1Participant2Programs3Payment HiddenSubmission ID Debug Thank you for your registration, please complete your Program Registration below.Form Code Registration is for* Participant Sibling Applicant's InfoApplicant's Name* First Last Birth Date*MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDay12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age*Applicant requires* Teen volunteer Trained adult aide – There will be an additional cost for the aide per program I will supply my own aide – no additional cost Independent Name of Parent/Guardian* First Last HiddenName of Parent/Guardian Parent/Guardian Email* Parent/Guardian Cell*Friendship Circle is eligible to accept PerformCare funding. Please indicate below if the participant is registered for PerformCare. HiddenPerformCare* Participant is approved with PerformCare Participant is not approved with PerformCare Participant is not approved with PerformCare but I am interested in finding out more HiddenPerformCare Choice* We will choose Friendship Circle as the provider for AASC (Agency After School Care) We decline to choose Friendship Circle as our AASC provider HiddenPerformCare Summer Camp We plan on choosing Friendship Circle as our summer camp provider Friendship Circle is eligible to accept DDD funding under category of 'Goods and Services'. Please indicate below if the participant has available funding in their budget. HiddenDDD Funding Availability* Participant may have DDD funding available Participant has DDD funding but budget is full Participant does not have DDD funding Friends@Home Jr.Register for Friends@Home Jr. Register for Friends@Home Jr. Friends@Home Jr. When would you like volunteers to come and visit your home?First Choice*SundayMondayTuesdayWednesdayThursdayFridayTime* : Hour Minutes AM PM AM/PM Second Choice*SundayMondayTuesdayWednesdayThursdayFridayTime* : Hour Minutes AM PM AM/PM Would you be interested in having* the same volunteer new volunteers Please note: To help protect the safety of those involved, background checks will be required of everyone in the household who is over 18, prior to starting Friends@HomeProgramsFootball CircleSundays, 12:30pm-2:00pmRegister for Football Circle October 27 November 17 June 8 Football Circle Price: Football Circle - QuantityShavuos Ice Cream PartyMonday, June 2, 5:00pmRegister for Shavuos Ice Cream Party Register for Shavuos Ice Cream Party Shavuos Ice Cream Party Price: FC Summer Camp Week #1 2025Monday-Thursday: 9:30am-3:00pmPrice: $1200Week #1: Monday, July 28 - 9:30am-3:00pmTuesday, July 29 - 9:30am-3:00pmWednesday, July 30 - 9:30am-3:00pmThursday, July 31 - 9:30am-3:00pmRegister for FC Summer Camp Week #1 2025 Register for FC Summer Camp Week #1 2025 FC Summer Camp Week #1 2025 Price: FC Summer Camp Week #2 2025Mon-Thurs; 9:30am-3:00pm Price: $1200Week #2: Monday, August 4 - 9:30am-3:00pmTuesday, August 5 - 9:30am-3:00pmWednesday, August 6 - 9:30am-3:00pmThursday, August 7 - 9:30am-3:00pmRegister for FC Summer Camp Week #2 2025 Register for FC Summer Camp Week #2 2025 FC Summer Camp Week #2 2025 Price: FC Summer Camp Week #3 2025Monday-Thursday: 9:30am-3:00pmPrice: $1200Week #3: Monday, August 11 - 9:30am-3:00pmTuesday, August 12 - 9:30am-3:00pmWednesday, August 13 - 9:30am-3:00pmThursday, August 14 - 9:30am-3:00pmRegister for FC Summer Camp Week #3 2025 Register for FC Summer Camp Week #3 2025 FC Summer Camp Week #3 2025 Price: Allies Summer Camp 2025Monday-Thursday: 9:30am-3:00pmPrice: $1200Monday, August 18 - 9:30am-3:00pmTuesday, August 19 - 9:30am-3:00pmWednesday, August 20 - 9:30am-3:00pmThursday, August 21 - 9:30am-3:00pmRegister for Allies Summer Camp 2025 Register for Allies Summer Camp 2025 Allies Summer Camp 2025 Price: Allie’s Summer Camp 21+ 2025Monday-Thursday: 10:00am-2:30pmMonday, August 18 - 10:00am-2:30pmTuesday, August 19 - 10:00am-2:30pmWednesday, August 20 - 10:00am-2:30pmThursday, August 21 - 10:00am-2:30pmRegister for Allie’s Summer Camp 21+ 2025 Register for Allie’s Summer Camp 21+ 2025 Allie’s Summer Camp 21+ 2025 Price: Adult Torah Circle 2025Sundays, 12:15 pm - 2:45 pmPrice: $1950Price: $2175Aide Fee: $1812.50September 7September 14September 21September 28October 5October 19November 2November 9November 23December 7December 14December 21January 4January 11January 18January 25February 1February 22March 1March 8March 15March 22March 29April 19April 26May 3May 17May 31June 7Register for Adult Torah Circle 2025 Register for Adult Torah Circle 2025 Adult Torah Circle 2025 Price: Adult Torah Circle 