Clone of Ohio TES Summer Program Registration Form 2025 [Fairlawn]

TES Fairlawn Summer Program Registration Form
Please select the best options for your child:

✔ Choose a program (Social Skills Group, Feeding Therapy, or Virtual Executive Functioning Skills)

✔ Select the age group

Please complete all sections. If you need help choosing, contact us—we’re happy to help!

For more information or questions, please contact info.oh@tesidea.com

Address: 3428 W. Market Street, Fairlawn, OH 44333 Phone: (330) 668-4041

SELECT GROUP AGE AND TIMES
Categories:All

All

Fairlawn: Elementary Social Group (Ages 8-12 Years) 10:00 am-1:00 pm

Fairlawn: Teen Social Group (Ages 13-17 Years) 10:00 am-1:00 pm

Fairlawn: Feeding Therapy Group (Ages 4-7 years)

Fairlawn: Feeding Therapy Group (Ages 8-11 years)

Executive Functioning Skills for Real Life
prevnext( X )
Fairlawn: Elementary Social Group (Ages 8-12 Years) 10:00 am-1:00 pm

June 5
One Session

$95.00 Quantity



June 26
One Session

$95.00 Quantity



July 17
One Session

$95.00 Quantity



Fairlawn: Teen Social Group (Ages 13-17 Years) 10:00 am-1:00 pm

June 12
One Session

$95.00 Quantity



July 10
One Session

$95.00 Quantity



July 24
One Session

$95.00 Quantity



Fairlawn: Feeding Therapy Group (Ages 4-7 years)

June 1-4 / 10:30-11:45 am

$350.00 Quantity



July 6-9 / 10:30-11:45 am

$350.00 Quantity



August 10-13 / 10:30-11:45 am
$350.00 Quantity



Fairlawn: Feeding Therapy Group (Ages 8-11 years)

June 1-4 / 12:15-1:30 pm

$350.00 Quantity



July 6-9 / 12:15-1:30 pm
$350.00 Quantity



August 10-13 / 12:15-1:30 pm
$350.00 Quantity



Executive Functioning Skills for Real Life

Executive Functioning Jumpstart
A virtual 2-week course focusing on practical skills to foster independence, focus, and follow-through. Questions? Must book 4 sessions. Book a Free Consultation now with Jennifer Wolverton, MS, OTR/L.

$150.00 Quantity



Executive Functioning Coaching
A virtual 6-week course focusing on practical skills to foster independence, focus, and follow-through. Questions? Must book all 12 quantities at one time. Book a Free Consultation now with Jennifer Wolverton, MS, OTR/L.

$150.00 Quantity



Total

$0.00
Child's Information
Child's Name

First NameLast Name
Birth Date

MonthDayYear
Grade
Gender

Other
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Home Number
Format: (000) 000-0000.
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Individuals Other than Parent/Guardian Authorization

Only these individuals have my authorization to care for my child in the event of an emergency and/or for drop-off and pick-up. Please advise these individuals they are authorized and will need to present identification to staff.
Contact's Name

First NameLast Name
Relationship
Contact's Name

First NameLast Name
Relationship
Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Informed Consent and Acknowledgement Waiver
Medical Release and Authorization
Assumption of Risk & Waiver of Liability Relating to Coronavirus/COVID-19
Refund Policy
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Parent/Guardian Signature
Please verify that you are human
Disclaimer:

Enrollment in the summer program is subject to review by Total Education Solutions (TES). After registration and payment are received, TES will review the child’s intake records or current programming to determine if the program is an appropriate fit. If it is determined that the program does not meet the child’s needs, TES reserves the right to recommend alternative services or programs that may be more appropriate. If the program is not appropriate for the child, TES will not process the payment or will reimburse the parent within 30 days.

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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TES Fairlawn Summer Program Registration Form