KidZone Connected!

New Hope KidZone's Special Needs Ministry

Your name *

Email address *

Phone number *

Child's Name (First and Last) *

Child's Birthday *

Child's Grade *

Child's Gender *

Briefly describe your child’s physical, cognitive and social abilities. *

Are there any medical concerns we need to know ie: allergies, contraindications? *

What interests and motivates your child?

How does your child communicate with others?

Does your child have any triggers or sensitivities that would create a negative experience?

If your child is agitated what is the best way to calm them? *

Can your child participate in snack time? *

Is there any other special information you would like us to know about your child?

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