Family ASL Immersion Camp-Power Up with ASL June 4-7, 2020 FAMILY/GUARDIAN REGISTRATION FORM
This form is to register your family for the Family ASL Immersion Camp-Power Up with ASL. If any answer doesn't apply mark NA.
The camp is open to anyone in your family that will communicate with your Deaf or Hard of Hearing Child, including but not limited to Grandparents, Aunts, Uncles, Cousins etc. Room, meals, activities and supplies are included. ASL will be the language of the camp.. ASL and Spanish interpreters will be provided during orientation, meals and announcements. REGISTRATION DEADLINE MAY 1, 2020. Email Lori Colwell, Camp Coordinator at
or call 913.210.8153 with any questions.
Name that your entire family will be registering under including grandparents, aunts, uncles, etc.
City and School District that your student attends.
Name of each registrant over the age of 12.
Name and age of each of the registrants ages 9-11.
Name and age of each registrants ages 6-8.
Name and age of each of the registrants ages 0-5 that will be in child care.
What is the primary language used in your home?
What is your experience with ASL?
ASL is new to our family.
We are at the word and phrase level.
We are at the beginner conversational level.
We are at the conversational level.
We area the advanced level.
Please list the names and ages of any family members over the ages of 9 that would like to be considered for Track 2 (Conversational to advanced conversational level)during the camp.
Will your family be staying in the dorm? Twin size beds, air mattresses, linens, towels and washcloths provided. You will need to bring your own pillows and extra blankets.
How many people will be staying in the dorm? For children too small to sleep in a bed or on an air mattress you will need to bring the equipment and bedding for them to sleep in.
Cost for the camp is $50.00 per person regardless of age. Please indicate the amount that you owe.
If other what is the amount you owe?
Limited scholarships are available. You may request a part or whole scholarship depending on your families need. If not requesting a scholarship select none. We do not want cost to be a barrier to your family attending the camp.
If other list the amount requested or none.
The new amount I with scholarship.
Pick one of the following two ways to pay the above amount for camp. Payment must be received by Friday, May 29, 2020. We cannot take payment during the camp.
Check by mail to KSD Endowment, and write ASL Camp in the memo. KSD Business Office 450 E Park Street Olatthe, KS 66062
Charge or debit by phone by calling Jeanette in the Busines Office at 913.210.8120. $1.50 processing fee applies
If you would like to make a donation to the camp you may send a check to the address listed above or call the number listed above.
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This form was created inside of Kansas Schools for the Deaf and the Blind.