Sibshops Registration Information Form

This form must be completed for each child who wishes to participate in Sibshops.

General Information

Date

Is your child between the ages of 6-13?

YesNo

Child's Name

Age

Gender

Has your child ever attended a Sibshop before?

YesNo

If yes, where?

Name of School

Grade

Parent(s) Name

Home Address

City

State

Zip

Primary Phone

Cell Phone

Email Address

Name or description of disability or health concern

What kind of related special education services (e.g. occupational or physical therapy, counseling, etc.) does this child receive?

Other siblings

Child's Name

Age

Gender

What do you hope your child will gain from Sibshops? Are there any particular topics you would like to address?

Does your enrolled child have any special needs, food allergies or other health restrictions of their own that we should know about?

Please provide any other information that you feel would make a Sibshops a more enjoyable and educational experience for your child?

Would you like your name, phone number or email address placed on a list to be distributed to other sibling participants and their families?

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