eBuddies | Special Accommodation Needs - CHILD INTAKE FORM

Please fill out this form for EACH CHILD that need special accommodations. **Please make sure you are logged out of your parent account, found on the top right BEFORE filling out this form for your child. *

*YOUR NAME needs to be your child's name 
**Use parent's email for child's info
Date

PARENT INFO

PLEASE ADD EACH PARENT/QUARDIAN

Child's Special Accommodation Needs

BEHAVIORAL

What we need from you:

We promise every time your child enters eKids; we will love and care for them well. Elevate Life Church wants both you and your entire family to have an incredible Sunday experience, and we are excited to partner with you to help make that happen.

In order to do that, we ask you to partner with us by agreeing that:
- If I am being paged, I will answer in a timely manner.
- If my child is medically fragile or has a history of seizures, I will meet with the eBuddies Director at my campus to develop a Medical Protocol to be implemented while my child is in eKids.
- My child has/has not (circle one) shown aggression toward adults and/or other children.
- I will not bring my child if they are contagious, have had a fever of 100 degrees or higher, or have vomited or had diarrhea in the 24 hours prior to the service.

Please sign your full name below

Date

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