Torah Circle Registration Parent/Guardian Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Child's Information Name * First Name Last Name Gender How old will your child be on October 1st, 2023? * Birth Date * MM DD YYYY Has your child participated in Friendship Circle programs before? * Current Grade for 2024/2025 * Does your child have any diagnoses that would impact his or her learning or being in a group environment? * Does your child have any other medical diagnosis we should be aware of? (Asthma, allergies, etc)? * Are there any sensory challenges / sensitives we need to be aware of? (Noise, textures, etc.) * What is your child’s preferred learning style (Hands on, modeling, being given direct instructions, reading, etc.)? * What is your child’s main form of communication (verbal, sign language, gestures, AAC device, PECS, etc.)? * What are some of your child’s favorite things to do? * Are there any behavioral challenges that you would like to make us aware of? (Elopement, Aggression, Rigidities, etc.), Please explain * Has your child ever participated in any Sunday School, Hebrew School, or Non-day School Jewish Educational program? * Jewish Day School Hebrew School/Sunday School Online Classes Private Tutor None, till now. Other Does your child read basic Hebrew? * We are trying to gauge what level your children are at. This is no indication that your child must know hebrew. Yes No Know's the letters Is your child potty trained? * Yes Yes, with a reminder No, not yet Do you give the Friendship Circle permission to change your childs diaper during our care? * For safety there will be 2 people present at all time. Yes, I give permission and will leave diaper, wipes, & gloves, and any other necessary materials to change my child No, I do not give permission. I will stay in the parent room or near the location in case my child needs to be changed. N/A Please note: Torah Circle will be providing snacks for all the children. Does your child have any food allergies? * Please use the space below to share any specific dietary needs we should be aware of. Any other comments you would like to share? *After submitting this form please pay for Torah Circle here https://www.friendshiphouston.com/registration/torah-circle Thank you for your registration! One of our staff members will be contacting you within 24-48 hours.
