First Friends Family Form
These questions are asked for the benefit of your child and so that we may provide the best experience and safest environment for everyone involved. Our Church and our First Friends respect your family's right to privacy. Any information shared from this form is communicated directly with those caring for your child/family member and only on a "need to know" basis. Please answer the below questions that apply to your child/family member and help our church best minister to your family.
First Friends Ministry
Your Name (First & Last) *
Your answer
Email Address *
Your answer
Parent/Caregiver's Name *
Your answer
Child/Family Member's Name *
Your answer
Date of Birth *
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DD
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YYYY
Parent/Caregiver's Contact Information *
Your answer
Parent/Caregiver's Email Address *
Your answer
My Child/Family Member has the following allergies and/or food sensitivities. *
Your answer
My Child/Family Member has the following diagnosis, medical condition or learning differences: (List all that apply) *
Your answer
My Child/Family Member's main mode of communication is: *
Required
My Child/Family Member has the following interest: (List all that apply) *
Your answer
My Child/Family Member can do these things independently: *
Your answer
My Child/Family Member is uncomfortable with or has an aversion to: *
Your answer
My Child/Family Member needs assistance with: *
Your answer
A trigger point for resistance, frustration, or behavioral problem may emerge for my child when: *
Your answer
When/if my child experiences a period of frustration, he/she calms when we: *
Your answer
My Child/Family Member Does/Does not enjoy music *
Required
My child seems most relaxed in settings: *
Required
My child is really picky about any of the following: (Name any and all that apply) *
Your answer
My child is prone to seizure: *
Required
Please list any additional information that you would like for us to know about your child:
Your answer
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