Registration Form

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Prior to attending class(es), please print and complete.  You may email information to or mail to Crafting a Calmer Self, LLC, 29 Montvale Avenue, Montvale, NJ 07645.  Thank you! 

Crafting a Calmer Self, L.L.C.

Everyday Adventures - Registration & Contact Information


Client Information - Please complete form and return to instructor prior to first session. 





Email Address:


Telephone (indicate home and mobile): 




Emergency Contact: 


Special Needs?





Sensory needs or preferences?



Sensory aversions, including smells or sounds?



Favorite interests? 



Communication challenges we need to be aware of? 



Physical challenges we need to be aware of? 



Current Occupation and/or goals? 



Classes you are interested in taking? 



What brings you to Crafting a Calmer Self?  What are your goals?  



COVID 19 Protocols - Please indicate if you are able to wear a mask.  (Masks are not mandatory for attending at this time.  However, masking protocols may be encouraged and/or reinstated as circumstances require such changes.) 

Please indicate if you require remote virtual instruction.  

Please provide any additional information you feel important on back of form