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The Organized Mind Track Out Camp

Track Out Camp Member Signup



TOM Track Out requires a $25.00 annual supply fee per family. This fee is for the materials which will be provided to our campers in order to be successful throughout the camp and at school. Once you have submitted this registration form and payment, campers can sign up for any of our programs throughout the year including track out camps, before and after school care, our #Adulting Series, and emergency care.



   
First Name *
Last Name *
E-mail Address
A verification link will be sent to this address.

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Create a Password
8 Characters minimum.
Letters and Numbers only, no symbols!


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#1 Parent/Guardian Name *
Relationship *
Phone Number *
#2 Parent/Guardian Name *
Relationship *
Phone Number *
Child #1 First and Last Name *
Age *
Current Grade *
School *
Child #2 First and Last Name
Age
Current Grade
School
Emergency Contact *
Allergies
Medications
Special Needs or Behavioral Concerns
Does your child currently have an IEP, 504, or EP? *
How did you hear about us? *
Referral Name *
 
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