Grade *
Select… Not yet in school Preschool/Junior Kindergarten Formal Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade
In Case of Emergency, please notify: *
(Please include Name, Relationship and Phone #)
Phone number *
Phone type Mobile Home Work Other
Phone number
Phone type Mobile Home Work Other
Primary Disability *
(If not applicable, simply answer N/A)
Secondary Disability
(If not applicable, simply answer N/A)
Please list your child's interests and activities they enjoy or are involved in. *
This helps us form relationships.
Allergies *
(Medicinal and/or Food)
Special Diet *
(If not applicable, simply answer N/A)
Medications we should be aware of *
(If not applicable, simply answer N/A)
Orientation/Attention/Concentration *
Oral Expressive Language *
When my child gets upset, he/she will... *
The best way to calm my child is... *
(Please specify any cues/prompts - verbal or physical - to use if needed)
If my child needs the restroom, he/she will communicate by... *
I know my child needs a break when... *
Other information you think would be helpful for us to know is...
What do you want your child to get out of their time at church?
How can we partner with you and your family to work together as your child grows in Christ?
Information Disclosure *
"I authorize the Unlimited Ministry at Sunnybrook Community Church to obtain information from son/daughter's school in relation to any educational, behavioral, or therapeutic plans that might be in place to assist with his/her education that my be beneficial to improving their experience as a part of the Unlimited special needs ministry. This includes but may not be limited to - IEP, current therapies, behavioral strategies, and any familiar visual/tactile objects or therapy toys/tools that are already used in the classroom".
Communication Agreement
Communication between parents and volunteers is crucial to making Unlimited successful and a positive experience for both families and volunteers. We ask that parents agree to weekly communication, and to notify the Unlimited Coordinator if they know there is a Sunday or Wednesday that the child will not be attending services - or as soon as possible in the event of a last minute absence. This will help us ensure that we are utilizing our volunteers as efficiently and fairly as possible.
Which service will you primarily attend? Please mark all that apply. *
Submit
