St. Mary and Archangel Michael Special Needs Ministry Registration Form
Registration form for participants with special needs in Sunday School and the Angels Monthly Camp Program for people with special needs
Child's Name *
Your answer
Parent's Name
Your answer
Parent's Phone Number *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Diagnosis/Educational Label *
Your answer
Allergy Information *
Your answer
Are there any stimulants that bother your child or any activities that are difficult for them to do? *
Your answer
What are your child's special Interests/strengths? *
Your answer
What suggestions do you have for us to better serve and understand your child?
Your answer
My child has my permission to attend St. Mary and Archangel Michael Coptic Orthodox Church MCP and to participate in all activities. I hereby give permission to the church and her servants, if deemed necessary, to order X-rays, routine tests and treatment for my child, and in the event I cannot be reached in an emergency, I hereby give permission to the physician to hospitalize, administer proper treatment, and to order injection and/or anesthesia and/or surgery for my child as named on this application. I understand that as a participant, my child may be photographed or videotaped during normal Camp activities, and these photos/videos may be used in promotional materials. I understand that St. Mary & Archangel Michael Coptic Orthodox Church MCP cannot be responsible for lost or broken items, and that unclaimed items will be donated to charity. I understand, and will comply with, all camp policies and procedures. I also understand, and will comply with, all cancellation policies and procedures. *
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