We are planning on summer Adult Group, Girls Hang Out and High School Group!  If you are interested in any of these groups, please fill out the registration form below. 

Summer Payment Options: Credit cards, check and cash are accepted. Insurance does not cover groups or camps. 

For other payment plans, please contact Lisa at l.dempseyslc@gmail.com

Summer Registration Form

Client Name *
Client Name
Parent Name *
Parent Name
Address *
Address
Phone
Phone
Group Interested in *
If you are interested in one of our several 5 weeks groups, please indicate which one in the field below.
A $100 non refundable deposit is required at the time of registration to hold your spot in a group. The $100 will be applied to your balance. If a group is not able to be offered you will be refunded your deposit in full. If a group is formed and you choose to no longer participate the deposit will not be refunded. By entering "$100" below you understand that you are committing to the nonrefundable deposit.
$
If you have any important information you need the office to know about your group, please indicate that here.

Thanks for signing up. Someone from our office will confirm your spot within 48 hours of receiving your deposit.