No School Fun Days & Camps Registration

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No School Fun Days & Camp Registration
(Ages 5-22)

No School Fun Days & Camp Registration

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).

REGISTRATION WILL CLOSE MARCH 19 @ 3PM. NO EXCEPTIONS.

Participant's Name

First

Last

Participant's Age

Are you a currently registered for the 2025-2026 year?

Parent's Email

Parent's Phone Number

What are their preferred items?

Please list fidget/sensory toys the participant enjoys so we can have those available here for them.

Are they allergic to any food or outside environmental?

Please describe in full detail what they are allergic to.

Do they carry emergency medicine on them?

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.

Is your child potty trained?

Yes!
Mostly, but needs reminders
Needs assistance
No- Wears Diapers

Can your child be in photos?

Will your child be accompanied by their Aide/RBT? If so, we MUST have a copy of their background check and signed contract PRIOR to camp starting.

Did you apply for scholarship?

REGISTRATION WILL CLOSE MARCH 19 @ 3PM. NO EXCEPTIONS.

Spring Break Camp: March 23 - March 27: 9AM - 3PM

ALL 5 days: Monday, March 23 - Friday, March 27 - $250.00
Monday, March 23 (in-house) - $65.00
Tuesday, March 24 (field trip) - $65.00
Wednesday, March 25 (in-house) - $65.00
Thursday, March 26 (field trip) - $65.00
Friday, March 27 (in-house) - $65.00

If you are registering for all 5 days the cost is $250 for the week and can select ALL 5 DAYS option. Or if you register for individual days the cost is $65 PER DAY, and please select which day.

Total

Item Quantity Qty Total

There are no products selected.

Spring Break Camp: March 23 - March 27: 9AM - 3PM - ALL 5 days: Monday, March 23 - Friday, March 27 1 $250.00

Spring Break Camp: March 23 - March 27: 9AM - 3PM - Monday, March 23 (in-house) 1 $65.00

Spring Break Camp: March 23 - March 27: 9AM - 3PM - Tuesday, March 24 (field trip) 1 $65.00

Spring Break Camp: March 23 - March 27: 9AM - 3PM - Wednesday, March 25 (in-house) 1 $65.00

Spring Break Camp: March 23 - March 27: 9AM - 3PM - Thursday, March 26 (field trip) 1 $65.00

Spring Break Camp: March 23 - March 27: 9AM - 3PM - Friday, March 27 (in-house) 1 $65.00

Subtotal

Total $0.00

Parent's Name

First

Last

Credit Card

No School Fun Days & Camp Registration (Ages 5-22)

No School Fun Days & Camp Registration

REGISTRATION WILL CLOSE MARCH 19 @ 3PM. NO EXCEPTIONS.

REGISTRATION WILL CLOSE MARCH 19 @ 3PM. NO EXCEPTIONS.

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No School Fun Days & Camp Registration
(Ages 5-22)

Stay connected,
submit your email