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.
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First Friends Ministry
Child's Name *
Child's Date of Birth *
Parent/Caregiver's Name *
Parent/Caregiver's Phone Number *
Parent/Caregiver's Email Address *
My Child/Family Member has the following diagnosis, medical condition or learning differences: (List all that apply) *
My Child/Family Member has the following allergies and/or food sensitivities. *
My Child/Family Member's main mode of communication is: *
My Child/Family Member has the following interest: (List all that apply) *
My Child/Family Member can do these things independently: *
My Child/Family Member is uncomfortable with or has an aversion to: *
My Child/Family Member toileting needs : *
A trigger point for resistance, frustration, or behavioral problem may emerge for my child when: *
When/if my child experiences a period of frustration, he/she calms when we: *
My Child/Family Member Does/Does not enjoy music *
My child seems most relaxed in settings: *
My child is really picky about any of the following: (Name any and all that apply) *
My child is prone to seizure: *
Please list any additional information that you would like for us to know about your child:
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