Elementary Age Child Form

Tell Us About Your Elementary Age Child

Parent/Guardian*

Cell Phone*( ) -

Email*

Child's*

Age*

Birthday*

Grade School*

How often does your family attend STWCI?*

Sporadically/few times per year

1-2x per month

3 or more x's per month

Any dietary/food restrictions we should be aware of?*

Is there anyone else you authorize to pick up your child from Children's Ministry? If so, please give their name, relation and cell # below.*

Does your child have any special needs/disabilities or (i.e. physical, verbal, visual, audio, mental, mobility, etc.) requiring special assistance? If so, please list them and the best way to serve your child during service.*

Does your child have any behavioral or mental health challenges? If so, please list them and the best way to respond to your child during service.*

Does your child have any medical conditions we need to be aware of during a typical service (i.e. injuries, allergies, TBI, vision, infections, diseases, etc.) ? If so, please list them and the best way to respond to your child during service.*

What is your child passionate about? Favorite activities?*

Are there any activities that your child does not enjoy or would prefer not to participate in?*

What helps to motivate your child to do their best?*

What triggers frustration or withdrawal?*

What would be the best response if your child becomes frustrated, sad or angry?*

Any other comments you would like to share that would help us while we care for your child?*

Important Reminders:

Keep your phone on vibrate! We send you a text message if your child needs you during service. Please respond immediately after you are contacted.
To reduce the spreading of the COVID-19 virus, we kindly ask that parents refrain from sending tithes or offering monies with their children until further notice. All monies can be submitted online or placed in the designated secure bins.

Please leave this field blank.

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