New Club Friendship Registration

Address*

Home Phone

Area Code Phone Number
School*
Grade*
Congregation*
Any allergies? If yes, please specifiy.
Parent's Information
Responsible Party*

MomDad
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 2024-25.*

Consent
Comments
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Club Friendship Information