Volunteer Registration First Name * Last Name * Birthday * MM 1 2 3 4 5 6 7 8 9 10 11 12 DD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YYYY 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Contact Information Cell Phone Number * Email * Religion * School/Occupation * Grade Medical Information Allergies/medical concerns * Emergency Contact Name (First Name, Last Name) * Phone Number * Cell Phone * Do you have any experience in volunteering for the special needs community? options: Yes, No If yes, kindly elaborate. * References
Please list 2 non-family references:
Full Name / Phone / Connection
Full Name / Phone / Connection
Required for volunteers under age of 18.
Mother's Name (First Name, Last Name) Mother's Cell Occupation Email Father's Name (First Name, Last Name) Father's Cell Occupation E-mail Programs TEEN SCENE
>Sunday, twice a month, 3:00-4:30 PM
Teen volunteers and teens with special needs get together monthly for social activities and group "hang outs", where they can have a great time while enhancing their social skills!
YOUNG ADULT CIRCLE
>Thursday, twice a month, 6:00-7:30 PM
Young adult volunteers and young adults with special needs come together monthly to form a social group in a non-judgmental and accepting environment. They get to experience an exciting array of activities such as karaoke, art, baking, sports and so much more.
>One Sunday a month, 4:00-5:00 PM
Travel the world & discover different yummy cuisines with fun, talented chefs!! Socialize with friends, discover your hidden talents, and come home with deliciousness and lots of pride!!
FRIENDS AT HOME
>Once a week throughout the school year, accommodates a wide variety of schedules
(Open for families who are a part of our Teen Scene Program)
Friends@Home pairs teenage volunteers and children with special needs for hours of fun and friendship through weekly home visits. This provides children the chance to bond with their volunteers in an environment they are most comfortable in, while their parents and siblings receive much-needed respite.
Through the weekly visits, the pair establishes a warm friendship that combats the loneliness and isolation so often felt by individuals with special needs while their teen volunteers learn the priceless value of giving.
LIFE SKILLS & JOB TRAINING PROGRAM
Monday- Friday, 9:00 A.M- 3:00 P.M.
Our goal is to provide our Adults with special needs with an immersive, real- world environment where they can practice critical life and job skills. The program includes hands on training in The Friendship Cafe, interpersonal & communication skills, academics such as basic math & reading, Yoga & relaxation techniques, a Mentorship program, Arts & more.
For Friends at Home and or Life Skills & Job Training Program - Which days and times work best for you? I would like to volunteer for the following * Permission and Waivers Code of Conduct *
Friendship Circle of Greater Fort Lauderdale provides very special and unique opportunities for volunteers, special friends, and their families to enrich the lives of each other. In doing so, most participants will encounter new and sometimes challenging situations. Thus, it is imperative to set expectations at the beginning so that volunteers, special friends, and parents understand what they can expect. Therefore, volunteers, special friends, and their families each certify and agree by signing below that they:
As a Parent/Guardian of a special needs child of Friendship Circle or a volunteer:
● I understand that Friendship Circle will match my child with a teenage/ young adult volunteer.
● I understand that it is necessary for me as parent(s)/guardian(s) to assume full oversight and supervision responsibilities with respect to all activities Friendship Circle’s assigned volunteer(s) share(s) with my child in connection with his/her participation in the program.
● I understand that participation in this activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct;
● I understand that participation in Friendship Circle activities involves a certain degree of risk, both physically and emotionally demanding. I have considered the risk involved and have given consent as indicated below for my participation
Will not use or possess any illegal drug, alcohol or controlled substances at any time, including at Friendship Circle events or programs;
● I will not bring any weapons, firearms or other dangerous items to any Friendship Circle event or program and I will not have any unsecured firearms in a home in which hosts a Friends at Home program;
● Have not and do not have any individual that has been convicted of a crime, other than minor traffic violations, living at or visiting a home that hosts a Friends at Home program and have not themselves been convicted of a crime;
● Do not themselves have and do not have any individual that has a history of violence or abuse of any kind living at or visiting a home that hosts a Friends at Home program;
● Acknowledge the risk of injury from activities involved in Friendship Circle events and knowingly and freely assume all such risks. In the event I observe any particular hazard that I believe could cause injury to a participant, I will immediately inform Friendship Circle staff of such hazard.;
● Will not participate in any activity that you believe you and/or your child cannot perform in accordance with the Friendship Circles activities’ instructions or in a safe manner;
● Agree Friendship Circle is not responsible for any damage or injury to myself, my child/participant or my property in regard to my participation in any Friendship Circle activity;
● Acknowledge that Friendship Circle is an independently owned, operated and controlled local corporation.
I have carefully read and agree to abide and be bound by all additional rules and policies in the Friendship Circle Handbooks and any additional rules pertinent to specific events. THE FAILURE TO ABIDE MAY, IN THE EXERCISE OF FRIENDSHIP CIRCLE’S SOLE AND ABSOLUTE DISCRETION, RESULT IN THE TERMINATION OF ALL FURTHER PROGRAM-RELATED VISITATIONS WITH YOUR CHILD.
*If volunteer is over 18, they can sign. If volunteer is under 18, the volunteer’s legal guardian must sign. Your typed name below signifies your electronic signature. The Friendship Circle accepts your electronic signature in place of a handwritten signature on a hard copy page.
Name of Authorized Signatory * Relationship to the Volunteer (write self if Volunteer > 18 yo) *