Partnering With Your Family

Thank you for helping us learn more about your child. Our desire is to create a safe, supportive, and welcoming environment where your child can thrive. The information you share will help our team better serve your family and respond appropriately to your child’s needs.

All information submitted through this form will be securely stored with limited access. By submitting this form, you consent to us storing and using this information for care and ministry purposes.

Parent Name*
First Last
Phone*
Email*
Which campus do you attend?*
Child's Name*
First Last
Communication & Interaction
How does your child best communicate (verbal, signs, picture cards, device)?*
How does your child let you know they're overwhelmed or need a break?*
Sensory & Environmental
Are there sensory sensitivities we should know about (loud sounds, certain textures, lighting, crowds)?*
Does your child have a comfort item or routine that helps them feel safe?*
Safety & Medical Response
Does your child have a condition that may require emergency response (seizures, severe allergic reaction)? If so, what is your action plan and who should we call?*
Are there any physical limitations we should accommodate?*

Accept The Invitation

The Skeptic Who Found Church

August 15 at 8:00 am

Do Good: Powhatan Ramp Builds

Partnering With Your Family

Communication & Interaction

Sensory & Environmental

Safety & Medical Response

Locations

Guidance

PCC