Successful Sounds ®

"A Neurologic Music Therapy Based Approach to Teaching the Autistic Child"

Welcome!

Got Music?

Neurologic/Music Therapy

Clinical Sessions

Social Skills Groups

"Camp Kidz Rock!" intro

2011 Camp Themes

Pricing & Registration

Camper Application Form

Workshops

Location

About Us

Contact
Registration PART I:  Apply
This is not a clinical setting, therefore, camp is not appropriate for children that require physical support or restraint and/or exhibit intensive behavioral or functional needs. For significant challenges and/or for children under the age of 4, clinical sessions are recommended.  Inquire within.

Due to the active, social nature of camp, the following are required of our campers:
Must be between the ages of 4 & 10
Must exhibit verbal communication
Must be potty trained/accident free (pull-ups not allowed)
Must not have any life threatening health conditions, seizures or heart problems
“Camp Kidz Rock!”
2011 Camper Application Form
Space is very limited so don't delay...

  
How did you hear about "Camp Kidz Rock!"?
Today's Date
Child's First Name
Child's Last Name
Child's Gender
Child's Age
Child's Date of Birth
Child's Diagnosis
Father/Guardian First Name
Father/Guardian Last Name
Mother/Guardian First Name
Mother/Guardian Last Name
Address Line 1
Address Line 2
City
State
Zip Code
Home Phone() -
Father Cell() -
Mother Cell() -
Father E-mail Address (required)
Mother E-mail Address (required)
Why are you interested in "Camp Kidz Rock!"? (20 spaces)
Briefly tell us about your child, including strengths/weaknesses, likes/dislikes. (20 spaces)
What do you wish your child to achieve from this camp? (20 spaces)
Anything else you'd like for us to know?
Which sessions are you interested in your child attending? (Session I; Session II; Session III; Session IV; all)
What is your childs' shirt size? (YS, YM, YL, S, M, L)

 After we receive and review your application we'll contact you!

 Thank you!