Special Needs Events and Program Registration

You are invited to join our growing circle of friends!

We strive to bring the Bible to life in our weekly program opportunities:

Sunday School classes are available 9:45 – 10:45 AM
Amplify, Tuesdays from 1:00-2:00 PM
Friendship Circle, Wednesdays from 11:00 AM – 1:00 PM

Visit the Special Needs Ministries web page for more information.

Sign up by checking the programs you’re interested in attending, and then come on over! We are here to serve you with love, prayer, and caring!

NOTE: Special Needs Ministry events are not drop-off events, so a PA or Caregiver may be required to remain with participants (as is applicable).

Special Needs Registration (Fall 2024)

Parents/Guardians Name(Required)

First Last

Phone(Required)

Email(Required)

Participant #1 Info

Participant #1 Info(Required)

First & Last Name

Mailing Address

Date of Birth

Special Events

Fall Homecoming Ball (Saturday, Sept 28, 6:00-8:00 p.m.)

Check as many as needed.

Weekly events (Fall 2024)

Amplify (Tuesdays, 1:00-2:00 p.m.)

Friendship Circle (In person, Wednesdays, 11 a.m.-1:00 p.m.)

Friendship Circle (ZOOM, Wednesdays, 11 a.m.-1:00 p.m.)

Check as many as needed.

Does participant #1 engage in behaviors that might be helpful to know about up front?(Required)

Yes

Please describe the behavior and the best way to redirect to a more preferred behavior. We want to use the same methods in order to not confuse your participant.(Required)

What level of reading would you recommend for your participant #1?(Required)

Participant #1 preference for reading out loud

Does not like to read out loud

Likes to read out loud but struggles with big words

Likes to read out loud and knows most words independently

Does Participant #1 Have Food Allergies?(Required)

Yes

Participant #1 Food Allergies

Participant Name

Food Allergy

Reaction Type

Participant #1 T-shirt preference

Participant #1 T-shirt size

2. Do you need to register more participants?

Yes

Participant #2 Info

Participant #2 Info(Required)

First & Last Name

Mailing Address

Date of Birth

Special Events

Spiritual Summer Deep Dive (July 9-11, 5:30-7:00 p.m.)

Fall Homecoming Ball (Saturday, Sept 28, 7:00-9:00 p.m.)

Check as many as needed.

Weekly events (Fall 2024)

Friendship Circle (GPC, Wednesdays, 11 a.m.-1:00 p.m.)

Friendship Circle (ZOOM, Wednesdays, 11 a.m.-1:00 p.m.)

Amplify (Fridays, 11:30 a.m.-12:30 p.m.)

Imagine That (Thursdays, 11 a.m.-12:30 p.m.)

Check as many as needed.

Does participant #2 engage in behaviors that might be helpful to know about up front?(Required)

Yes

Please describe the behavior and the best way to redirect to a more preferred behavior. We want to use the same methods in order to not confuse your participant.

What level of reading would you recommend for your participant #2?

Participant #2 preference for reading out loud

Does not like to read out loud

Likes to read out loud but struggles with big words

Likes to read out loud and knows most words independently

Does Participant #2 Have Food Allergies?(Required)

Yes

Participant #2 Food Allergies

Participant Name

Food Allergy

Reaction Type

Participant #2 T-shirt preference

Participant #2 T-shirt size

3. Do you need to register more participants?

Yes

Participant #3 Info

First & Last Name

Date of Birth

Mailing Address

Special Events

Spiritual Summer Deep Dive (July 9-11, 5:30-7:00 p.m.)

Fall Homecoming Ball (Saturday, Sept 28, 7:00-9:00 p.m.)

Check as many as needed.

Weekly events (Fall 2024)

Friendship Circle (GPC, Wednesdays, 11 a.m.-1:00 p.m.)

Friendship Circle (ZOOM, Wednesdays, 11 a.m.-1:00 p.m.)

Amplify (Fridays, 11:30 a.m.-12:30 p.m.)

Imagine That (Thursdays, 11 a.m.-12:30 p.m.)

Check as many as needed.

Does participant #3 engage in behaviors that might be helpful to know about up front?(Required)

Yes

Please describe the behavior and the best way to redirect to a more preferred behavior. We want to use the same methods in order to not confuse your participant.

What level of reading would you recommend for your participant #3?

Participant #3 preference for reading out loud

Does not like to read out loud

Likes to read out loud but struggles with big words

Likes to read out loud and knows most words independently

Does Participant #3 Have Food Allergies?(Required)

Yes

Participant #3 Food Allergies

Participant Name

Food Allergy

Reaction Type

Participant #3 T-shirt preference

Participant #3 T-shirt size

Emergency Contacts

Please list 3 names to contact in case we cannot reach the primary contact in order of preference

Emergency Contact #1

Name

Phone

Emergency Contact 2

Name

Phone

Emergency Contact 3

Name

Phone

Photo Release(Required)

Yes

I agree to let my participant be photographed and/or videotaped during the activities of Friendship Circle. I understand that pictures or recordings may be used for personal use, development of Germantown Presbyterian Church –Special Needs slideshows, training purposes, and/or to help with the promotion and/or fundraising.

Liability Release(Required)

Yes

In recognition of the possible danger connected with any physical activity of the participant, I hereby knowingly and voluntarily waive any right or cause of action of any kind whatsoever arising as the result of such activity for which any liability may or could accrue to Germantown Presbyterian Church, sponsors, agents, employees, volunteers, or instructors.

Special Needs Events and Program Registration

You are invited to join our growing circle of friends!

Special Needs Registration (Fall 2024)

Participant #1 Info

Participant #2 Info

Participant #3 Info

Emergency Contacts

KEY WORDS

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