The Social Circuit

Program Information & Demographics

Welcome to The Social Circuit: An after-school social club for youth with autism, ages 6-14.

The Social Circuit is a supportive, hands-on social skills program designed for youth with autism who want to build friendships, practice communication, and develop confidence in a structured and engaging environment. Participants meet weekly to engage in group activities that involve teamwork, problem-solving, creativity, and basic technology or entrepreneurship projects.

Whether it's building a simple robot, designing a small business idea, or coding a basic game together, each activity is designed to strengthen real-world skills like turn-taking, collaboration, self-advocacy, and leadership. The Social Circuit celebrates each child's unique strengths while helping them feel more connected, capable, and included.
Confidentiality Notice
The information collected on this form is confidential and will only be used for program-related purposes. It will be stored securely and shared only with staff members directly involved in supporting your child's participation in The Social Circuit. We are committed to respecting your family's privacy and maintaining the confidentiality of all personal and medical information.

















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In the event of an illness, behavioral incident, or injury that impacts your child's ability to safely participate, we will first attempt to reach the listed parent/guardian. If we are unable to reach you within a reasonable timeframe, we will contact the listed emergency contact.

In the event of an illness, behavioral incident, or injury that impacts your child's ability to safely participate, we will first attempt to reach the listed parent/guardian. If we are unable to reach you within a reasonable timeframe, we will contact the listed emergency contact.

List the name and phone numbers of anyone who is authorized to pick up the participant. The participant will only be released to individuals named here. If you need to change, add, or remove any of the information on this form, contact Alex Martin alex.martin@esarc.org

Program Disclaimers & Waiver of Liability

Waiver of Liability

The Social Circuit is a group-based social skills program and does not provide 1:1 support, personal care assistance, or medical supervision. Staff are not responsible for feeding, toileting, changing, or administering medications. Parents or guardians may send a snack from home if needed, but The Social Circuit / Easterseals Northeast Indiana does not provide food or dietary accommodations. No food or drinks are permitted in the activity room. All participants must wear closed-toe shoes to ensure safety during hands-on activities.

Late Pick-Up Policy:
The Social Circuit ends promptly at the scheduled time. It is the responsibility of the parent/guardian to ensure timely pick-up. If a participant has not been picked up within 15 minutes of program end time and we are unable to reach a parent/guardian, emergency contact, or authorized pick-up contact, staff may contact local authorities (such as the Fort Wayne Police Department) for assistance. Repeated late pick-ups may result in dismissal from the program.

Assumption of Risk:
Participation in The Social Circuit at Easterseals Northeast Indiana may involve hands-on activities, collaborative projects, and the use of equipment and materials. While every effort is made to create a safe and supportive environment, including the use of age-appropriate materials and supervision, there are inherent risks in any group-based program. The facilitator is trained in the proper use of all program equipment and follows safety procedures to reduce the likelihood of accidents or injuries. By signing below, I acknowledge and accept these risks and agree to support my child's participation under these conditions.

Behavior Expectations:
This program is not equipped to provide intensive behavioral support or one-on-one supervision. If a participant's behavior creates an ongoing safety concern or significantly disrupts group activities, we may request a parent meeting, develop a support plan, or discontinue participation. 

Medical Emergency Protocol:
In the event of a medical emergency, staff will contact emergency services if necessary and will make all reasonable efforts to reach a parent, guardian, or emergency contact before taking further action.

Personal Belongings:
The Social Circuit and Easterseals Northeast Indiana are not responsible for lost, stolen, or damaged items. Please avoid bringing valuables or unnecessary items to the program.

Program Changes:
The Social Circuit and Easterseals Northeast Indiana reserve the right to adjust scheduling, activities, group size, or delivery method based on staffing, health, safety, or other concerns.

Photo & Media Release:
I give permission for my child to be photographed or recorded during program activities for documentation and promotional use unless I opt out in writing.




Contact Information