2024 5-Day Club Student Sign-Up

If you would like to enroll in (or request) a 5-Day Club for your child, please fill out and submit this form.

Child's Name

*

Grade

*

Birthdate

*

Parents'/Guardians' Names

*

Is at least one parent/guardian in the military?

*

Please select one option.

Yes No

Parent/Guardian Phone

*

Parent/Guardian Email

*

This address will receive a confirmation email

Address

*

Child's School

*

Church (if any)

*

Comments (allergies, walking, needs picked up, etc.)

*

Preferred Week(s) of Club

*

Please select all that apply.

No Preference June 17-21, 2024 July 1-5, 2024 July 8-12, 2024 July 15-19, 2024 July 22-26, 2024 July 29-August 2, 2024 August 5-9, 2024 August 12-16, 2024

Preferred Time(s) of Day (club time is only 1.5 hours)

*

Please select all that apply.

No Preference Morning (8am - Noon) Afternoon (Noon - 4pm) Evening (4pm - 9pm)

Preferred Location (specify neighborhood, landmark, etc.)

*

Description

If you would like to enroll in (or request) a 5-Day Club for your child, please fill out and submit this form.

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