Summer Links to Learning Registration
Camp Day runs 9:00am - 3:30pm. Early drop off begins 7:30am - Late pick up until 5:30pm

Proof of medical records and payment will be due upon confirmation of the registration process. Please contact our office with any questions or concerns at 716-874-6175 or email contact@apot-wny.com

Email address *
Please select the week(s) you're registering for: *
Required
Will you be requiring early drop off (7:30-9:30am) or late pick up (3:30-5:30pm)?
Camper's full name *
Your answer
Camper's nickname(s)
Your answer
Parent/guardian name(s) and relationships *
Your answer
Home address (street, city, state, zip) *
Your answer
Primary phone number *
Your answer
Secondary phone number
Your answer
Camper's date of birth *
MM
/
DD
/
YYYY
Camper's gender *
Grade entering in September 2019 *
School/District
Your answer
Does your child currently have an IEP (Individualized Education Plan?) *
Does your child receive related services at school? (Physical, occupational, speech therapy, etc.) *
Emergency contact information (name, relationship, phone, address) *
Your answer
List full name/phone and relationship for all adults who have permission to pick up your child from camp: *
Your answer
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