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Chabad Beaches Aaron & Blanche Scharf CenterThe Aaron and Blanche Scharf Chabad Center

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6-week course delves into 'The Journey of the Soul Hanukkah event brings together family, faith Happy Thanksgivukkah and Black Thursday Medical ethics and dilemmas discussed at 6-week seminar at Chabad at the Beaches Chabad at the Beaches Celebrates a Decade of Service Chabad celebrates Purim by remembering Esther 3rd Kosher Food Festival at the Ribault Garden Club Chabad @ the Beaches Presents 8th Annual Gala Dinner Recovery from addiction means finding a new spirituality Rappin' rabbi uses music to break barriers

Religious Profiling Jewish faith keeps them 'solid’ while incarcerated Judaism: What part does meditation play in the practice of your faith? Nature-based spirituality on rise, from Darwin to 'Avatar' Jacksonville Lights Menorah Man who helped saved 2,500 Jews during the Holocaust will speak at Hanukkah ceremony Chabad offers kosher food event for teens Shofar So Good Matzah class is parts cooking, custom Rally in support of Israel

Demonstrators support Israel's military action Hanukkah's lessons of strength felt on first night Hanukkah message for everyone Trying to overcome darkness with light Woman who escaped Nazis now an 'affirmation of life' Older Stories Hanukkah and BMX

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Volunteer Registration Form Friendship Circle Child Registration Form

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Friendship Circle Hospital Visitations Homebound / Retirement Home Visitations Prison Chaplaincy Funerals / Jewish Burial Society Counseling Koshering Services Board of Directors

Upcoming at Chabad Holidays Torah & Tea JLI Course Laibl Wolf: Stop Stressing and Start Living Past Events

Sukkot & Simchat Torah

About Services Schedule Children's Service High Holiday Reservations Rosh Hashana Dinner High Holiday Guide Purchase an Aliya High Holiday Checklist Yizkor Book Rosh Hashana 4 Kids

Cteen Mobile Escape Room Kids Holiday Program

Order Lulav & Etrog Sukkot Under the Stars Ladies Sukkot Samba in the Sukkah Men's Sukkot Steak & Scotch in the Sukkah Simchat Torah Ckids Sukkot: Family Team Up

Light Up Jacksonville 2022 Fire & Ice Festival CTeen 2022 Ladies Night Out 2022 Menorah Workshop Atlantic Beach Celebration

Purim Under the Sea Purim in NYC Matonos L'evyonim Fund

Sell Chometz Buy Matzah Community Seder Schedule of Services Maot Chitim Matzah Bakery Passover Megasite Moshiach Meal RSVP

Schedule Shavuot Late Night Torah-Thon Shavuot Ice Cream Party Shavuot on the Grill Yizkor Service

Documentry - 9 Av Reservation

Mysticism/Chasidut

Torah & Tea Book Club Past

Advanced Hebrew Judaism 101 Women Chanukah Class Passover Class Kosher Lunch n Learn Law BLT Passover

Adult Hebrew School Tanya Learn Conversational Hebrew Conversational Hebrew

Adult
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Upcoming at Chabad

Laibl Wolf: Stop Stressing and Start Living

Celebrate Summer Picnic

High Holidays Sukkot & Simchat Torah Chanukah 10 Shvat 19 Kislev Tu B'Shvat Purim 11 Nissan Pesach Lag Baomer

Shavuot Gimmel Tammuz Tisha B'av Chai Elul

Kosher Week Jewish Festival One Shabbat One World Rosh Hashana Dinner Sukkot Dinner Under the Stars Sushi In the Sukkah/Simchat Beit Hashoeva Cultural Series Torah Dedication Ceremony Family Camping High Holiday Fair/Shofar Factory

Story Hour @ the Neptune Beach Library Chanukah Town Center Chanukah Landing Shofar Factory Model Matzah Bakery The Shabbos Project Reservation A Fuego Mundo Shabbat Shabbat Atlantic Beach Kosher Food Fest Kosher Festival

Book & Art Club Pre Chanukah Winn Dixie Books a Million Torah Dedication CKids Club International Shabbat Dinner A Man's Night Holiday Cultural Festival Cantorial Shabbat RSVP YJP Chanukah Reserve

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ב"ה

Community Friendship Circle

Friendship Circle Child Registration Form

Child's Information:
Child's Name:*

First Name Last Name
Gender:*

Female Male
Birth Date*

Month Day Year

Address:

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

Home phone:

Area Code Phone Number
School:
Grade:
Religion:
How did you hear about The Friendship Circle?*
Parent's Information:
Father's Name*

First Name Last Name
Father's Cell Phone*

Area Code Phone Number
Work Phone*

Area Code Phone Number
E-mail
Occupation:
Mother's Name*

First Name Last Name
Mother's Cell Phone*

Area Code Phone Number
Work Phone*

Area Code Phone Number
E-mail
Occupation:
Marital Status:

Married Divorced
Does your child live with you?

Yes No
Medical Information:
What are your child's special needs?*
Please list any allergies or medical conditions we should be aware of:*
Emergency Contact Name*

First Name Last Name
Relation to Child*
Phone Number*

Area Code Phone Number
Cell Number*

Area Code Phone Number
Consent:*

I give The Friendship Circle permission to contact my child's doctor if emergency medical advice is needed and I can't be reached.
Doctor's Name*

First Name Last Name
Doctor's Phone Number*

Area Code Phone Number
Consent:*

In case of a medical emergency requiring immediate emergency care, I authorize the paramedics to take my child to the nearest hospital if necessary.
Health Insurance Provider:*
Policy Number:*
Additional Information:
What languages does your child speak?*
Which activities does your child enjoy doing most?*
Which activities does your child not like doing?*
Are there any activity restrictions for your child?*
Does your child occasionally exhibit any of the following behaviors?

Biting Grabbing Kicking Cursing Hitting Pulling Hair Other
What is the best method of handling the situation?
Is your child completely toilet trained?*

Yes No
Is your child sensitive to any of the following?*

Light Noise Touch Movement N/A
How does your child best communicate?*

Verbal Non-verbal Sign Other
Please list any therapists that your child is currently seeing:*
Is there anything else we should know about your child? (attention span, outgoing/shy, etc.)
Should be Empty:

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