Age 18+

Participant's Information
Full Name*

First Name Last Name
School/Employment
Please indicate any information which may have changed since last year i.e. phone number, email, mailing address etc...
Parental Agreement
I permit my son/daughter's photo to be used for publicity purposes.*

Consent
Where applicable, I permit my son/daughter to be transported by the Friendship Circle to or from activities.*

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 son/daughter while participating in a Friendship Circle program for the year 2023-24*

Consent
Comments
Program Registration Options
8 scheduled events

$175- all 8 events (1 free event)$25 - pay per event
Payment Information
Total

$0.00

Payment

Credit Card Check

Postal / Zip Code

Country

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