Friend Parent/Caregiver Name:* Parent/Caregiver Name is Required Participant's (Friend's) Name:* Participant's (Friend's) Name is Required Friend's Birthdate:* Friend's Birthdate is Required Phone:* Phone is Required Billing email:* Billing email is Required Class Info Email, if different:* Class Info Email, if different is Required Parent or Caregiver:* Parent or Caregiver is Required Parent Caregiver Provide a short description of the Friend (personality, likes/dislikes, what motivates them to do non-preferred activities, etc): Provide a short description of the Friend (personality, likes/dislikes, what motivates them to do non-preferred activities, etc) is not valid FLC likes to know the top 3 goals of our Friends so we can support and encourage them. Please list your Friend's top 3 goals.: FLC likes to know the top 3 goals of our Friends so we can support and encourage them. Please list your Friend's top 3 goals. is not valid Please describe your Friend's communication (fully verbal, partially verbal, uses communication device). Any helpful words for us to know or understand?: Please describe your Friend's communication (fully verbal, partially verbal, uses communication device). Any helpful words for us to know or understand? is not valid Please rate the Friend's skill level of speaking and standing with confidence: Please rate the Friend's skill level of speaking and standing with confidence is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill level of self-advocating their wants and needs: Please rate the Friend's skill level of self-advocating their wants and needs is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill level in expressing herself/himself with creativity: Please rate the Friend's skill level in expressing herself/himself with creativity is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill level of self-initiating progress towards goals: Please rate the Friend's skill level of self-initiating progress towards goals is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill level in completing at least 90 minutes of activity/exercise per week: Please rate the Friend's skill level in completing at least 90 minutes of activity/exercise per week is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill level in maintaining a healthy weight: Please rate the Friend's skill level in maintaining a healthy weight is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill level in cleaning up after herself/himself: Please rate the Friend's skill level in cleaning up after herself/himself is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill in completing a personal hygiene routine: Please rate the Friend's skill in completing a personal hygiene routine is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill level in contributing to responsibilities at home: Please rate the Friend's skill level in contributing to responsibilities at home is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill level in following a checklist (visual or verbal): Please rate the Friend's skill level in following a checklist (visual or verbal) is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support Please rate the Friend's skill level in following verbal directions: Please rate the Friend's skill level in following verbal directions is not valid High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support How did you hear about Friends Life Community?: How did you hear about Friends Life Community? is not valid Which of the services at FLC are you interested in? (Select all that apply.): Which of the services at FLC are you interested in? (Select all that apply.) is not valid Day ProgramSocial ClubCoachingVirtual Classes Username:* Invalid Username Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match * No val Please fix the errors above
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