DREAM Summer Camp 2026 Participant Info

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Thank you for your interest in attending DREAM Summer Camp for teens (14+) and adults! Please allow 10 minutes to complete this intake form.

Please note that completion of this form does not mean you are officially registered. It means you have expressed interest for a spot that is available or the waiting list (as indicated for each week below).

Upon completing this form, please contact your regional center service coordinator (if you plan to use regional center funding) to let them know you are requesting to attend Dream Summer Camp. Communicate the number of weeks you would like to attend DREAM Summer Camp to your service coordinator.

If you are an SDP client, please coordinator with your independent facilitator and/or service coordinator to get this camp approved in your spending plan.

Camp will be 9am to 2:30pm daily.

$600 per week (for a 4 participant to 1 camp staff ratio)

Add $150 per week (for a 2 participant to 1 camp staff ratio) if extra support is needed.

Email *

First and Last name of Camp Participant *

Age of Camper *

First & Last Name of Parent/Caregiver *

Best contact phone number in case we need to reach you before, during, or after camp. *

Address *

Let us know which weeks of camp you are signing up for. We get cancellations all the time due to families' summer plans changing, so there is a likelihood you will get called. *

Week 1: June 15-19. (join our WAIT LIST)

Week 2: June 22-26. (join WAIT LIST)

Week 3: June 29- July 2. (no camp on July 3 to observe July 4) (join WAIT LIST)

Week 4: July 6-10. (join WAIT LIST)

Week 5: July 13-17. (join WAIT LIST)

Week 6: July 20-24. (join WAIT LIST)

Week 7: July 27-31. (join WAIT LIST)

Week 8: August 3-7 (join WAIT LIST)

Required

I understand that the camp participant-to-staff ratio is 4 to 1 for our standard $600 rate per week. If my child needs more support, there is an option to add on more support at 2 participants to 1 staff member for an extra $150 a week.

If my child needs a 1 on 1 staff member, I understand I will need to bring my own support person. Reasons to bring a 1 on 1 support person include the need for physical assistance with toileting, aggressive behaviors, self-injurious behaviors, and/or eloping.

I understand

Please indicate what is the best fit for you in terms of needing support at the camp. *

The standard 4-to-1 camper to staff ratio works for me for those with low support needs ($600/week)

I will need 2-to-1 camper to staff support. Support in this category includes supervision during toileting (with no physical assistance), access to communication if nonspeaking or minimally speaking, etc.; please note that people with severe behaviors or self-injurious behaviors will need to bring a one-to-one support person) ($600 plus $150/week)

I will bring a 1-to-1 support person and agree to pay the standard rate ($600/week)

Please let us know how you plan to fund camp.

*If using regional center funding, we will work with your service coordinator to complete payment. Full payment is due within 45 days of camp completion. If payment is not received within this time frame, the family may be held responsible for completing the payment.

Private pay

Tri-counties regional center, traditional program

North Los Angeles Regional Center, traditional program

Tri-counties regional center, Self-determination program

North Los Angeles Regional Center, Self-determination program

Other:

Required

Regional center service coordinator name.

Write N/A if not applicable.

Regional center service coordinator email address.

Write N/A if not applicable.

Regional center service coordinator phone number.

Write N/A if not applicable.

For regional center and SDP clients who will use an FMS to pay for camp, please list your FMS.

FMS contact information

How did you learn about DREAM camp? (Feel free to elaborate under the "Other" option.) *

Another family or friend

DREAM website

Social Media

Autism and Communication Center emails

Other:

Required

Is there anything you would like to clarify or share with us? *

A copy of your responses will be emailed to the address you provided.

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