Registration Form

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

Crafting a Calmer Self, L.L.C.

Arts and Crafts - Class Registration Form



Client Information


Child’s Name:

Parent’s Name:

Email Address:

Telephone:

Address:

Age:

Special Needs?

 

 

Allergies?

 

Sensory needs or preferences?

 

 

Sensory aversions, including smells or sounds?

 

 

Verbal?

Favorite color?

Favorite book?

Favorite interests?

 

Physical limitations?

 

What brings you to Crafting a Calmer Self?  Goals for your child?

 

 

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