MoveAbility Kids - Get to Know Me Form
Please fill out this application as it will help our coaches develop a more unique program around your childs abilities! Write in the text area below the question and click SUBMIT ( to MoveAbilityGuelph@gmail.com) when you are finished! You can also opt to print this form and fill it out by hand and bring it to your first class if you prefer :)
Email address *
First and Last Name of Guardian(s):
Your answer
Home Address:
Your answer
Phone Number:
Your answer
Participants/Child's First and Last Name:
Your answer
Participant's birthday (day/month/year): *
Your answer
T-shirt size
Please identify your child's exceptionality here in proper medical terms:
Your answer
Other Relevant Medical Information (i.e Allergies, Epi Pen) :
Your answer
When my child tries new things/ is physically challenged, he/she:
Your answer
When my child meets new friends, he/she feels:
Your answer
When my child hears music, he\she responds by...
My child prefers music that is:
Please select any option that describes your child:
Sometimes my child has trouble with:
My child's range of motion is:
Sometimes my childs coach will need to remind me to:
Your answer
Something that is unique about my child is:
Your answer
One new thing my child wants to learn this session:
Your answer
Please feel free to add anything else about your child that you feel is necessary for our instructors to know:
Your answer
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