Are you signing your child up or to be a volunteer?*

Mentee (Participant)
Mentor (Volunteer)

If you are registering as a mentor (volunteer), your parent/guardian's contact information is required if you are under the age of 18. If you are over the age of 18, please CLICK HERE to complete the Over-18 registration form.

The Under-18 volunteer registration information is at the bottom of this form.

Parent/Guardian Contact Information

Country*

Email Address*

Confirm Email Address*

Phone Number*

Cell Phone Number

Alternate Parent/Guardian's Name

Alternate Parent/Guardian Email Address

Alternate Parent/Guardian's Phone Number

I hereby grant the Friendship Circle permission to use my or my child’s likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.*

I hereby authorize the Friendship Circle to release my or my child’s registration information to Friendship Circle staff and assigned volunteer mentor.*

Participant's Information

Participant Name

Participant's Birthday

School

Grade

Special Needs?

Activities Enjoyed

Activities Not Enjoyed

Best Motivator

If "Other" was selected, please list the behavior in the "Comments" section at the bottom of this form.

Allergies

Seizures

Are you interested in Home Visits?

Day/Time Preferences for Home Visits

Volunteer Information

Name

Date of Birth

Grade

School Attending in 2021/2022

Phone Number

Email Address

Do you have any experience with children with special needs?

Availability (Check all that apply)

Weekdays
Weekends
Afternoons
Mornings

What programs are you interested in?

Being paired with a buddy
Tuesday Club Sessions
Sunday Outings

What does Friendship mean to you?

Additional Comments

Security

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Friendship Circle Registration

Are you signing your child up or to be a volunteer?*

Parent/Guardian Contact Information

Country*

State / Province*

Address*

City*

State / Province*

*

*

*

*

*

*

Email Address*

Confirm Email Address*

Phone Number*

Cell Phone Number

Alternate Parent/Guardian's Name

Alternate Parent/Guardian Email Address

Alternate Parent/Guardian's Phone Number

I hereby grant the Friendship Circle permission to use my or my child’s likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.*

I hereby authorize the Friendship Circle to release my or my child’s registration information to Friendship Circle staff and assigned volunteer mentor.*

Participant's Information

Participant Name

Participant's Birthday

School

Grade

Special Needs?

Communication Clarify

Activities Enjoyed

Activities Not Enjoyed

Best Motivator

Does the participant occasionally exhibit any of the following behaviors?

Allergies

Seizures

Are you interested in Home Visits?

Day/Time Preferences for Home Visits

Volunteer Information

Name

Date of Birth

Grade

School Attending in 2021/2022

Phone Number

Email Address

Do you have any experience with children with special needs?

Availability (Check all that apply)

What programs are you interested in?

What does Friendship mean to you?

Additional Comments

Security