2025/26 Scholarship/Program Addition Adults

Become part of the solution and join our circle!

Adult Programs: Use this form to add or join a program for Session 2 and rolling admission!

Please complete this form in it's entirety and be as detailed as possible as this is the information we share with our program staff and therapists. Some of our programs partially rely on grants for funding, and certain pieces of information are collected for the purpose of required grant reporting. Client privacy protection will be observed in accordance with those rules set forth in the Health Insurance Portability and Accountability Act (HIPPA).

Participant's Name

First

Last

Participant's Birth Date

Participant's Age

Primary Parent/Guardian or Caretaker

First

Last

Primary Parent/Guardian Email Address

Primary Parent/Guardian Phone Number

Authorized Person #1 (Pick-up and Drop-off)

First

Last

Authorized Person #1 Phone Number

Authorized Person #2 (Pick-up and Drop-off)

First

Last

Authorized Person #2 Phone Number

Does the participant have any allergies or food sensitivities? If so, please provide details.

Does the participant carry emergency medicine on them and will be bringing to programs? (Ex: Epi-pen or Seizure Spray)

If you child carries an EPI- PEN you MUST carry Benadryl to administer as well. Friendship Circle Miami WILL ONLY administer NASAL SEIZURE SPRAY AND EPI-PEN, we WILL NOT administer daily medications, NSAIDS or rectal seizure spray. In the event of a seizure or epi-pen is required 911 will be called as well as Primary Contact.

Will the Participant be attending programs with their own Registered Behavior Technician (RBT)?

Scholarships

Did you apply for Scholarship assistance (2025/26)?

Click yes, if you have gotten a code from Program Manager to prorate the program.

Friendship Circle Program(s):

Please let us know which programs you’d like to register for... For families interested in a more comprehensive experience, we also offer an Annual Membership.

Sunday Circle (Ages 18 - 30): 2 Sundays a month 10 AM-12 PM

Full Year: January 11 - May 17 (9 classes) - $180.00

Join us twice a month on Sundays from 10:00AM – 12:00PM for a fun and engaging session filled with creative activities and social interaction designed to inspire and connect.

Movement Circle: (Mondays from 4:00 -5:00 PM)

Session 1: September 15- December 15 - $180.00
Session 2: January 5 - May 11 - $240.00

Join us every Monday from 4:00PM – 5:00PM for an engaging and energetic movement session.

Art Circle: (Mondays from 5:00-6:00 PM)

Session 1: September 15- December 15 - $180.00
Session 2: January 5 - May 11 - $240.00

Join us every Monday from 5:00PM – 6:00PM for Art Circle.

Sports Circle (Tuesdays from 5:00 - 6:00PM): Free

Session 1: September 16- December 16
Session 2: January 6 - May 12

Get active and develop teamwork every Tuesday from 5:00PM – 6:00PM in Sports Circle, where all skill levels are welcome. If your child is absent more than 5 times, we reserve the right to give your spot to another child.

Karate Circle: (Wednesdays from 4:00 - 5:00PM)

Session 1: September 17 - December 16, 2026 - $135.00
Session 2: January 7 - May 12, 2026 - $240.00

Get active and develop teamwork every Wednesday from 4:00PM – 5:00PM in Karate Circle with Kia Kidz, where all skill levels are welcome.

FC Band (Wednesdays from 5:00-6:00) FREE

FC BAND

No experience is needed. If your child is absent more than 5 times, we reserve the right to give your spot to another child.

Cooking Circle: (Thursdays from 5:00 - 6:00 PM)

Session 1: September 18 - December 16, 2026 - $120.00
Session 2: January 8 - May 12, 2026 - $320.00

Learn and prepare food skills such as mixing, following recipes, chopping, and more every Thursday from 5:00PM – 6:00PM

Adult Social Group: (2 Tuesdays: 6:30 -8)/ (1 Sunday: 1:30 - 4:30)

BOTH Tuesdays and Sundays - January- May - $270.00
Tuesday ONLY: January- May (10 classes) - $150.00
Sunday ONLY: January- May (4 classes) - $120.00

(1) Sunday a month: 1:30 - 4:30 PM/ (2) Tuesdays a month: 6:30 - 8:00 PM. Tuesdays are in house activities. Sunday is a field trip.

I hereby grant permission for photographs of my child, without any identifying information, to be used by Friendship Circle and its partners for publicity related to Friendship Circle activities.

We sincerely appreciate your support in helping us share the impact of our programs with the community. By allowing us to highlight your child’s talents, you contribute to keeping our costs low and our marketing efforts authentic and effective.

Program Payment

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Parent's Name

First

Last

Enter Payment Information

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Total

Item Quantity Qty Total

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Sunday Circle (Ages 18 - 30): 2 Sundays a month 10 AM-12 PM - Full Year: January 11 - May 17 (9 classes) 1 $180.00

Movement Circle: (Mondays from 4:00 -5:00 PM) - Session 1: September 15- December 15 1 $180.00

Movement Circle: (Mondays from 4:00 -5:00 PM) - Session 2: January 5 - May 11 1 $240.00

Art Circle: (Mondays from 5:00-6:00 PM) - Session 1: September 15- December 15 1 $180.00

Art Circle: (Mondays from 5:00-6:00 PM) - Session 2: January 5 - May 11 1 $240.00

Sports Circle (Tuesdays from 5:00 - 6:00PM): Free - Session 1: September 16- December 16 1 $0.00

Sports Circle (Tuesdays from 5:00 - 6:00PM): Free - Session 2: January 6 - May 12 1 $0.00

Karate Circle: (Wednesdays from 4:00 - 5:00PM) - Session 1: September 17 - December 16, 2026 1 $135.00

Karate Circle: (Wednesdays from 4:00 - 5:00PM) - Session 2: January 7 - May 12, 2026 1 $240.00

FC Band (Wednesdays from 5:00-6:00) FREE - FC BAND 1 $0.00

Cooking Circle: (Thursdays from 5:00 - 6:00 PM) - Session 1: September 18 - December 16, 2026 1 $120.00

Cooking Circle: (Thursdays from 5:00 - 6:00 PM) - Session 2: January 8 - May 12, 2026 1 $320.00

Adult Social Group: (2 Tuesdays: 6:30 -8)/ (1 Sunday: 1:30 - 4:30) - BOTH Tuesdays and Sundays - January- May 1 $270.00

Adult Social Group: (2 Tuesdays: 6:30 -8)/ (1 Sunday: 1:30 - 4:30) - Tuesday ONLY: January- May (10 classes) 1 $150.00

Adult Social Group: (2 Tuesdays: 6:30 -8)/ (1 Sunday: 1:30 - 4:30) - Sunday ONLY: January- May (4 classes) 1 $120.00

Subtotal

Total $0.00

Adult Programs: Use this form to add or join a program for Session 2 and rolling admission!

Scholarships

Friendship Circle Program(s):

Program Payment

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