2019 Special Summer Camp Registration

Thank you for your interest in Special Summer Camp at Brooks Avenue Church of Christ! We are planning a great 5 weeks of camp this year and can't wait for you and your family to see all that we have in store for our campers!

This camp is for individuals with special needs. The activities and pace are structured to support those with developmental delays and autism. Campers should have multiple or severe disabilities, such that they might have difficulty functioning at a camp designed for children without special needs.

We are limited in the number of campers we can accept.

Completing this form will allow us to get some initial information about your camper and once completed, one of our Directors will call you to find out more information. Completing this Registration form DOES NOT automatically guarantee a spot at camp. Your child's spot can only be confirmed after talking with a Director and when tuition is received IN FULL. Tuition can be paid online or via check. Links to pay online and address to mail payment can be found below. Limited scholarships can be given when needed and when all other forms of financial assistance have been exhausted. If your child has services through Alliance Behavioral Health, he/she may be eligible for "Flex Funds" to assist with the cost of Camp.

The dates for Special Summer Camp have been modified for Summer 2019 based on feedback from volunteers and camper parents. The times have stayed the same.

Camp runs from 8:00 AM - 4:00 PM with the option of attending for a half day OR full day each week. We strive to make this camp as affordable as possible:
Half day (8:00 AM-noon) is $100/week
Full day (8:00 AM-4:00 PM) is $200/week.

We have 2 separate camps for younger and older campers. Younger camp is typically for ages 3-9 and older camp is typically for anyone 10 years and older. Younger camp has more manipulatives to encourage fine motor and gross motor skills, sensory-friendly activities and is generally structured to suit younger children's needs. Older camp has more activities that encourage life skills and group skills training, independence and is generally structured to suit older individual's needs. We have no top age limit but we do ask that no campers be younger than 3 years old. We understand that age can be relative in the special needs community so if you are not sure which camp your child should attend, please sign up for the camp that fits their age range and then talk to the Directors for more information when they call you.

Brenda Branch and Brook Hancock-Galesic will be the directors for special summer camp as well as an additional diretor we will be adding this summer. Both of these women have extensive backgrounds working with the special needs population and have directed Special Summer Camp before. They have created weeks full of activities and guests that will make Camp a day of FUN for all who attend!

To pay tuition online (after getting approval from a Camp Director), please visit the link below and then choose "Quick Give" to make a payment with no login information required. Be sure to put in the "Additional Information" section that you are paying Camp Tuition for this particular camper or we will likely have trouble finding this payment with all the other online donations we receive. This line needs to read "Camp Tuition for (child's name)".

Address to pay registration fee online:
http://www.easytithe.com/dl/?uid=Broo700696&campus=SPECIALNEEDS

You may also mail or drop off a check to:

Brooks Avenue Church of Christ
Attn: Melinda Oldham
700 Brooks Avenue
Raleigh, NC 27607

Thank you again for your interest and we look forward to meeting or seeing your camper again!! If you have any questions, please contact Brook Hancock-Galesic at Brookgalesic@gmail.com

Camper's Name: *
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Other name this individual goes by:
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Camper's Age: *
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When will this camper attend (check all that apply): *
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Parent(s) Name(s): *
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Frequently checked email address: *
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Primary phone number and to whom it belongs: *
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Secondary phone number and to whom it belongs:
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Complete home address: *
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School or Day Program this camper attends:
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Does this camper have any particular likes/interests? *
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What is an effective reward/motivator for this camper? *
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What particular goals would you like us to work on to keep consistency with therapies or routines? *
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Will this camper come with a 1:1 assistant? *
Is this camper potty-trained? *
List any allergies/sensitivities this camper has or list "NKA" for no known allergies *
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What is this camper's diagnosis? *
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Is there anything else you would like us to know? *
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How did you hear of Special Summer Camp? *
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