Volunteer Registration Form
Name
*
First Name
Last Name
Volunteer's Cell
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Gender
*
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School
*
Grade
*
Please Select
9
10
11
12
College
Other
Which year will you (or did you graduate High School)
*
Please Select
2023
2024
2025
2026
2027
2028
2029
other
How many years have you been volunteering for Friendship Circle
*
Please Select
This is my 1st year
This is my 2nd year
This is my 3rd year
This is my 4th year
Did you come to Volunteer Orientation
*
Yes
No
How did you hear about Friendship Circle?
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Parents Info
Mothers Name
First Name
Last Name
Mother's Cell
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Occupation
Father's Name
First Name
Last Name
Father's Cell
*
Please enter a valid phone number.
Format: (000) 000-0000.
Father's Occupation
Parent Email
*
example@example.com
Parent's Marital Status
Married
Divorced
Widowed
Other
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Emergency & Safety Info
Emergency Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name (other than parent)
First Name
Last Name
Please list any allergies or medical conditions that we should be aware of:
Please list any additional concerns or information our staff should be aware of to ensure volunteer safety:
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Volunteer Recommendation
In order to ensure the integrity of our volunteers, we ask that you provide a reference that we can contact about you. We will send them a form to complete, and all information will be held in confidence.
Name of Reference and relationship to you:
Email address or phone number of reference
Kindly send this message to your reference to fill out- Hey! I'm signing up to volunteer with Friendship Circle, where I'll be working with children with disabilities. Would you be able to fill out this reference form for me? I really appreciate your help. Thank you! WWW.FC5TOWNS.COM/reference
*
Yes I sent the link
Other
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Volunteer Opportunities
Which programs would you like to volunteer at?
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Friends @ Home 1x weekly
Judaica Circle 1x weekly- Wednesdays 5:00-6:45 (Girls only)
Girls Dance- Sundays/ Fridays/ Legal Holidays
T-YAD 1x monthly- Sundays/Saturday night
Kugel and Kumzitz 2x monthly (Boys only)- Mondays 7:15-8:40
Shabbat Circle 1X monthly- Shabbat Afternoons (Cedarhurst)
Hama'agal (4-5 times throughout the year)
JAM (Tuesday a few times a year)
Fun and Fitness (Sundays 4:10-5:20)
U matter (Saturday nights)
If you selected Friends @ Home, which day of the week & time works best for you?
What's your second choice of day & time?
Is there a partner with whom you'd like to do Friends @ Home? If yes, please provide name and contact info.
Any comments, questions or concerns?
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COMMITMENT TO EVERYONE’S SAFETY AND WELL-BEING
Friendship Circle provides unique opportunities for volunteers, children, teens and their families to socialize and have fun. 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, friends, and parents understand what they can expect. Therefore, volunteers, friends, and their families each certify and agree by checking each box and signing below that they:Understand that participation in this activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct;Understand that participation in Friendship Circle activities involves a certain degree of risk and can be physically, mentally, and emotionally demanding. I have carefully considered the risk involved and have given consent for me and/or my child to participate in this activity;Do not use or possess any illegal drug, alcohol or controlled substances at any time, including at Friendship Circle events or programs;Do not have any alcohol or tobacco products at Friendship Circle events or programs, including Friends at Home;Do not bring any weapons, firearms or other dangerous items to any Friendship Circle event or program;Do not have any unsecured firearms in a home 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;Agree to a background check.Acknowledge the risk of injury from the activities involved in the Friendship Circle events or program and knowingly and freely assume all such risks;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;If you observe any significant hazard during your participation in any Event, you will stop participating in the event and inform the Friendship Circle of such hazard immediately;Agree Friendship Circle is not responsible for any damages to personal property or injury in which the Friendship Circle had no knowledge of the particular hazard or any activity outside of Friendship Circle sponsored events;Acknowledge that Friendship Circle is an independently owned, operated and controlled local corporation.Release Friendship Circle, the directors, board, officers, activity coordinators, and all employees, volunteers, related parties, and other organizations associated with the activity from any and all claims or liability arising out of this participation;In case of emergency involving my child, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. Medical providers are authorized to disclose to the adult in charge examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities.
Please sign here to show that you agree with all the above.
*
Date
-
Month
-
Day
Year
Date
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Friendship Circle's Code of Conduct
I will promote the creation of a friendship community based on mutual respect and a sense of personal well-being. I will treat others with honor and respect because we are all created in the image of G-d.As a volunteer of Friendship Circle:I understand that Friendship Circle expects me to behave responsibly. I agree to utilize my best judgment and sense of responsibility when spending time with the child with whom I am matched.I understand that the use of a cell phone during any Friendship Circle program does not promote a healthy friendship and should only be used in case of emergency.In the event that I am unable to volunteer during my scheduled visit, I will try to find another day to substitute and I will notify the parents of my special friend, and my Friends@Home coordinator at least 48 hours in advance.I agree to respect the privacy of all participants of the Friendship Circle and to keep personal information confidential.I understand that once I commit to attend an event, the Friendship Circle staff and special friends expect me to be there. I agree to attend and give it my best effort. In the event that I cannot attend, I agree to give notice to Friendship Circle staff, at least 48 hours in advance.If someone gets hurt or some other incident occurs while I am volunteering, it is my responsibility to immediately report the occurrence to Friendship Circle staff.I agree to represent the Friendship Circle to the best of my abilities.I have carefully read and agree to abide and be bound by all additional rules and policies for The Friendship Circle and any additional rules pertinent to specific events.I agree to volunteer for Friendship Circle. I grant Friendship Circle permission to use my name, image, likeness, or recording in connection with any promotional materials including, but not limited to, brochures, advertising, and broadcasts. I understand that participation in Friendship Circle activities involves a certain degree of risk and can be physically, mentally, and emotionally demanding. I have carefully considered the risk involved and agree to participate in this activity. I also understand that participation in this activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct as set forth by the Staff. I understand that this local Friendship Circle is independently owned, operated and controlled. I release the Friendship Circle and its employees, directors, officers, and volunteers as well as its affiliates and all other organizations associated with Friendship Circle from any and all claims or liability arising out of this participation.
Please sign here to show that you agree with all the above.
*
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Communication
Friendship Circle's main mode of communication is WhatsApp. Communication is key to every successful organization, and therefore, we expect volunteers to respond when they receive a message in a prompt manner. If messages are repeatedly ignored, we will assume you no longer want to volunteer and we will remove you from our volunteer list.
Please sign to show that you agree to communicate with Friendship Circle via WhatsApp and respond to messages in a timely fashion.
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Friendship Circle's WhatsApp number is 516-418-2388 (to reach Hadassah) Did you save the number?
*
Yes
I don't have whats app
Other
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