Summer Camp Participant - Friendship Circle Miami

Are you a current participant?

Parent/ Guardian 1 Name

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Last

Parent's / Guardian 1 E-mail

Parent's / Guardian 1 Phone Number

Participant's Name

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Participant's Age

Any allergies for food sensitivity?

Authorized Pick Up Person 1

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Authorized Pick Up Person 2

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Last

Is your child potty trained?

Yes!
Mostly, but needs reminders
No - we do not accept diapers/pull ups at this time. You will need to have your own aid attend.

Can you child be in photos?

Will your child be accompanied by their ABA therapist? If so, we MUST have a copy of their background check PRIOR to camp starting.

Which days would you like to attend?

Are you currently on scholarship?

Scholarship Code:

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Item Quantity Qty Total

There are no products selected.

Which days would you like to attend? - Monday: August 12: Trampoline High 1 $60.00

Which days would you like to attend? - Tuesday: August 13: Sky Zone 1 $60.00

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Total $0.00

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