Phone number
Phone type Mobile Home Work Other
Child's Grade *
Select… Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Other
Reason for Accommodation *
i.e. Medical Need, Learning Difference, etc.
Behavioral Tendencies *
i.e. Shyness, Hitting, Running Away, etc.
How do you (or other parent/guardians) handle these behaviors? *
Please share any and all calming strategies that our team can use to reinforce what is used outside of Kidtown
Communication Skills *
Select… Verbal Non-Verbal Communication Device Other
Care Information *
Please check all that apply
Please provide details/specifics on care needs indicated above *
What are their likes? dislikes? *
Please share any that would help us engage and interact with your child. Be sure include favorite items that your child may like to carry.
Any additional helpful information to better assist us *
Submit
