1Participant2Programs3Payment This field is hidden when viewing the formSubmission IDDebugThank you for your registration, please complete your Program Registration below.Form CodeRegistration is for* Participant Sibling Applicant's InfoApplicant's Name* First Last Birth Date*MonthMonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age*This field is hidden when viewing the formApplicant 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 This field is hidden when viewing the formName of Parent/GuardianParent/Guardian Email* Parent/Guardian Cell*Friendship Circle is eligible to accept PerformCare funding. Please indicate below if the participant is registered for PerformCare. This field is hidden when viewing the formPerformCare* 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 This field is hidden when viewing the formPerformCare 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 This field is hidden when viewing the formPerformCare 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. This field is hidden when viewing the formDDD 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.I'm interested in Friends@Home Jr. I'm interested in 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@HomeProgramsAdult Torah CircleSundays, 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 Register for Adult Torah Circle Adult Torah Circle Price: Adult Torah Circle Price: Adult Torah Circle Aide Fee Price: Torah CircleSundays, 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 Register for Torah Circle Torah Circle Price: Torah Circle Price: Torah Circle Aide Fee Price: Adult Mornings: MondayMondays, 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 20July 27Register for Adult Mornings: Monday Register for Adult Mornings: Monday Adult Mornings: Monday Price: Adult Mornings: Monday Aide Fee Price: Adult Afternoons: MondayMondays, 5:00 - 6:30 pmPrice: $1665Aide Fee: $1387.50September 8September 15September 29October 20October 27November 3November 10November 17November 24December 1December 8January 5January 12January 26February 2February 9February 23March 9March 16March 23March 30April 13April 20April 27May 4May 11May 18June 1June 8June 15June 22June 29July 6July 13July 20July 27Register for Adult Afternoons: Monday Register for Adult Afternoons: Monday Adult Afternoons: Monday Price: Adult Afternoons: Monday Aide Fee Price: After School: MondayMondays, 4:00 - 6:00 pmPrice: $2217Price: $2220Aide Fee: $2030September 8September 15September 29October 20October 27November 3November 10November 17November 24December 1December 8January 5January 12January 26February 2February 9February 23March 9March 16March 23March 30April 13April 20April 27May 4May 11May 18June 1June 8June 15June 22June 29July 6July 13July 20July 27Register for After School: Monday Register for After School: Monday After School: Monday Price: After School: Monday Price: After School: Monday Aide Fee Price: Adult Evenings: BowlingTuesdays, 6:00-7:30pmPrice: $765Aide Fee: $637.50September 9October 21November 4November 18December 2January 6January 20February 3February 17March 17April 21May 5May 19June 2June 16June 30July 14July 28Register for Adult Evenings: Bowling Register for Adult Evenings: Bowling Adult Evenings: Bowling Price: Adult Evenings: Bowling Aide Fee Price: Adult Mornings: TuesdayTuesdays, 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 21July 28Register for Adult Mornings: Tuesday Register for Adult Mornings: Tuesday Adult Mornings: Tuesday Price: Adult Mornings: Tuesday Aide Fee Price: After School: TuesdayTuesdays, 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 21July 28Register for After School: Tuesday Register for After School: Tuesday After School: Tuesday Price: After School: Tuesday Aide Fee Price: Adult Mornings: WednesdayWednesdays, 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 22July 29Register for Adult Mornings: Wednesday Register for Adult Mornings: Wednesday Adult Mornings: Wednesday Price: Adult Mornings: Wednesday Aide Fee Price: Adult Afternoons: WednesdayWednesdays, 5:00 - 6:30 pmPrice: $1275Price: $1530September 10September 17October 22October 29November 5November 12November 19December 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 