2025 Price: Adult Torah Circle 2025 Aide Fee Price: Torah Circle 2025Sundays, 9:30 am - 12:00 pmPrice: $1950Price: $2175Aide Fee: $2175September 7September 14September 21September 28October 5October 19November 2November 9November 23December 7December 14December 21January 4January 11January 18January 25February 1February 22March 1March 8March 15March 22March 29April 19April 26May 3May 17May 31June 7Register for Torah Circle 2025 Register for Torah Circle 2025 Torah Circle 2025 Price: Torah Circle 2025 Price: Torah Circle 2025 Aide Fee Price: Adult Afternoons: Monday 2025Mondays, 5:00 - 6:30 pmPrice: $1665Aide Fee: $1387.50September 8September 15September 29October 20October 27November 3November 10November 17November 24December 1December 8December 22January 5January 12January 26February 2February 9February 23March 2March 9March 16March 23March 30April 13April 20April 27May 4May 11May 18June 1June 8June 15June 22June 29July 6July 13July 20Register for Adult Afternoons: Monday 2025 Register for Adult Afternoons: Monday 2025 Adult Afternoons: Monday 2025 Price: Adult Afternoons: Monday 2025 Aide Fee Price: After School: Monday 2025Mondays, 4:00 - 6:00 pmPrice: $2217Price: $2220Aide Fee: $2030September 8September 15September 29October 20October 27November 3November 10November 17November 24December 1December 8December 22January 5January 12January 26February 2February 9February 23March 2March 9March 16March 23March 30April 13April 20April 27May 4May 11May 18June 1June 8June 15June 22June 29July 6July 13July 20Register for After School: Monday 2025 Register for After School: Monday 2025 After School: Monday 2025 Price: After School: Monday 2025 Price: After School: Monday 2025 Aide Fee Price: Adult Mornings: Monday 2025Mondays, 10:00 am - 1:00 pm Price: $3420Aide Fee: $2850September 8September 15September 29October 6October 20October 27November 3November 10November 17November 24December 1December 8December 15January 5January 12January 26February 2February 9February 23March 2March 9March 16March 23March 30April 13April 20April 27May 4May 11May 18June 1June 8June 15June 22June 29July 6July 13July 20Register for Adult Mornings: Monday 2025 Register for Adult Mornings: Monday 2025 Adult Mornings: Monday 2025 Price: Adult Mornings: Monday 2025 Aide Fee Price: After School: Tuesday 2025Tuesdays, 4:00 - 6:00 pmPrice: $2220Aide Fee: $2035September 9September 16September 30October 21October 28November 4November 11November 18November 25December 2December 9January 6January 13January 20January 27February 3February 10February 17February 24March 10March 17March 24April 14April 21April 28May 5May 12May 19May 26June 2June 9June 16June 23June 30July 7July 14July 21Register for After School: Tuesday 2025 Register for After School: Tuesday 2025 After School: Tuesday 2025 Price: After School: Tuesday 2025 Aide Fee Price: Adult Evenings: Bowling 2025Tuesdays, 6:00-7:30pmPrice: $765Aide Fee: $637.50September 9October 21November 4November 18December 2January 6January 20February 3February 17March 17April 21May 5May 19June 2June 16June 30July 14Register for Adult Evenings: Bowling 2025 Register for Adult Evenings: Bowling 2025 Adult Evenings: Bowling 2025 Price: Adult Evenings: Bowling 2025 Aide Fee Price: Adult Mornings: Tuesday 2025Tuesdays, 10:00 am - 1:00 pm Price: $3420Aide Fee: $2850September 9September 16September 30October 21October 28November 4November 11November 18November 25December 2December 9December 16January 6January 13January 20January 27February 3February 10February 17February 24March 10March 17March 24April 14April 21April 28May 5May 12May 19May 26June 2June 9June 16June 23June 30July 7July 14July 21Register for Adult Mornings: Tuesday 2025 Register for Adult Mornings: Tuesday 2025 Adult Mornings: Tuesday 2025 Price: Adult Mornings: Tuesday 2025 Aide Fee Price: After School: Wednesday 2025Wednesdays, 4:00 - 6:00 pmPrice: $1870Price: $2040September 10September 17October 22October 29November 5November 12November 19November 26December 3December 10January 7January 14January 21January 28February 4February 11February 18March 4March 11March 18March 25April 15April 22May 6May 13May 20June 3June 10June 17June 24July 1July 8July 15July 22Register for After School: Wednesday 2025 Register for After School: Wednesday 2025 After School: Wednesday 2025 Price: After School: Wednesday 2025 Price: Adult Mornings: Wednesday 2025Wednesdays, 10:00 am - 1:00 pm Price: $3240Aide Fee: $2700September 10September 17October 22October 29November 5November 12November 19November 26December 