SEN/Behaviour Enquiry Form
Please fill in all relevant fields to allow Get Active Sports to have as much information on the needs of your child as possible. It is important we are aware of the level of care and support your child needs, and how we can best accommodate for special requirements. Please ensure this form is as accurate as possible to allow us to maintain the correct level of care and provide the most enjoyable environment for all involved.
Name of child
*
Name of Parent
Location
*
Desired Dates Required
*
Date of birth
*
-
Day
-
Month
Year
Date
Age
*
Description of additional needs/behaviour challenges
*
Is there anything your child likes or really enjoys?
*
Is there anything your child really dislikes or can cause an upset reaction?
*
If your child becomes upset, how do you or your school best manage this?
*
Does your child have any behavioural, social or emotional difficulties that you know of?
*
Please provide details of any physical disabilities (where applicable)
*
Does your child have any learning or communication difficulties? (speech and language delay, non-verbal etc.)
*
Will your child need help at lunch time?
*
Yes
No
Other
Does your child have a 1:1 or 2:1 provision in place at school?
*
Yes
No
They attend a SEN school
Other
Will your child require any additional supervision whilst toileting?
*
Yes
No
Other
Does your child ever need to be physically restrained, or show any aggressive behaviours towards others?
*
Yes
No
Other
Is your child likely to hide or run off during our sessions?
*
Yes
No
Other
Will your child need an extra bit of support when explaining activities?
*
Yes
No
Other
Additional Comments - Please use this section to advise us of any behaviours you would like us to encourage or discourage, or any techniques you find helps to support your child
Email
example@example.com
Telephone Number
Submit
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