Please print this form, check the programs you are interested in and send to: 

Cisco Center, 540 Baltimore Annapolis Boulevard, Suite #3, Severna Park, MD 21146

Child Registration

I am interested in the following programs (please print page, check all that you are interested in, and mail or bring to the Cisco Center):

                                 Fall Programs

A. Pre-School Program: This is a 1/2 day program for children with special needs. It is an environment rich in language development with a small teacher to student ratio promoting pre-academic instruction, social skills development, language skills, oral motor activities, sensory motor activities, gross/fine motor activities, developmental sound skills, snacks (cooking on Fridays), music/songs, and developmental activities incorporating sequencing, following directions, alphabet, numbers, colors, and shapes. CHILDREN ARE NOT REQUIRED TO BE TOILET TRAINED.

______   AM Session: 9:00 AM - 11:45 AM
             Check One:    _____ 5 Days     _____ 3 Days     _____ 2 Days


______   PM Session: 12:50 PM - 3:30 PM
             Check One:    _____ 5 Days     _____ 3 Days     _____ 2 Days


Extended Hours Available:

_____ Morning: AM 8:00 AM - 9:00 AM

_____ Lunch: 11:50 AM - 12:45 PM

_____ After School: 3:30 PM - 4:30 PM


                                Additional Fall Programs

Monday and Wednesday

_____ Phys. Ed./Games/Gymnastics - This program is designed to introduce children to a wide range of sports and activities all the while building coordination, increasing self esteem, and improving social/language skills in a non-competitive environment.

Tuesday

______ Dance/Movement - This class will focus on the joy of movement while incorporating balance, body awareness, spatial awareness, and sensory motor skills. It will increase your child's listening skills, reduce stress, increase self-esteem, and improve their social/language skills.

Thursday

_____ Art - This class will use a multi-sensory approach to making creative, three dimensional art projects. It will include a variety of sensory motor, visual perception, and perceptual motor skills.

Friday

_____ Science & Nature Club - This program will offer fun, interactive, hands-on activities to explore the world around us. The class will promote further development of your child's imagination as well as increase problem solving, listening, and social/language skills.

----------------------------------------------------------------------------------------------------

_____ Mom and Dad's Night Out - Once a month child care program (activities, snacks, movie, etc.): 6:00 PM-10:00 PM.

____  Tutoring - individual pre-academic, elementary, and middle school.

____  Speech and Language Therapy - individual or small group.

____  Oral/Motor Group - Small group developing oral motor skills to facilitate speech development.

____  Social/Language Group - Small groups emphasizing social/language interaction and play skills.

____  Parent Inservice Training - Behaviors, Pre-Academics, Child Development, Social Development, IEP Process, Language Development.

____  Father's Group - A Dad's only group, taught by a Dad, to discuss and share techniques to facilitate social/language skills with your child in the home and community.

____  Family and Child Advocacy - A parent group discussing and sharing information related to your child's educational development and the IEP process.