Volunteer Registration
Please apply only if you think you are responsible enough and will be committed.

Your Information
First Name:* Last Name:*
  Month Day Year  
Date of Birth:*
Address:* City:*
    Postal Code:*
Telephone:* Cell phone:
School:* Grade:*
I consider myself:*
Additional Information
Mother's Name:*   Title:
Mother's Cellphone:   E-mail:
Father's Name:*   Title:
Father's Cellphone:   E-mail:
I understand that to receive a signature on a Community Service form I must send in a weekly email about my visits.
Medical Information
Emergency Contact Name (other than a parent):* Phone:*
Relationship:* Cellphone:
Please list any allergies:*
Please list any medical conditions that we should be aware of:*
Parental Consent
This section must be approved by a parent before proceeding to the completion of the form.
I give my teen permission to volunteer in the Friendship Circle.
I give my teen permission to attend Friendship Circle trips.
I agree that my teen’s photos may be used for any and all Friendship Circle publicity purposes.
I would like to volunteer for:
When would you like to volunteer at a special needs child’s home?
1st choice      
Day of the week: Time:
2nd choice      
Day of the week: Time:
Do you have a friend with whom you'd like to volunteer? Yes No
If yes please provide your friend’s name:
Are your parents available to drive you to or from a child’s home? Yes No
   Volunteer Opportunities  
Friends at Home
Community Adventures
Get Moving
You are what you Eat
    Please specify:
I agree to keep all information about my circle friend and their family confidential.
In the event that I am unable to volunteer I will try to find another day to substitute and I will call my special friend in advance.
In the event that I am unable to attend Bowling League I will try to find a substitute volunteer and I will call the office in advance.