Home About Us Staff FAQs Join the Waitlist! Visit Trinity Church Join our Team! All-About-Me Form! Child's Name(Required)Date of Birth(Required)Does your child have a nickname?(Required)Family InformationParent's Name(s)(Required)Marital Status:(Required)MarriedDivorcedSeparatedSingleDescribe any custody/visitation arrangements we need to be aware of:Are there any other children at home?(Required) Yes No What are their names, ages, and relationship to your child?(Required)Are there any other adults in the home?(Required) Yes No What are their names and relationship to your child?(Required)What is your primary language spoken at home? Secondary, if applicable?(Required)What family support do you have in the area?(Required)What does a typical day look like for you? (Work, classes, etc)(Required)Child InformationDoes your child have any allergies?(Required) Yes No How does it manifest itself?(Required) Asthma Hay Fever Hives Other Please explain:(Required)Do you know what causes his/her allergy?(Required)Does your child have frequent colds?(Required) Yes No Not Sure Does your child have frequent earaches?(Required) Yes No Not Sure Does your child have frequent tonsillitis?(Required) Yes No Not Sure Does your child have frequent stomach aches?(Required) Yes No Not Sure Do they vomit easily?(Required) Yes No Not Sure Do they run high fevers easily?(Required) Yes No Not Sure Is your child on medication regularly?(Required) Yes No Please specify:(Required)Does your child have any special needs we should be aware of?(Required)Has your child had any other exposure to childcare?(Required)What discipline and/or guidance techniques do you use at home with your child?(Required)What times do they go to bed?(Required)What time does your child awaken?(Required)Does your child share his/her room?(Required) Yes No With whom?(Required)Does your child have any eating problems?(Required) Yes No Please specify:(Required)Are there any dietary restrictions?(Required)What makes your child angry or upset?(Required)How do you handle this?(Required)Is there any other information you would like us to know about your child?(Required)What are your child's favorite play activities indoors and outdoors?(Required)Does your child have a favorite blanket or stuffed animal they like to cuddle with?(Required)What snacks does your child like/dislike?(Required)What are your child's typical diapering/bathroom routines?(Required)Does your child have a difficult time transitioning from one activity to another?(Required) Yes No Does your child like to sit down and listen to a story?(Required) Yes No When your child is upset, what are some things that normally help them feel better?(Required)Describe your child's personality:(Required)Are there any unique features in the child's home or past experience which may have affected his/her?(Required) Yes No Please give details(Required)In what specific ways can we help your child?(Required)Developmental HistoryDisregard this section for infantsWere there any unusual or difficult factors involved in the pregnancy or birth of this child?(Required) Yes No Please explain:(Required)At what age your child crawl?At what age did your child become toilet trained?At what age did your child use short sentences?Does your child dress themselves?Does your child walk?Does your child name objects?Does your child have bowel movements?From your perspective, is your child developing physically, socially, and emotionally at a similar pace with other children their age? Yes No Are you concerned at all about your child's behavior or development? Yes No Please explain:(Required)Is there anything we haven’t asked that you would like us to know? At TEDCenter, we work to build and maintain positive relationships that meet the needs of everyone. Share with us anything you think would be good for us to know about your child’s interests, dislikes, personality or temperament, etc.?(Required)