All for One Intake Form

Please fill out this form and click submit.
The following questions are intended to give the ministry initial information so that we can serve our friends with special needs in the most interactive, safe, and supportive environment. Our team will respect your family's right to privacy.  Any information that is shared is communicated with those would will be directly caring for your family member and only on a "need to know" basis. 

After completing this form, a member of our team will be reaching out to greet you, discuss any questions or concerns you may have and help determine the best way to serve this friend with special needs.  

If you have any questions, please send an email to for more information.
Tell us about this friend with special needs


Emergency Contact (Other than those listed above)

Medical/Basic Needs

Please respond to the questions below.  If an item does not apply to this friend, please type "Not Applicable".

Please select all that apply.
Person's Likes and Interests

One of best ways we can connect with others is getting to know the things they enjoy.  Please share any information below.

If an item does not apply to this friend, please type "Not Applicable".
Please read the following before submitting this form

By submitting this form, you are acknowledging and agreeing to the following for all Bethesda Baptist Church activities and ministries:

1. You can read Bethesda’s Statement of Faith here.

2. Guidelines for Conduct:
Any participant failing to abide by these rules may be sent home immediately.
• Possession of weapons, illicit drugs, alcohol, and tobacco products is prohibited.
• No sexual misconduct or inappropriate displays of affection (defined as exposure, touching, or inappropriate reference to body areas normally covered by undergarments).
• Be respectful and encouraging, maintaining a positive attitude toward others.
• Be respectful of both facilities and the property of others, including Bethesda Baptist Church, host homes, and event locations. 
• Avoid using foul language or any speech (including “humor”) that puts down, makes fun of, or stereotypes other persons or groups.

3. Media: I hereby give Bethesda Baptist Church permission to reproduce, edit, exhibit, project, display, copyright, and publish, photographic images and/or moving pictures and/or videotaped images of me and/or Participant, with or without voice, in which I and/or Participant are included, in whole or in part, photographed, taped, videotaped, and/or recorded prior to, during, and/or after activities and events.

4. Liability: In consideration of Bethesda allowing the Participant to participate in All for One Special Needs Ministry, I, the undersigned, do hereby release, forever discharge and agree to hold harmless Bethesda, its pastors, directors, employees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the ministry activities. I, the parent or legal guardian of this Participant, hereby grant my permission for the Participant to participate fully in ministry activities. Furthermore, I, on behalf of my participant, hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. The undersigned further hereby agrees to hold harmless and indemnify said Church for any liability sustained by the church as the result of negligent, willful or intentional acts of said Participant, including expenses incurred attendant thereto.

Thank you for your interest in All for One!     

A member of our team will reach out to you to welcome you and your family to Bethesda, answer any questions you have, and assist you in determining the most supportive All for One option for your family member with special needs.  We look forward to talking and meeting you soon!


Please fill out this form and click submit.