Client registration — ClubSENsational

Parent / guardian

Name *

Relationship to participant *

Mother Father Legal guardian

Phone *

Email address *

Address *

Postcode *

Participant

Name *

Date of birth *

Gender *

School / college / residential *

Participant photo (face or ID) *

Upload a clear photo of the participant's face, or a photo of their ID document. JPEG/PNG work best (on iPhone prefer “Most Compatible”). Large photos are compressed automatically before upload.

Medical & support plans

Does the participant have an EHCP? *

Yes No In progress

Is the participant supported by a social worker? *

Yes No Not sure

Motivators or favourite activities *

Dislikes or things to avoid *

Regular medication (name and dosage if applicable) *

Diagnosed allergies (food or environmental) *

Relevant medical conditions *

Health or emergency plan in place? *

Yes No

Behaviour

Known triggers *

Select all that apply (at least one).

Loud or unexpected noise Transitions or changes to routine Waiting or delays Sensory overload (e.g. lights, textures) Being told “no” / denied access Fatigue or hunger Physical proximity or touch Group settings or crowds None identified

Strategies that help regulate *

Select all that apply (at least one).

Movement / space to pace or jump Pressure or deep touch Preferred toy or object Visual support (first/then, countdown, etc.) Quiet space or break Supportive adult staying nearby Breathing exercises / calming prompts None identified

Additional notes on behaviour *

Support when regulated (calm and engaged) *

1to1 2to1

Support when dysregulated *

Can self-regulate with minimal prompts Needs adult nearby and occasional guidance Needs active adult support throughout episodes Requires continuous supervision from an adult when distressed May require support from two adults to safely regulate

Communication

Expressive communication (select all that apply) *

Select at least one option.

Mainly communicates through behaviour Gestural or non-verbal cues Verbal – full sentences Verbal – limited words or scripts Uses signs (e.g. Makaton) Uses AAC (tablet, GoTalk, speech device) Uses PECS or visuals to express needs

How does the participant best understand instructions? *

Verbal instructions only Verbal + gestures Visual support needed (symbols, schedules, first-then boards)

Preferred communication strategies that work well *

Independence

Mobility & physical independence *

Walks independently Uses mobility aids (wheelchair, walker) Needs adult assistance for transitions or moving between spaces

Personal care *

Fully independent (toileting, dressing) Needs physical assistance or supervision

Task engagement *

Can follow a simple routine independently Needs 1:1 support to complete most activities

Transitions & flexibility *

Adapts easily to change in activities or environment Struggles with unexpected changes or waiting time

Risk awareness & safety *

Understands basic safety rules No awareness of danger – needs constant supervision

Anything else we should know? *

Client details & support form

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