Emergency Contact Information

Emergency Contact Information

 Email
  • Child Registration Form

  • Parents' Information


  • -
  • -
  • -
  • -
  • -
  • -
  • Emergency Contact

  • -
  • -
  • -
  • By entering my initals below, I certify that all information in this form is correct. and i agree to the waivers below.

    I give legal authorization for the Friendship Circle of Cleveland to use some or all of the information in this form to the best of their ability to secure and provide a healthy enviorment for my child when they are in their care.

    I release the Friendship Circle, its providers and administrators, from ALL liability for any incident which affects the health, welfare, or safety of my child in the provision of a Friendship Circle program for the year 2015/2016. I agree that a parent/guardian will be at my home while the volunteers are interacting with my child for Friends @ Home. In the event that I choose a volunteer for my personal babysitting, I will take full responsibility for any actions at that point.

  • Reload
  • Should be Empty:
 Email