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#Post#: 730--------------------------------------------------
Family Child Application (ages 2-17)
By: Admin Date: October 21, 2018, 7:56 pm
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[center]Eastlantis Family Child Application[/center]
Please complete the following application in order to be
considered for membership. Send the completed application to
eastlantisageplayforum@gmail.com. We look forward to your
application! Leave all questions completely intact unless stated
otherwise. (You may remove explanations, but not the questions
themselves.) If you do not have an answer for something, simply
write N/A. If you already have an account on the site, you may
skip the Confidential Information.
[hr]
Confidential, Administrative Information: (kept for
Administrative records only)
Real Life Name (or nickname, something the Administration can
call you):
Real Life Age (18 or older only):
Email Address:
Primary motivation for joining Eastlantis:
How did you find Eastlantis?
Names(s) of parent(s) applying for membership with you OR
parents already on site:
Names(s) and age(s) of children applying for: (Each child must
have a separate application, but you only need to complete
confidential information once.)
[hr]
Child Information: (To be posted in the appropriate family
profile section.)
HTML [img width=200 height=201http://[/img]
Name (First, Middle, Last):
Nickname(s):
Gender:
Age:
Birthday:
Grade Level:
Extracurricular activities (please keep age appropriate):
Personal Pets (please limit to domestic animals only):
Personal Possessions:
Personality (likes/dislikes/character traits):
Memories: (Provide 3+ memories that impact only your child, not
the overall history of the family.
Example: A struggled with ear infections as a toddler and
eventually had to have tubes put in his ears at the age of 7. It
happened during the summer and he hated not being able to go
swimming while his siblings could.)
THE FOLLOWING MUST BE COMPLETED BY THE BIG, IN THE BEST INTEREST
OF THE INNER. SERIOUS RESPONSES ONLY.
Disclaimer: Behaving in a manner that calls for an adult with a
certain kind of authority (ie in school or legally) or being
directly disrespectful to a particular adult will be taken as
consent for the appropriate authority to handle the behavior in
the case that there is no other option (such as there not being
a male police officer).
(If only specific people are welcome to use a specific method,
put their name beside the option (with their permission).)
In what ways are you comfortable with men disciplining the
inner?
a) verbal correction and/or referral to: (list parent or
guardian's name)
b) non-physical punishment
c) spanking (list any and all women specifically allowed to
spank, including the parent/guardian.)
d) I am not comfortable with discipline from men in any way.
(Please erase all other options. This option should not be
selected if the child's parent or guardian is male.)
In what ways are you comfortable with women disciplining the
inner?
a) verbal correction and/or referral to: (list parent or
guardian's name)
b) non-physical punishment
c) spanking (list any and all women specifically allowed to
spank, including the parent/guardian.)
d) I am not comfortable with discipline from women in any way.
(Please erase all other options. This option should not be
selected if the child's parent or guardian is female.)
Forms of punishment allowed: Please erase the ones not allowed
to be used and give insight into the reaction from the child for
the ones allowed.*Remember that a time-out may include a
peppermint oil suppository*
Sent to room for time out
Sent to the corner for time out
Put in a chair for a time out
Being held for a time out (when the peppermint oil suppository
is used, for comfort)
Written forms of punishment (ex. lines, essays, copying Bible
passages)
Creative method of punishment
Spanking (clothed)
Spanking (bare bottom)
Spanking (thighs)
Spanking implements allowed: Please erase the ones not allowed
to be used and give insight into the reaction from the child for
the ones allowed.
Hand
Ping Pong Paddle
Wooden Ruler
Plastic Ruler
Plastic Hairbrush
Wooden Hairbrush
Wooden Paddle with no holes
Wooden Spoon
Wooden Dowel
La chancla/La chancleta (common in Spanish families)
Switch
Belt or Strap
Intimate Care: Remember that no matter the context in which
these occur, holding time would not exceed the receiver's age
and thus would not be unreasonable as a holding time and would
not cause an accident. Please explain how the child would react
emotionally to each:
Rectal temperature taking:
Enema with plain, warm water (non-punishment):
Fleet enema--saline; would sting (for punishment):
Suppository (glycerin; non-punishment):
Suppository (peppermint oil, for punishment):
Limits (things that must NEVER happen in an interaction. If it
happens, the post should be modified to erase the limit
crossed.):
Triggers (Things that will create a fight, flight, or freeze
response):
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