Name of Mother *
Name of Mother
Name of Father *
Name of Father
Address
Address
Participant's Name *
Participant's Name
If you have more than one child with special needs please add their information in the Comment field below.
Gender *
Age *
Age
Are you? *
How did you find out about Friendship Circle

Register for an Intake

Friendship Circle requires that all new families participate in an intake meeting before their child participates in programs. You will meet with a family coordinator who will give you a tour of our facility and discuss the programs that are available for your child. The intake is also a good time to ask any questions or share any concerns you may have. Intake Meetings are generally held twice a week.

Fill out the form to get started.