Circle of Friends Registration
Round Table - Wednesdays at 4:00 September 15 - November 17 | Please fill out this form and click submit.
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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Child/Youth's Name - 1
*
Age
*
Please select one option.
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Select Option
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Birthdate
*
Grade
*
Please select one option.
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Select Option
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Child/Youth's Name - 2
Age
Please select one option.
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Select Option
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Birthdate
Grade
Please select one option.
K
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Select Option
K
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Child/Youth's Name - 3
Age
Please select one option.
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18
Select Option
5
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Birthdate
Grade
Please select one option.
K
1
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Select Option
K
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My child(ren) have these allergies:
*
My child(ren) have these special needs:
*
Transportation: Do you need assistance with transportation?
*
Please select one option.
Yes
No
Select Option
Yes
No
Photography: SPC has my permission to use pictures taken during RoundTable for publicity or on bulletin boards
*
Please select one option.
Yes
No
Select Option
Yes
No
Medical: I give my permission for the staff of RoundTable to administer basic first aid. In case of emergency, RoundTable staff are authorized to seek medical care and transport to a hospital if necessary.
*
Please select one option.
Yes
No
Select Option
Yes
No
COVID: I am aware that RoundTable staff and volunteers are taking many precautions (masks, sanitizing, distance, small groups, outdoors, etc.) to keep the children and adults safe. I also understand that attending RoundTable is not completely risk-free. I will emphasize at home the importance of masks, social distancing, and sanitizing, and I will not send my child(ren) if he/she has been exposed to the virus, has a temperature, or is not feeling well.
*
Please select one option.
Yes
No
Select Option
Yes
No
Submit
Description
Round Table - Wednesdays at 4:00 September 15 - November 17
Please fill out this form and click submit.
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