Sensory Family Fellowship Participant Profile
Please complete this form to help us better understand your child’s sensory profile and daily experiences.
We are excited to welcome your whole family! While participants enjoy activities, parents and caregivers are invited to stay, relax, enjoy refreshments, and connect with other families. Because every child’s needs can change from moment to moment, we ask that a parent, guardian, or approved caregiver remain on site throughout the program. This helps us work together quickly and lovingly if a child needs their familiar support.
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I understand that this is a family-attended program and that a parent, guardian, or approved caregiver must remain on campus for the duration of my child’s participation.
Child's First Name
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First Name
Child’s Age
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Parent/Guardian Name
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First Name
Last Name
Parent/Guardian Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
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Email
Phone
Text Message
Would you like to receive communication about other opportunities to connect with us outside of Sensory Family Fellowship? You may opt-out at anytime.
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Yes
No
Do you grant us permission to take/publish photos of your child to tell the story of Sensory Family Fellowship?
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Yes
No
Allergies/Dietary Restrictions
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Which sensory experiences does your child typically seek out?
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Movement (jumping, spinning, swinging)
Touch (soft fabrics, messy play, fidgeting, weighted items)
Sounds (music, humming, making noises)
Visual (lights, colors, patterns)
Oral (chewing, mouthing objects, tasting)
Other
Which sensory experiences does your child tend to avoid or dislike?
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Loud noises
Bright lights
Certain textures (clothing, food, materials)
Strong smells
Crowded or busy environments
Other
What behaviors does your child display when overwhelmed or stressed?
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Hitting/kicking
Running Away/Hiding
Screaming
Getting in other people's space (ex. frequent hugging, handholding, physical contact, climbing on others/leaning on them, etc.)
Repeating the Script (ex. constantly repeating a favorite tv show scene, singing a familiar song on repeat, etc.)
None of the above
Other
What strategies or supports help your child feel calm and comfortable?
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Additional comments or information you’d like to share about your child.
Submit
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