Youth Summer Program Registration Form


      1. Child’s emergency and medical info
      2. Child’s nutritional and medication info
      3. Child’s IEP-Individualized Educational Plan info
      4. Your device, at least 30 minutes, and good Wi-Fi or cellular reception
      5. Your financial info (only for applicants requesting financial assistance)
    1. Fill out each section completely. Skip the areas that do not apply.
    2. After you submit your packet, we will receive a notification. Registration is not complete until payment arrangement or financial assistance has been approved.
    3. Registrants will submit their payment via PayPal ( within 15 days of receiving this packet. Check and cash payments are due prior to attendance. NOTE: Refunds from PayPal payments will result in a $50 processing fee.


    Youth Services is a series of programs designed to provide teens with disabilities in Dallas County world-class services and support in the areas of life skills and recreation.

    Youth Services seeks to serve children of all socioeconomic and ethnic backgrounds.

    Camp Connections is an 8-week summer camp program from June 3rd to July 26th, tiered to support a range of disabilities and appropriate age groups through education, art, and games. The curriculum offers social, life, and vocational skills (older teens), activities, as well as community inclusion and volunteering opportunities. It is administered by qualified special education teachers, aides, and specialists.

    In addition to our full 8-week option, we offer one 4-week session: Session 1: June 3 – June 28 -OR- Session 2: July 1 – July 26

    Youth Services Goals – Promote achievement of academic, social and life skills, provide a fun and safe environment, and deliver peace of mind for caregivers who need relief.

    Youth Services Sponsorship – This program has been made possible by a generous grant to Ability Connection from The Crystal Charity Ball.

    1. Program Policy

    Youth Services uses best practices in promoting acceptance and inclusion. We do our best to not turn away any qualifying registrant due to lack of funds or severity of the disability. We do not discriminate based on race or cultural ethnicity, religion, social or political affiliation, or sexual orientation. We do not share confidential information of applicants, members, or families with any agency or individuals outside of our organization, nor do we specify individuals based on such information. The safety and rights of our members and staff are our priority.

    While we desire to serve all members with disabilities, we must honor our policy concerning capacity, safety, hygiene and grooming, transportation for attendees, overall best daily care and service for attendees, and honoring our Code of Conduct. The best way for members to use best practices and judgment is by adhering to the Youth Services Code of Conduct (see below).

    Please INITIAL each box after reading the corresponding statements.

    I agree that:

    Code of Conduct (click link, save, and review document with your child)

    2. Summer Program Membership

    Primary Contact

    Secondary Contact

    Medical Issues/Allergies

    Transportation (If transportation is needed, please let us know and we can discuss possible options.)

    Releases and Refunds

    I have provided the correct information; I have read all of the information on this page; I hold Ability Connection harmless of any associated risks.

    3. Abilities, Skills & Goals

    In order to best serve our members, we invite parents to share knowledge of their child’s abilities, skills, and goals as early as possible. This information is crucial to our program for the following reasons:

    • Providing a foundation for effective planning
    • Providing a base to foster mentoring relationships with members
    • Assisting staff with realistic individual goal setting for members
    • Effective planning to increase the likelihood of achieving their goals
    • Promoting achievement of academic and social skills

    4. Assistive Technology & Devices

    Assistive Technology (AT)

    Any member who requires AT to communicate or complete tasks must have their device operable and charged for each day. Camp Connections does not provide any AT or other devices for members. Staff persons are not required to operate AT for members but are willing to learn and assist members. In order to do so, Camp Connections requires your consent.

    Cell Phones, iPads, Tablets, Other Devices

    Members are allowed to have cell phones. We discourage non-emergency cell phone use. We also discourage bringing gaming, music and non-AT devices to Summer Program, however, Camp Connections does not confiscate members’ devices for any reason. Members are responsible for their own devices and personal belongings, and their devices should remain on their person.

    5. Safety & Nutrition Agreement

    Camp Connections practices a two-deep policy where there are always at least two staff persons present wherever a member is present at all times. Camp Connections does not provide medical attention or treatment to members. If medical attention is needed for a member at any time beyond First Aid treatment, members must have doctor and emergency contacts, medical facility, prescription medication, and food allergy information included in their files. There will be a staff nurse available for First Aid, medication administration, and food allergy purposes only. There will also be at least one staff person trained in CPR in each classroom. CPR can only be performed by the certified staff person while another staff person calls emergency. All Camp Connections staff persons have been trained on policies regarding negligence and protected health information.


    Medication Consent

    If you marked “Y” for assistance, be sure to MAKE AN APPOINTMENT with the Vice President of Youth Services to discuss and demonstrate proper medication administration. These details will be entered into our system and maintained in the daily log.

    6. Hygiene & Toileting Consent

    Camp Connections and Ability Connection ensure the utmost care when assisting members requiring mobility and toileting assistance. We understand that this support may be related to cognitive development, physical development, or both. Camp Connections is staffed with trained and willing aides to accompany, assist, and “habit train” individuals who may require this support.

    Support System

    If there is a support system already in place for your child, please share those details below and during the face-to-face (in-person or virtual) follow-up meeting following your packet submission. Camp Connections staff will reinforce what you already have in place to maintain consistency in the habit training.

    If there is no consistent habit training in place, Camp Connection is willing to assist and will provide you with some suggestions on the best practices currently in use.

    If you marked “Y” for hygiene and toileting assistance, be sure to MAKE AN APPOINTMENT with the Vice President of Youth Services to discuss and demonstrate proper hygiene and toileting assistance. Camp Connections staff persons designated for hygiene and toileting require in-service training by the Ability Connection staff nurse or the Ability Connection Training Center Director. These details will be entered into our system and maintained in the daily log.

    7. Emergency Form

    Primary Emergency Contact

    Secondary Emergency Contact

    Primary Care Doctor

    Additional Emergency Contacts

    Camp Connections uses best practices in all emergency situations. Should any emergency arise specific to your child, Camp Connections staff is trained to provide basic first aid.

    There will be a nurse present on-site or by phone consultation. There will also be a security guard posted on-site during operating hours.

    Camp Connections adheres to state codes and standards for emergencies requiring evacuation or sheltering in-place.

    I have provided the correct information; I have read all of the information in this packet; I hold Ability Connection harmless of any associated risks.

    8. Financial Acknowledgment (Private Pay, Tuition Assistance)

    Submit completed packet within 15 days of receiving this Summer Program packet. Submit payment within 15 days once accepted into the program. Start date: June 5, 2023

    Self Pay

    No financial assistance is required. I agree to pay the total amount within 15 days.

    Payment options

    PayPal is preferred, however we can accept personal checks, money orders, or cash. Choose the method that is best for you.

    PayPal: @AbilityConnection
    (If using a cell phone, the PayPal app must be downloaded from Google Play for Android, or Apple Store for iPhone. Entering your banking information is required. If using a browser from any device, use Type “Camp Connections Summer” in the Notes section.

    Tuition Assistance

    Thanks to our sponsors, tuition assistance is available if needed. We require financial statements for verification (check stubs for income verification, medical and other related expenses for the applicant). Please contact Youth Services immediately at to be considered. You will be responsible for submitting the remaining balance within 30 days of acceptance to the Summer Program.

    Please check before submitting.