6th & 7th Grade Volunteer Registration

Address*

Home Phone*

Area Code Phone Number
Cell Number*

Area Code Phone Number
School*
Grade*
Date of your Bar/Bat Mitzvah

Month Day Year
Congregation*
Bnai Mitzvah Fundraiser
Create your own personal fundraising page to support Friendship Circle and receive a surprise gift!

See a sample of an actual page from one of our Bnai Mitzvah Volunteers by clicking this link www.fcmd.org/rachel
I'm interested in learning more about creating my own personal fundraising page

Yes
Parent's Information
Responsible Party*

Mom Dad
Responsible Party's E-mail*
Father's Name

First Name Last Name
E-mail
Cell Phone

Area Code Phone Number
Occupation
Mother's Name

First Name Last Name
E-mail
Cell Phone

Area Code Phone Number
Occupation
Parental Permission
I hereby give my son/daughter permission to participate in Friendship Circle programs.*

Consent
I permit my son/daughter's photo to be used for publicity purposes.*

Consent
I hereby release the Friendship Circle, its providers and administrators from ALL liability resulting from any incident which affects the health, welfare or safety of my child while participating in a Friendship Circle program for the year 2020-21*

Consent
Comments
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6th & 7th Grade Volunteer Information