Summer Series: Nature-Based Social Groups

Thank you for your interest in PPT's Social Groups. Please complete this form. Following your sign-up, we will reach out with next steps!

To complete registration, there is a $100 fee to hold your child's place for our group services. This fee will be applied to your first month's tuition once the services begin and is nonrefundable. Groups start the week of June 1st, 2026 and end on July 31st, 2026.

NOTE: If enough children join the waitlist, additional group offerings will be considered.

Today's Date:

Date

Which group are you registering your child for?

Ages provided for a general reference, but this is fluid based on your child's maturity level and skillset.

*Please only sign up for one spot per registration submission. This means the number "1" is only displayed in one box.

If the group you are hoping to join is full, please add your child to the appropriate waitlist below; often family schedule's change and a spot opens up, and you will be the first for us to reach out to!

Please confirm the day you selected.

Are you a returning PPT Occupational Therapy client?

Child's Full Name:

First NameLast Name

Child's Birthdate:

Date

Parent/Guardian Full Name:

First NameLast Name

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Phone Number:

Please enter a valid phone number.Format: (000) 000-0000.

Parent/Guardian Email:

example@example.com

Where did you hear about Playful Palms Therapy?

I understand that an OT evaluation is required by state law prior to beginning occupational therapy services. Does your child have a current OT evaluation that is 12 months or newer?

Behavior Policy:

Our therapists use cues of safety, sensory supports, and relationship-based interventions to help children handle big emotions and behaviors. Children who attend our services must be able to follow simple directions (most of the time!), and have basic safety awareness to be in wild nature settings with the therapist but NOT always within arm’s reach. This means that your child does not elope.

Our groups take place on acres of natural space with access to rivers, marshes, ponds, elevation changes, trees, and natural hazards like thorny plants and potential animals. This is not an ideal environment for children who have significant behaviors or support needs for safety in this setting. If a child has disruptive behaviors that impact the safety of themselves or the therapists in this environment, we will immediately collaborate with the parents to discuss relationship-based strategies to further support safety in the environment. Should it be decided by the therapist and parent that this setting is not a good fit for the child, services will be terminated.

Please verify by checking EACH box that matches your child's abilities.

Please leave any comments, questions, or concerns you have about your child's participation in outdoor occupational therapy based on the above behavior policy.

I understand that Playful Palms Therapy does not work directly with any insurance company. Playful Palms Therapy is a direct provider for the family. It accepts Private Pay only. We can provide Superbills upon request.

If you would like to subscribe to our email newsletter to receive periodic emails from Playful Palms Therapy, please enter your email here! We send tips, resources, and give subscribers first dibs for our services.

Billing for this series will take place on June 1st for the remaining amount: $620. This will cover all sessions through June and July. This is non-refundable.

JOIN OUR EMAIL LIST HERE!

I have filled out this form completely and reviewed it for accuracy. I understand that Playful Palms Therapy will contact me within 48 hours with next steps

My Products

Registration Deposit

Enter description

$100.00

WAITLIST

No fee at this time- once you move off the waitlist, we will reach out to complete your deposit.

Free

Total

Payment Methods

Credit Card

Apple Pay