behaviors that may impede their ability to engage in group activities? Check all that apply

Is there anything else I should know about your child?

This camp will be run by a trained Occupational Therapist who has the experience and expertise in working with children with all abilities. Each camp will have a minimum of 5 students and a maximum of 8 students. Additionally, there will be an adult aide to help assist the OT with the camp. However, if a child's behavior is not suitable for a group setting, please consider signing up for 1:1 handwriting tutoring to meet your child's needs by emailing us at feedforwardot@gmail.com.

Please list in order of whom to contact first*

Name*

First NameLast Name

Relationship*

Phone Number*

Please let us know if this child has any allergies*

List medications if this child is currently taking*

Has this child had any serious illnesses or operations?*

YesNo

If yes, please describe

Can this child take part in regular physical activities?*

YesNo

Do you want to indicate any related information?

Date of Registration

Date

Camp will be between 10am-12pm from Monday thru Friday
Cost: $150/per camper (increases to $175 if registering after May 30th)
$50 registration fee is due within one week of registration, not to exceed camp start date (a separate email will be sent to you after registering)
Remaining camp fee balance is due on the first day of camp
Remaining camp fee can be paid by the following: cash or card
A 5-minute grace period is allotted after camp for parents to pick up their children. Late pick-up after this time will incur $25 per 10 minutes late.
Children should come with sneakers and comfortable clothing since camp will entail some light physical activity.
Children should wear clothing that parents don't mind getting dirty due to sensory material being used that may get on the child's clothes.
Homework will be provided after each class for more practice outside of camp hours. Homework shouldn't exceed more than 20-30 minutes a day.
Upon completion of the camp, each camper will receive a certificate and fine motor/handwriting tools they can take with them for the new school year to assist them with handwriting!
Our Handwriting Summer Camp will be held at Victory Creative Learning located at 508 N Gray Street, Killeen, TX 76541.

DISCLAIMER: This camp does not constitute as skilled occupational therapy services, which requires a comprehensive individual evaluation for each child. It is a handwriting camp run by an occupational therapist as a general service to all students who need assistance with handwriting skills, despite a diagnosis or lack thereof. If you are interested in individualized OT services, please inquire by sending an email to feedforwardot@gmail.com.

Handwriting Summer Camp Application Form

Student Information

Parent(s)/Guardian(s) Information

Emergency Information

Health Information