Arbor Pointe Church VBS Registration
Registration Form for Arbor Pointe Church VBS June 19-23, 2017
Student's Name
Your answer
Parent/Family/Guardian Name
Your answer
Address
Your answer
Email Address
Your answer
Phone Number Home
Your answer
Phone Number Cell
Your answer
Phone Number Work
Your answer
Date of Birth
MM
/
DD
/
YYYY
Age
Your answer
Last school grade completed
Your answer
Home Church
Your answer
Friends of your child at this church
Your answer
Allergies/Medical Information/Other
Your answer
Emergency Contact #1 Name
Your answer
Emergency Contact #1 Phone
Your answer
Emergency Contact #2 Name
Your answer
Emergency Contact #2 Phone
Your answer
Dismissal Information (Name of persons(s) who may pick up this child from VBS
Your answer
Special Needs
If your child has special needs, please also fill out the questions below
How does your child best communicate his/her needs?
Your answer
How does your child communicate when she or he does not want something?
Your answer
What are your child's strengths?
Your answer
What are you child's challenges?
Your answer
What does your child like to do?
Your answer
How does your child socialize/make friends?
Your answer
Are there any aggressive/inappropriate behaviors we should know about?
Your answer
Are there any triggers of inappropriate behavior?
Your answer
What are some things that help hold your child's attention?
Your answer
Does your child have any dietary or environmental issues we should be aware of?
Your answer
Does you child have physical limitations? If so, briefly describe
Your answer
Are there medical issues we need to be aware of (seizures, diabetes, medications)?
Your answer
What are some ways we can help your child learn about God's love?
Your answer
Is there anything else you would like for us to know?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms