Retreat Children's Program - Friendship Circle of Wisconsin

If you plan to enroll multiple children in our children's program during the retreat, please complete a separate form for each child. This ensures we have the information needed to support each child individually, so you can fully relax and enjoy the retreat.
Full Name of Mom
First Name Last Name
E-mail
I would like to receive news and updates by email
Phone Number

Address

Full Name of Child
First Name Last Name
Birth Date of child

Month Day Year
Full Name of Emergency Contact
First Name Last Name
Phone Number of Emergency Contact
To help us create a positive experience for your child, are there any triggers, sensitivities, or situations we should be aware of? Please provide details.
Are there any behaviors or support needs we should be aware of to help your child have a successful experience in the program? How do they communicate their needs?
To help create a safe, supportive, and successful experience for all, we review each registration to ensure the program is an appropriate fit. A member of our team may reach out to gather additional information about your child's needs and supports.

Thank you for taking your time to complete this!
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