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Social Skills in Motion is a small-group, inclusive, movement-based program designed to support social-emotional growth through play, movement, and meaningful connection. Children practice communication, cooperation, emotional regulation, and flexible thinking in a supportive environment where every participant feels safe, supported, and included. Each session includes a parent take-home resource designed to encourage skill carryover between home and program participation, along with developmental growth tracking throughout the 7-week experience to help families celebrate progress and emerging skills. Focus Areas: • Social skills & peer interaction • Emotional regulation • Confidence & independence

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *

Students entered below will be added to your family's account

Additional Information:

Other Questions/Comments:

Credit Card Verification:

Card Number: *

Name as it appears on card: *

Nickname:

Card Expiration Month: *

Exp Year: *

Address Line 1:

Address Line 2:

City:

State: Zip:*

eCheck/Bank Draft:

Bank Name:

Bank Routing Number:

(9-digit number)

Your Account Name:

(Your name on your bank statement)

Your Account Type:

Account Number: