Vbs Registration Form Page 2

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VBS Registration Form
Special Needs Considerations
Child’s Name:_________________________
1. How does your child best communicate his/her needs? ___________________________________________
__________________________________________________________________________________________________
2. How does your child communicate when she or he does not want something? ______________________
__________________________________________________________________________________________________
3. What are your child’s strengths? _________________________________________________________________
___________________________________________________________________________________________________
4. What are your child’s challenges? ________________________________________________________________
___________________________________________________________________________________________________
5. What does your child like to do? _________________________________________________________________
__________________________________________________________________________________________________
6. How does your child socialize/make friends? _____________________________________________________
__________________________________________________________________________________________________
7. Are there any aggressive/inappropriate behaviors we should know about? __________________________
___________________________________________________________________________________________________
8. Are there any triggers of inappropriate behaviors? ________________________________________________
__________________________________________________________________________________________________
9. What are some things that help hold your child’s attention? ________________________________________
___________________________________________________________________________________________________
10. Does your child have any dietary or environmental issues we should be aware of? _________________
___________________________________________________________________________________________________
11. Does your child have physical limitations? If so, briefly describe :__________________________________
________________________________________________________________________________________________
12. Are there medical issues we need to be aware of (seizures, diabetes, medications)? ________________
___________________________________________________________________________________________________
13. What are some ways we can help your child learn about God’s love? ______________________________
____________________________________________________________________________________________
14. Is there anything else you would like for us to know? _____________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
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