139 in TMC Kids

Thank you for choosing to worship with us at The Moody Church and for entrusting us with the opportunity to help your child grow in their worship! We are blessed that in our children’s ministry (TMC Kids) we have kids of all abilities levels. It may be that your child is deaf, blind, has down syndrome, autism or a physical disability; our aim is for all children and volunteers in our ministries to, “accept one another just as Christ accepted us, in order to bring praise to God” (Rom. 15:17).

For us to best minister to your child we ask that you please take a moment to fill out an Individual Worship Plan (IWP) below. This confidential form allows for us to gather information to best serve your child and, if helpful, assign a buddy to them. If you have any questions or concerns about this form please feel free to email tmc.139@moodychurch.org

Leadership: Elizabeth Wade

Fill out an IWP for your child

Date*
MM slash DD slash YYYY
Parent/Caregiver(s)*
Email for above Caregiver(s)*
Phone*
Participant Name*
First Last
Participant Birthday*
MM slash DD slash YYYY
Disability Type*
We don’t like labels- but they can be helpful in providing a minimal level of understanding.
Strengths and Abilities*
What he/she is good at. What they do well.
Challenges*
What kinds of things are difficult for him/her to do that would be helpful for us to know? Please include any fears/aversions (if applicable)
Communication*
How does he/she communicate best (Output AND Input)? e.g. verbal, gestures, ASL, electronic device, PECS cards, single words, etc.
Preferred Activities*
What does he/she really enjoy doing? e.g. hobbies, favorite things/activities
Motor Abilities*
e.g. does he/she need assistance with mobility (walking/rolling)? Writing/Cutting/Gluing (hand over hand)?
Restroom*
Please Check One (additional comments can be made below in ‘Other Information’ Box)
- The individual can use the restroom independently
- The individual needs some support // Staff may help
- The individual needs some support // Please page me for help
Allergies / Dietary Restrictions / Other Health Concerns (if applicable)*
Re-Direction & Reinforcement Techniques (if applicable)*
If the person is having a difficult time participating with the group, what is a helpful way to encourage participation? And/Or what are techniques that will NOT be helpful? Specifically, what are preferred “praise” methods (high-fives, stickers, words, etc.)?
The Individual has a behavior plan at home/school/work that I would like to be followed as closely as possible when he/she is at church.*
If “yes,” we will contact you for details and collaboration
- Yes
- No
Any Other Information That Would Be Helpful To Know About*
Goals/ Hopes/ Dreams For This Upcoming Year*
Could be Spiritual, Social, Behavioral, etc.
Additional Emergency Contact*
Someone besides parents *Please include relationship to the individual (aunt/uncle/ neighbor, etc.) *Please include Phone number