Special Needs Buddy Application
Our church and kids ministry workers respect your family's right to privacy. Any information shared from this form is communicated directly with those caring for your child and only on a "need to know" basis.
Child's Name
Your answer
Date of birth
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DD
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YYYY
Age
Your answer
Grade/Ability Level
Your answer
Parent(s) Name
Your answer
Cell Phone
Your answer
Email
Your answer
Behavior Information:
When your child is upset, what's the best way to communicate with him/her?
Your answer
What are things that may trigger your child?
Your answer
What calms your child during a melt down/tantrum?
Your answer
When your child becomes excited, anxious or frustrated, what does he/she do?
Your answer
What are some activities and motivation factors that your child responds to and enjoys?
Your answer
Do you foresee any challenges with your child's participation in church activities? If so, what?
Your answer
Would you like your child to participate in our Buddy System?
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