Beth Tzedec Sensory Room - October 24 - Form

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Beth Tzedec Sensory Room - October 24

INTRODUCING THE BETH TZEDEC SENSORY ROOM:
As an important component of our congregation-wide commitment to inclusivity and engagement, Beth Tzedec is proud to offer a Sensory Room pop-up.

WHAT IS A SENSORY ROOM?
A sensory room is a comfortable, safe environment where individuals have access to specially selected equipment that stimulates the senses to promote relaxation and exploration. Our Sensory Room has been designed as a calming space for those aged 4+ up to and including adults where they can feel welcome and included at an especially busy time of year.

WHO IS THE SENSORY ROOM FOR?
Our sensory room is a versatile space designed for individuals aged 4+ (up to and including adults) with neuro-diversity and sensory processing considerations including those with autism spectrum disorder (ASD), Sensory Processing Disorders (SPD), Developmental Delays, ADHD, and Anxiety Disorders.

For sessions with children 18 and younger, each session can accommodate up to 2 children who are accompanied by a parent or caregiver over 18 years old.

LOOKING FOR MORE INFORMATION?
Click HERE for more details.

DETAILS TO KNOW BEFORE YOU REGISTER:

A maximum of 1 adult participant over 18 (and an adult caregiver) OR 2 children aged 4-18 years will be allowed by appointment only for 40 minute sessions.
Participants 18 and under MUST be accompanied by a parent/caregiver (18+) who have registered.

ARE YOU READY TO REGISTER?
Registration is free, but space is limited and available by pre-booking only. Please see below to register. For more information about our sensory room, please click HERE.

REGISTRATION DETAILS

* Parent 1 First Name (Or Adult 18+ Participant First Name)

* Parent 1 Last Name (or Adult 18+ Participant Last Name)

* Email

* Mobile

Parent 2 First Name (if applicable)

Parent 2 Last Name (if applicable)

Parent 2 Email (if applicable)

Parent 2 Mobile (if applicable)

Caregiver First Name (if applicable)

Caregiver Last Name (if applicable)

Caregiver Email (if applicable)

Caregiver Mobile (if applicable)

How many children 4 to 18 are you registering to attend the Sensory Room? If the participant is over 18, only one may register.

Please Select OneOneTwoPlease note that for children 4 to 18, there is a limit of two siblings who can attend the Sensory room during one session and they must be accompanied by a parent or caregiver (18+) whose name must be provided above. For adult participants 18+, only one may register (along with an adult caregiver).

Participant 1 First Name

Participant 1 Last Name

Participant 1 birthdate (MM/DD/YYYY)

Please (confidentially) provide information you are comfortable to share about the participant's neuro-diversity or sensory processing condition.

Child 2 First Name

Child 2 Last Name

Child 2 birthdate (MM/DD/YYYY)

Please (confidentially) provide information you are comfortable to share about your child's neuro-diversity or sensory processing condition.

Registration Time

To book your Sensory Room appointment, choose ONE time slot from the list below.

SENSORY ROOM GUIDELINES AND WAIVER FORM

Once you submit your registration, we will get back to you to verify your requested timeslot. We will share a document outlining important guidelines for use of the sensory room, and provide a waiver form which must be signed to complete the registration process.

Thank you very much for your interest in our Sensory Room pop up.

Wed, June 4 2025
8 Sivan 5785

Wed, June 4 2025 8 Sivan 5785