3December 10December 17January 7January 14January 21January 28February 4February 11February 18March 4March 11March 18March 25April 15April 22May 6May 13May 20May 27June 3June 10June 17June 24July 1July 8July 15July 22Register for Adult Mornings: Wednesday 2025 Register for Adult Mornings: Wednesday 2025 Adult Mornings: Wednesday 2025 Price: Adult Mornings: Wednesday 2025 Aide Fee Price: Adult Afternoons: Wednesday 2025Wednesdays, 5:00 - 6:30 pmPrice: $1275Price: $1530September 10September 17October 22October 29November 5November 12November 19November 26December 3December 10January 7January 14January 21January 28February 4February 11February 18March 4March 11March 18March 25April 15April 22May 6May 13May 20June 3June 10June 17June 24July 1July 8July 15July 22Register for Adult Afternoons: Wednesday 2025 Register for Adult Afternoons: Wednesday 2025 Adult Afternoons: Wednesday 2025 Price: Adult Afternoons: Wednesday 2025 Price: Adult Mornings: Thursday 2025Thursdays, 10:00 am - 1:00 pm Price: $3510Aide Fee: $2925September 11September 18September 25October 9October 16October 23October 30November 13November 20December 4December 11December 18January 8January 15January 22January 29February 5February 12February 19February 26March 5March 12March 19March 26April 16April 23April 30May 7May 14May 21May 28June 4June 11June 18June 25July 2July 9July 16July 23Register for Adult Mornings: Thursday 2025 Register for Adult Mornings: Thursday 2025 Adult Mornings: Thursday 2025 Price: Adult Mornings: Thursday 2025 Aide Fee Price: After School: Thursday 2025Thursdays, 4:00 - 6:00 pmPrice: $2280Aide Fee: $1900September 11September 18September 25October 9October 16October 23October 30November 13November 20December 4December 11January 8January 15January 22January 29February 5February 12February 19February 26March 5March 12March 19March 26April 16April 23April 30May 7May 14May 28June 4June 11June 18June 25July 2July 9July 16July 23Register for After School: Thursday 2025 Register for After School: Thursday 2025 After School: Thursday 2025 Price: After School: Thursday 2025 Aide Fee Price: Adult Evenings: Joshuas Club 2025Tuesdays, 7:00-8:00pmSeptember 16November 11December 9January 13February 10March 10April 14May 12June 9July 7Register for Adult Evenings: Joshuas Club 2025 Register for Adult Evenings: Joshuas Club 2025 Adult Evenings: Joshuas Club 2025 Price: Adult Evenings: Movie Night 2025Tuesdays, 6:00-7:30pmPrice: $405Aide Fee: $337.50September 30October 28November 25January 27February 24March 24May 26June 23July 21Register for Adult Evenings: Movie Night 2025 Register for Adult Evenings: Movie Night 2025 Adult Evenings: Movie Night 2025 Price: Adult Evenings: Movie Night 2025 Aide Fee Price: Saturday Night FunSaturdays, 6:30pm-8:30pmRegister for Saturday Night Fun November 22 January 10 Saturday Night Fun Price: Saturday Night Fun - QuantityAllie’s Winter CampPrice: $180Price: $270Aide Fee: $135Wednesday, December 24 - 10:00am-12:30pmFriday, December 26 - 10:00am-12:30pmMonday, December 29 - 10:00am-3:00pmWednesday, December 31 - 10:00am-3:00pmRegister for Allie’s Winter Camp Register for Allie’s Winter Camp Allie’s Winter Camp Price: Allie’s Winter Camp Price: Allie’s Winter Camp Aide Fee Price: Form CalculationsDeposit Amount TotalDepositRemainder After DepositHalf PaymentQuarter PaymentProgram Summary Total ScholarshipsScholarship I would like to request a partial Scholarship HiddenI would like to request a partial Scholarship I would like to request a partial Scholarship We will contact you shortly regarding the scholarship amount.HiddenHow much would you be comfortable paying? HiddenI will make a team and try to raise money for the FC Walk I will make a team and try to raise money for the FC Walk PaymentTotal $0.00 Pay Preference - Under 21* I will choose Friendship Circle and use PerformCare for my form of payment I will self pay Pay Preference - Over 21* I will use my DDD budget I will self pay Total Charged Today$0 Total Charged Today$0HiddenPayment Summary {:111}SignatureNotify on Non Attendance* In the event that my child is unable to attend any of the above selected programs, I will notify the Friendship Circle. Who is filling out this form?* Mother Father Legal Guardian Signature*CommentsThis form is an application to register for programs at Friendship Circle. It is not a confirmation of program enrollment.  You will receive a follow-up email when enrollment is confirmed.CommentsThis field is for validation purposes and should be left unchanged. Δ