Youth Week Survey

Social activities are important in the development of our children. In all of our social activities, our blind and visually impaired children –

*Build communication skills
*Make new friends
*Build stronger relationships
*Improve travel skills
*Build independent living skills

Participants pre-requisites:
1. Be at least 8 years old
2. Be able to follow instructions
3. Be willing to work independently and in a team

Our youth week sessions are free, held in a safe environment and a great way to gain greater confidence. sign up for 1 or all of our youth sessions.

Question Title

* 1. Select a session your child is interested in participating in. You can select more than 1:

Autumn Break (5 days)

Winter Break (5 days)

Spring Break (5 days)

Summer Break - Camp Get Ahead (7 days)

Information about the session(s) you have signed up for will be sent to you upon receipt of your sign in form.

Question Title

* 2. Student Info

Youth Name

School

Question Title

* 3. Parent/ Guardian Info

Parent Signature

Email Address

Phone Number

By clicking "DONE" button, I consent to signing this document electronically and agree that my electronic signature is the legal equivalence of my manual signature.