22July 29Register for Adult Afternoons: Wednesday Register for Adult Afternoons: Wednesday Adult Afternoons: Wednesday Price: Adult Afternoons: Wednesday Price: After School: WednesdayWednesdays, 4:00 - 6:00 pmPrice: $1870Price: $2040September 10September 17October 22October 29November 5November 12November 19December 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 22July 29Register for After School: Wednesday Register for After School: Wednesday After School: Wednesday Price: After School: Wednesday Price: Adult Mornings: ThursdayThursdays, 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 23July 30Register for Adult Mornings: Thursday Register for Adult Mornings: Thursday Adult Mornings: Thursday Price: Adult Mornings: Thursday Aide Fee Price: After School: ThursdayThursdays, 4:00 - 6:00 pmPrice: $2280Aide Fee: $1900September 11September 18September 25October 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 23July 30Register for After School: Thursday Register for After School: Thursday After School: Thursday Price: After School: Thursday Aide Fee Price: Adult Evenings: Joshuas Club7:00-8:00pmThursday, September 18Tuesday, November 11Tuesday, December 9Tuesday, January 13Tuesday, February 10Tuesday, March 10Wednesday, March 25Tuesday, April 14Tuesday, May 12Tuesday, June 9Tuesday, July 7Register for Adult Evenings: Joshuas Club Register for Adult Evenings: Joshuas Club Adult Evenings: Joshuas Club Price: Adult Evenings: Movie NightTuesdays, 6:00-7:30pmPrice: $405Aide Fee: $337.50September 30October 28November 25January 27February 24March 24May 26June 23July 21Register for Adult Evenings: Movie Night Register for Adult Evenings: Movie Night Adult Evenings: Movie Night Price: Adult Evenings: Movie Night Aide Fee Price: Football CircleSundays, 11:00am-1:00pmRegister for Football Circle November 2 May 31 Football Circle Price: Football Circle - QuantityFC Summer Camp Week #1 2026Monday-Thursday: 9:30am-3:00pm & Friday; 9:30am-1:00pmPrice: $1390Week #1: Monday, August 3 - 9:30am-3:00pmTuesday, August 4 - 9:30am-3:00pmWednesday, August 5 - 9:30am-3:00pmThursday, August 6 - 9:30am-3:00pmFriday, August 7 - 9:30am-1:00pmRegister for FC Summer Camp Week #1 2026 Register for FC Summer Camp Week #1 2026 FC Summer Camp Week #1 2026 Price: FC Summer Camp Week #2 2026Mon-Thurs; 9:30am-3:00pm. Friday; 9:30am-1:00pmPrice: $1390Week #2: Monday, August 10 - 9:30am-3:00pmTuesday, August 11 - 9:30am-3:00pmWednesday, August 12 - 9:30am-3:00pmThursday, August 13 - 9:30am-3:00pmFriday, August 14 - 9:30am-1:00pmRegister for FC Summer Camp Week #2 2026 Register for FC Summer Camp Week #2 2026 FC Summer Camp Week #2 2026 Price: FC Summer Camp Week #3 2026Monday-Thursday: 9:30am-3:00pm & Friday; 9:30am-1:00pmPrice: $1390Week #3: Monday, August 17 - 9:30am-3:00pmTuesday, August 18 - 9:30am-3:00pmWednesday, August 19 - 9:30am-3:00pmThursday, August 20 - 9:30am-3:00pmFriday, August 21 - 9:30am-1:00pmRegister for FC Summer Camp Week #3 2026 Register for FC Summer Camp Week #3 2026 FC Summer Camp Week #3 2026 Price: FC Adults Summer Experience 2026Monday-Thursday: 10:00am-2:30pm & Friday 10:00-1:00pmPrice: $1155Monday, August 24 - 10:00am-2:30pmTuesday, August 25 - 10:00am-2:30pmWednesday, August 26 - 10:00am-2:30pmThursday, August 27 - 10:00am-2:30pmFriday, August 28 - 10:00am-1:00pmRegister for FC Adults Summer Experience 2026 Register for FC Adults Summer Experience 2026 FC Adults Summer Experience 2026 Price: Form CalculationsDeposit AmountTotalDepositRemainder After DepositHalf PaymentQuarter PaymentProgram Summary TotalScholarshipsScholarship I would like to request a partial Scholarship This field is hidden when viewing the formI would like to request a partial Scholarship I would like to request a partial Scholarship We will contact you shortly regarding the scholarship amount.This field is hidden when viewing the formHow much would you be comfortable paying?This field is hidden when viewing the formI 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$0This field is hidden when viewing the formPayment 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.PhoneThis field is for validation purposes and should be left unchanged. Δ