Connections Behavior Planning & Intervention

Parent/Guardian Name*

First Last

Parent/Guardian Email*

Enter Email Confirm Email

Parent/Guardian Mobile Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Camper Information

Child Name 1*

First Last

Child 1 Age*

Child Name 2

First Last

Child 2 Age

Child Name 3

First Last

Child 3 Age

Policy Acknowledgments*

This camp is for ages 6-18 years old

This camp’s staffing is a 2:1 or 3:1 staff ratio to campers

You must pay for an entire week of camp at a time; you are allowed to pay in full at the start of camp

Tuition payments are due 2 weeks prior to your camp week

All activities are on site, we do not tranport campers

We are a behavioral health agency and all of our staff are highly trained ABA practitioners

We will not provide snacks or food, please send a water bottle and snacks as needed

Please acknowledge that you understand the following rules and policies for attending our summer camps.

Select Your Preferred Program(s)*

You may select more than one program.

Full Day (9-3)

Half Day Morning (9-12)

Half Day Afternoon (12-3)

Federal Way Half Day ($300/week)

Week of June 24 – 28

Week of July 1 – 5

Week of July 8 – 12

Week of July 15 – 19

Week of July 22 – 26

Week of July 29 – Aug 2

Week of Aug 5 – Aug 9

Week of Aug 12 – Aug 16

Federal Way Full Day ($500/week)

Week of June 24 – 28

Week of July 1 – 5

Week of July 8 – 12

Week of July 15 – 19

Week of July 22 – 26

Week of July 29 – Aug 2

Week of Aug 5 – Aug 9

Week of Aug 12 – Aug 16

Shoreline Half Day ($300/week)

Week of June 24 – 28

Week of July 1 – 5

Week of July 8 – 12

Week of July 15 – 19

Week of July 22 – 26

Week of July 29 – Aug 2

Week of Aug 5 – Aug 9

Week of Aug 12 – Aug 16

Shoreline Full Day ($500/week)

Week of June 24 – 28

Week of July 1 – 5

Week of July 8 – 12

Week of July 15 – 19

Week of July 22 – 26

Week of July 29 – Aug 2

Week of Aug 5 – Aug 9

Week of Aug 12 – Aug 16

Message

Please use this space to provide any information that may be pertinent to your child or situation.

Registration Deposit Per child ($200) *

Price: $200.00

Please enter the number of children attending camp.

Total

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Summer Camp 2024 Registration

Camper Information

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