MVP Signup Form

Join the Bar/Bat Mitzvah program for middle school students with Friendship Circle! Discover how to support individuals with various disabilities, learn respectful ways to interact, and understand the impact of giving back to the community. Through a three-part series featuring fun games, interactive videos, insightful discussions led by specialists and therapists, and hands-on volunteer opportunities, you’ll gain valuable skills while making a meaningful difference.

Who: middle school students

Dates: Oct 26, Nov 2, Feb 1, Feb 22

Time: 6:30-8 PM

Location: At the FC, 48 Union St., Stamford

For more information, email [email protected]

Volunteer information

Full Name*

First Name Last Name

E-mail*

Phone Number*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Birth Date*

Month Day Year

Time of Birth*

Are you Jewish?*

YesNo

School*

Grade*

Year graduating*

Parent information

Mother's Name*

First Name Last Name

Mother's Email*

Mother's Cell*

Father's Name*

First Name Last Name

Father's Email*

Father's Cell*

Parent Marital Status*

MarriedWidowedDivorcedSingle

Additional information

Date of Bar/Bat Mitzvah Celebration*

Month Day Year

Jewish Name*

If no Jewish name, indicate N/A

Siblings' names and ages*

Parental consent

I give my teen permission to volunteer in the Friendship Circle:*

YesNo

I permit my child's photos to be used for publicity purposes: *

YesNo

Parent/guardian electronic signature*

Today's Date*

Month Day Year

I would like to receive news and updates by email

My son/daughter has my permission to attend Friendship Circle events. I agree not to hold Friendship Circle responsible for any accident, loss or theft that may occur during the course of an event. I hereby give my permission to the physician selected by the Friendship Circle to hospitalize, and/or secure necessary treatment or anesthesia for my child, as named above, in the event that I cannot be reached in an emergency. I hereby give my permission that paramedics may transport my child to the nearest hospital. If necessary, I have indicated any pertinent medical information below. I agree to the terms and conditions of this application.

Comments: (optional)

Volunteer's Signature*

Full name of Parent/Guardian*

First Name Last Name

Parent/Guardian's signature*

Date*

Month Day Year

Mitzvah Volunteer Program

Volunteer information

Parent information

Additional information

Parental consent

Medical & Emergency Release