Please complete and submit the form below for each child with special needs that you have already registered. Special Needs Support Form We are excited and blessed to have your child joining us for the “Summer Games 2020 Camp” this year! It is our earnest desire to help your child have a very positive experience at the camp, learn new skills, and meet new friends. Fearfully And Wonderfully Made board members, MCS staff members, and Licensed Physical, Occupational or Speech Therapists will be on-site during the camp to assist all kids who require additional support. We will be providing supervision and training to volunteers from the community who will be serving as buddies to each child. In order to provide appropriate support for your child, we would appreciate you providing us with the following information. We will be reviewing the information that you provide to us prior to the start of the camp so that we have the supports necessary for your child when he/she arrives on his/her first day of camp.Parent / Guardian Name* First Last Parent / Guardian Email* Camper Name* First Last Birthday* MM slash DD slash YYYY Sex* Male Female Is this the camper's first time at a sports camp?* Yes No Does Your Child Have Allergies?* Yes No List All Known Allergies*Medical Conditions*This is a very physically active sports camp. Are there medical conditions that impact your child’s participation or safety in active play and sports? Yes No Please Explain Medical Conditions*Medications*Please list any medications that your child currently takes: Let us know if these medications cause sun or heat sensitivity. *Parents will be responsible to provide sun protection for their child everyday.How does your child communicate best?*How does your child indicate the need for help?*What type of visual supports does your child use (if/then, picture schedules, etc…)?*Does your child have any gross motor skill or mobility challenges?*Approximately how long can your child attend to a small group, structured activity?* Does your child have any sensory needs (i.e. sensitivities/triggers)? What type of sensory supports does your child need (i.e. movement breaks, deep pressure, etc…)?*Does your child have any behavioral concerns (i.e. aggression, running away, impulsive behavior, etc…)? Please explain:*Does your child need any assistance for toileting or hygiene?*How does your child indicate the need for toileting?*Does your child need assistance with feeding?*Please explain any further support you feel your child would benefit from, to successfully participate in this Camp:*Photograph Authorization*Participating in this camp is going to be a great experience and we would love the chance to share your camper’s experience with other families. We would be thrilled to use your camper’s photo for our website, newsletter, Facebook and other marketing materials. The undersigned consents to and authorizes the taking of pictures of camp participation activities to be used on the Maranatha Christian School and Fearfully And Wonderfully Made website, newsletter, Facebook and other company marketing publications. The campers' name will not be published. Yes No Signature Parent/Guardian*I agree that the information provided here is accurate and best represents my child's needs. Δ