Volunteer 

As a teenager we challenge you to give time,  patience and love.

Build a friendship with someone who truly loves, accepts, and won’t forget you.

In addition to making an impact on a child, you will see the impact your work makes on yourself.

By helping others you help yourself feel more fulfilled, self confident, and comfortable in your own skin.

It means hours and hours of fun in a safe environment.

It means getting to meet other teenagers who are committed, caring and responsible.

It means gaining a sense of security and self esteem that comes with knowing that what you do makes a difference in the life of a child.


Volunteer Registration   
 

Please fill out the information below.

A Friendship Circle staff member will be in contact with you shortly to arrange a meeting and finalize the registration.

There is no registration fee.

Click here for a printable registration form.

 

(All fields marked with * are mandatory)

)If you do not know an answer, or the question does not apply to you, please mark the space provided with N/A) 

Volunteer Information

Gender: * 

Male

Female


First Name: *

 Last Name: *

 

 Birthday: (DD/MM/YYYY) *

Address: *

City: *

 State: *

  

Zip Code: *

Home Phone: *

 

Cell Phone: *

Email Address: *

 Date of Bar/Bat Mitzvah: (if applicable)

School: *

Grade: *

 Religion: *

 

Parental Information

(or Legal Guardian)

 Parent 1 Name: *

Parent 1 Cell: *

Parent 2 Name:

  

Parent 2 Cell:

Parent Email Address: *

 

Programs and Scheduling

When would you like to volunteer at the home of a child with special needs?

Most convenient dayof the week: *

 

Time: *

 

 If the above day is not available, which other day would work? *

 

Time: *

   

I would be interested in volunteering for Sunday Circle: *

Do you have a friend with whom you would like to volunteer at the home of a special needs child? *

 

Your Friend's Name:

Phone number:

 

Are your parents available to drive you to and from the child's home? *

Are you available to drive to and from the child's home? *

 

References

(Mandatory for new FC Volunteers)

Please list two references, who are not relatives of yours.

Name of first reference: *

Relationship to you: *

Phone: *

Cell: *

 Name of second reference: *

 

Relationship to you: *

 Phone: *


 

Cell: *

 

About you

Please describe yourself:

 

 What are your interests and hobbies?

  


 Are you okay with pets?

 

What do you hope to gain from the program?

 

 

 

Volunteer Consent

In the event that I am unable to volunteer, I will try to find another day to substitute, and I will always call my special friend in advance.

I Agree

I will relate feedback to the Friendship Circle Volunteer Coordinator after every visit, or if scheduling conflicts occur, in order to uphold my commitment to the Friendship Circle.

I agree 

I will keep all information about my special friend and their family confidential

I agree 

Volunteer Signature: 

 Date: (DD/MM/YYYY)

 

Parental Consent 

I (Parent of the Volunteer) give my teen permission to volunteer in the Friendship Circle

I agree

I (Parent of the Volunteer) agree to release the Friendship Circle, its providers and administrators from all liability for any incident which affects the health, welfare, or safety of my teen during their participation in the Friendship Circle programs.

I agree

I (Parent of the Volunteer) give permission for my teen's photo/s to be used for publicity purposes

I (Parent of the Volunteer) give my teen permission to attend Friendship Circle trips. 

I (Parent of the Volunteer) would be interested in assisting the Friendship Circle in future events.

Signature of Parent:


 

Date: (DD/MM/YYYY)

 

Parental Medical Consent

In case of an emergency, when neither parent can be reached, please provide a name of someone who will take responsibility for your teen.

Name:

Relationship:

Phone:

Cell:

 

In case of a medical emergency requiring immediate emergency care, I authorize the paramedics to take my child to the nearest hospital, if necessary.

I agree

Health Insurance Name:

Policy Number :

Please list any medication being taken by your teen: (if none, please write none)

 

Does your teen have any allergic reactions to any medication?  (if none, please write none)

 

Please list any dietary restrictions we should be aware of  (if none, please write none)

 

Please list any special medical circumstances. (Including allergies)  (If none, please write none)

 

Signature of Parent:

Date: (DD/MM/YYYY)

 

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Friendship Circle
1302 E Las Olas Boulevard
Fort Lauderdale, FL 33301
754-800-1770