APSM - Hobby Social Confidence - Summer 2026

  • SOCIAL CONFIDENCE CLASS Summer 2026 Registration

  • Explore independence

    through creativity!

    Participants will develop practical skills including planning, budgeting, and teamwork while participating in fun, creative hobbies.

    Throughout the session, students will take short, walking field trips to nearby locations to practice all the wonderful skills they are learning.  This class will take place both onsite at Adrian's Place as well as off-site in the surrounding community.

    SUMMER SESSION

    June 15, 2026 - August 3, 2026

    Mondays: 2:30 PM - 3:30 PM

    Ages 13+

    8 Session Course $600.00

     

    Registration Forms and Payment must be turned in prior to participation in any activity and will include a transportation waiver. 

    For Regional Center: Contact your service Coordinator and provide Vendor Code: PW8803, service code: 063. We need to receive Purchase of Service Approved.

    Location: Adrian’s Place Santa Monica, 1806 Lincoln Blvd, Santa Monica, CA 90404

    * Participants need to commit to ALL sessions in a session as there is no refund if a class is missed.  

    * All participants must be self-sufficient or have an aide for support.

    *This class is intended for participants who are motivated to learn new skills.

    *We are Regional Center Approved vendor.  Vendor Code PW8803

    If you have any questions, contact us at 310.581.8101 or info@AdriansPlaceSM.com.

  • Participant Preferred Pronoun
  • Participant Date of Birth *
     - -
  • Format: (000) 000-0000.

  • B. Parent/Guardian Information

  • A. Participant Information

  • Ralationship to the Participant
  • Format: (000) 000-0000.
  • Type of Phone Number
  • Format: (000) 000-0000.
  • Alternative Type of Phone Number

  • *IMPORTANT: Please be aware that we hire staff based on the total number of participants. Therefore, there are no refunds for missed days during the course.

  • C. Emergency Contact Information

    Please list the name and contact information to contact in an emergency/authorized to pick up your participant.

  • Emergency Contact 1

  • Format: (000) 000-0000.
  • Type of Phone Number
  • Is this Emergency Contact 1 authorized to pick up the participant?*
  • Please check YES if BOTH apply: 1) the participant was enrolled in the Holiday Pary Planning Course that ended December 2025, AND 2) There are no changes to the participant's health or other information?

  • D. General Intake Information

  • Participant General Information 

  • Will your participant be attending with 1 on 1 support? (Please note: 1:1 support is required if participant needs help managing behavioral challenges or is not bathroom independent)*
  • If 18+ yrs. of age, can the participant arrive and leave independently?*

  • Tell us about your Participant

  • Please check any that apply:*
  • PROMOTIONAL CONSENT Do you consent to receive updates on classes, programs, and events from Adrian’s Place Santa Monica?*
  • PHOTO AND VIDEO RELEASE Do you consent for Adrian’s Place Santa Monica to use, copy or display your participant’s photograph or video recorded image to promote Adrian’s Place through advertisements on websites, television, News releases, brochures, pamphlets or others.*

  • I. Adrian’s Place Policy and Procedure

    Health and Safety:  If your participant is experiencing any symptoms of illness, please keep them at home and notify us of their absence. 

    Attendance:  In the event that your participant will be absent, please notify us.        

    Support Aide: If your particpant requires additional support, you will need to provide a one-to-one support aide. Participants in need of one-to-one support must arrive with support or they will not be permitted to participate in the class.

    Bathroom: Due to our program design and liability coverage, we are not permitted to assist participants in the restroom. Therefore, ALL participants must be bathroom independent in order to attend to our class or must attend with one-to-one support. 

  • ADRIAN'S PLACE TRANSPORTION WAIVER

  • I give permission to Adrian’s Place Santa Monica for my child/charge (“camper”)  to be transported by walking and/or by public transportation to an event at a specified location on a date indicated prior to a field trip or off-site event. I understand that my child is expected to follow all applicable laws and to follow the directions provided by the driver and/or other adult staff and/or volunteers. I understand that participation in an identified event is not a requirement for participation in the Adrian’s Place Santa Monica program.

     I have read, understand, and discussed with my child that:

    1. They will be traveling by walking and/or public transportation.

    2. They are expected to respect each other, the vehicles they ride in, and the people they travel with during the trip;

    3. Riding in a motor vehicle may result in personal injuries or death from accidents, collisions or acts by riders, other drivers, or objects; and

    4. They are to remain in their seats and not be disruptive to the driver of the vehicle.

    I recognize that by participating in this activity, as with any activity involving motor vehicle transportation, my child may risk personal injury or permanent loss.

    I hereby attest and verify that I have been advised of the potential risks, that I have full knowledge of the risks involved in this activity, and that I assume any expenses that may be incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses.

    As a condition for the transportation received, I, for myself, my child/charge, my executors and assigns, further agree to release and forever discharge Adrian’s Place Santa Monica, its owners, operators, employees and volunteers from any claim that I might have myself or that I could bring on my child’s behalf with regard to any damages, demands or actions whatsoever, including those based on negligence, in any manner arising out of this transportation. I have read this entire waiver and permission form, fully understand it, and agree to be legally bound by its terms.

  • I authorize Adrian’s Place Santa Monica to transport my child/charge.*
  • As an additional layer of safety for the participants, do you consent to an Air-Tag tracking device being placed in the camper's name tag for use only when the camper is off of the Adrian's Place premises.*

  • ADRIAN’S PLACE ASSUMPTIONOF RISK / RELEASE OF LIABILITY / INDEMNIFICATION AGREEMENT

  • As consideration for permission to enter onto the real property located 1806-1808 Lincoln Blvd., Santa Monica, CA 90404 (“Property”) to attend various gatherings, including but not limited to, time before and/or after an activity, unorganized free time, participation of any organized recreational, educational or therapeutic activity, movie nights, potlucks or other similar social gatherings organized by or in association with Adrian’s Place Santa Monica, LLC, (“Company”) the undersigned acknowledges, appreciates, willingly and with full knowledge, agrees that:

    1. Entering onto the Property inherently includes possible dangers, including but not limited to personal injury, and possible death, damage to personal property or exposure to and illness from infectious diseases, including but not limited to MRSA, influenza, and COVID-19. While rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,

    2. I, ON BEHALF OF MYSELF OR FOR THE MINOR IDENTIFIED BELOW, KNOWINGLY AND FREELY ASSUMES ALL SUCH INHERENT RISKS, both known and unknown, EVEN IF ARISING FROM THE ACTIVE OR PASSIVE NEGLIGENCE OF others, and assumes full responsibility for participation; and,

    3. I recognize the importance of complying with, and I will ensure that I or the Minor fully complies with, any applicable laws, policies, rules, instructions, and posted warnings entering on to the Property. Minor and I understand that if we believe anything on the Property may be unsafe, we will advise a Company representative and may refuse to enter on the Property. Entering onto the Property and remaining on the Property shall constitute consent to these terms. 

    4. On behalf of myself or the Minor, HEREBY RELEASE AND HOLD HARMLESS the Company, directors, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE ACTIVE OR PASSIVE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law. Further I or on behalf of the Minor agree to defend the Company for any and all claims, suits, allegations or action brought against the Company arising out of, relating to or based in any way out of such presence on the Property, regardless of the doctrine of comparative fault.

    5. I agree that if any portion of this contract is held invalid, the remainder will continue in full legal force and effect. I understand and agree that the law of the state of California shall apply. I agree that all disputes shall only be brought in the State Court of California without regard to the choice of law doctrine. I agree to the personal jurisdiction of California to adjudicate any such dispute.

     

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