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Forms & Registration
Ongoing Programs
New Family Contact Form
Interested in joining Friendship Circle and learning about our programs and activities? Fill out this form to get started.

PLEASE NOTE: All new families interested in joining Friendship Circle's Programs must have a meeting with the family coordinator. Upon submission of this form you will be contacted to set up a meeting.
Mother's Name *
First Name              Surname
Father's Name *
First Name              Surname
Email Address *
Phone Number *
 --  --  
Street Address
Address Line 2
City*                           Province   
Zip                              Country
Participant Information
How many individuals have special needs? 

Name of Participant #1 *  

First Name        Surname
Male Female
Date Of Birth
 /  /
MM         DD         YYYY
Medical Diagnosis
Name of Participant #2
First Name       Surname
Male Female
Date Of Birth 
 /  /
MM        DD         YYYY
Medical Diagnosis
How did you hear about Friendship Circle
Car Magnet        Google        Doctor/therapist        Friend
Questions & Comments


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