Friendship Club Registration

*Denotes Required Field

Personal Information

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Health Concerns

Emergency Contact

Residence (If Applicable)

Release

  • I give permission to be photographed and or/filmed for Friendship Club activity, which will only be used for Friendship Club activity.
  • I will release to Friendship Club medical information that may be necessary in case of emergency.

Date I am agreeing to release:

Virtual Signature: By clicking this box I declare that I have read and agree to the above release form. 

If the individual is under the age of 18, or unable to consent on their own, a parent or guardian must sign on his or her behalf.

Date I am agreeing to release:

Virtual Signature: By clicking this box I declare that I have read and agree to the above release form.