Participant
Date of Birth
Age
Mental Age
Gender
Diagnosis
Briefly describe your child's disability
Address
City
State
Zip
Parent/Caregiver Email
Second email(optional)
Home Phone
Parent/Caregiver Name
Cell Phone #1
Cell Phone #2
Emergency Contact Name and Number
Insurance Provider
Insurance Policy #
Physician
Physician Phone #
Allergies (including food allergies and sensitivities)
Medications
Is your child in a wheelchair and/or will they be bringing any
assitive equipment?
Is your child sensitive to sounds or crowds such as cheering
and loud music?
Are there any negative behaviors we should be aware of?
Now do you typically restore peace when negative behaviors
or emotional breakdowns occur?
Please provide details describing how much assistance your child
needs with walking, eating, using the restroom, etc.
Does your child wander or "run off"?  If yes, in what situations?
What else may we need to know about your child to ensure they
will have the best experience possible?
BFF Registration Form