Parent's Name

Email *

Phone *

Child's Name *

Child's Date of Birth *

The Late Talker Group is 6 sessions long over 2 weeks and takes place on Tuesdays, Wednesdays and Thursdays from 9:00am-10:00am starting on July 8th and ending on July 17th. A parent or caregiver must attend with their child.

Tell Us A Bit About Your Child *

Does your child currently receive speech therapy? *

Y

N

Has your child been diagnosed with a language delay or disorder?

Yes

No

What goals do you have for your child's speech/language? *

What else would you like me to know about your child's speech/language? *

The total cost is $300.

$150 deposit required to hold your child's spot.

Your card will be charged the remainder of the balance two weeks before camp date.

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