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2012 SUMMER CAMP

 

PHOTO GALLERY

 

 

 

 

 

 

 

Registration Page

 

Mission Outlet
Registration Page
(Camp Location Family Fun Center)


All kids must go through a brief interview and assessment process to Qualify for this therapeutic Summer Camp. If you have proper insurance coverage, Mission Outlet will provide the opportunity for the parent and child to meet other outside Professional agencies who we have partnered with to further service and work more in depth with your child to provide additional services as needed. If your child is currently working with another outside source or agency, Mission Outlet will welcome them and will assist them in any manner necessary.
Also, your child may still qualify for this program but still not be excepted due to multiple reasons such as full capacity, not enough avail staff in a particular area , Special needs of a child that Mission Outlet cannot handle.
However please feel assured that we will make every attempt to enroll as many kids as quickly as we can into our all exciting 2012 Mission Outlet Summer Camp.

To begin your enrollment process, fill in below all information completely and accurately. Someone will be contacting you shortly.

 

Child 1      
Parents Name      
Childs name Address
Phone City
D.O.B State
Name of School Zip
SS# Grade
Name of Insurance Insurance #
No Insurance    
       
Child 2      
Parents Name    
Childs name Address
Phone City
D.O.B State
Name of School Zip
SS# Grade
Name of Insurance Insurance #
No Insurance    

 

Child 3
Parents Name    
Childs name Address
Phone City
D.O.B State
Name of School Zip
SS# Grade
Name of Insurance Insurance #
No Insurance    
 

 

 

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