RISE Ministry Intake Form

Child's Name

Date of Birth

Grade

Parent/Gaurdian's Name

Phone

This address will receive a confirmation email

Address

Please describe your child’s diagnosis, medical condition or learning differences.

What are some things that may cause your child to get frustrated? What are some helpful techniques to calm him or her?

Does your child have specific sensory needs?

Best way to communicate with your child?

Any dietary restrictions?

Other helpful information?

Description

At Kids Lane, our vision is to partner with parents to help children know and grow in Christ. Our RISE Ministry plays a vital role in this mission by supporting parents of children with special needs. We strive to welcome all children and families into Kids Lane with open arms!

To get started, please fill out the RISE Ministry Intake Form below, and our team will work to find a buddy for your child.

RISE Ministry Intake Form

Description

Please Fix the Following