West Row Baptist Church 
At West Row we have a number of groups for children and we would like to know how we can best support your child. Please fill in the form below so that we can get to know a little bit about them. 
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Email *
Name of Child *
Childs Date of Birth *
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DD
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What groups you are you interested in? *
Childs Diagnosis (if applicable)
Childs Area of Need *
Your name, phone number and relationship to child. *
Does your child have extra support in school *
Does your child need assistance when using the toilet? If yes, please specify. *
What are you child's strengths? *
What are any potential challenges your child may have? *
What strategies could help your child? *
Is there any other information you would like us to know?
Would you be happy for us to contact you to discuss your child's needs. *
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