New Family Form

We are so happy you are here! Please take a moment to fill out this form and tell us a little bit about you and your family!

- The Kids Team

Your name *

Last name

Email address *

Phone number *

Phone type

Gender *

Address *

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Household members

Please fill this form out for any additional parents/guardians that will be allowed to pick up/drop off your child as well as your child's information.

Does your child/children have any allergies/special needs? *

Does your child have an EpiPen or inhaler *

(please note- item must be left with the child. teachers cannot administer)

Yes

What makes your child upset/what are the warning signs?

What calms your child down?

Check any applicable information that might be helpful to team members to best minister to your child

Please note, for children 3 and up, parents will be notified in case of an accident or diaper change.

Hits

Kicks

Bites

Tends to run (leaves area without permission)

Aversion to sitting

Challenges with transitions

Special bathroom needs (help going potty, diaper changes, potty training, etc.)

None of the above apply to my child

Can your child tolerate snacks that contain sugar? *

Yes

Please note- our church's Sidekicks program does not provide therapy, behavior modification programs or medical intervention.

Grade

The Church On The Way
info@tcotw.org
(818) 779-8000

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