Support Us
Skip to content
Facebook
YouTube
LinkedIn
Instagram
News |
Events |
Staff Resources |
Careers
Search for:
Our School
About
Enrollment
Our Team
Curriculum
School Calendars
Testimonials
Funding
Locations
Schedule Tour
Programs
Inclusion
Therapies
Donate Now
ABA / Therapy
Now Hiring
Contact
Summer Camps
Rock the Summer AGAIN! – 2021 Summer Camp Registration
ADMIN-TLS
2021-01-29T18:33:42+00:00
Rock the Summer AGAIN! – 2021 Summer Camp Registration
Please enable JavaScript in your browser to complete this form.
Student Name
*
First
Last
Age
*
Grade Level
*
Parent/Guardian
*
Phone
*
Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
Summer Camp - $750 Material Fee + $2,250 Camp Fee
*
$3,000 Total
$400 Classroom Peer Only (LIMITED SPOTS)
$100 Non-Refundable Registration Fee
*Non-refundable Registration Fee Due Upon Registration
Payment Source:
*
Private Pay (Out of Pocket)
Autism Scholarship
Franklin County Pilot Program
Location: Choose One
*
Central (Worthington)
North East (Johnstown)
South (Canal Winchester)
Student T-Shirt Size
*
Youth XS
Youth S
Youth M
Youth L
Youth XL
Small
Medium
Large
XL
2XL
Total Paid
$0.00
*Non- Refundable Registration Fee MUST Be Paid with Registration ($100.00)
By Initialing this Form I understand that This is a Binding Non-Refundable Fee.
*
Behavior Clause / Teacher Shortage - Please Initial after reading
*
*** TLS BEHAVIOR CLAUSE: IN ORDER TO ENSURE A SAFE AND EFFECTIVE LEARNING ENVIRONMENT, THE LEARNING SPECTRUM ASKS THAT STUDENT'S BEHAVIOR BE MANAGEABLE INDEPENDENTLY IN A SMALL GROUP SETTING*** ***Due to the national teacher shortage, enrollment for summer programming cannot be guaranteed until May 15, 2022. Registration Fee will be refunded if necessary.
Website
Submit
Printable Registration
Page load link
Go to Top