DISCOVERY CLUB - Schedule Request Form Summer 2021

Boys & Girls Clubs of MetroWest

169 Pleasant Street, Marlborough, MA 01752 Fax: 508-229-7818 Phone: 508-485-4912
DISCOVERY CLUB - SUMMER 2021 SCHEDULE REQUEST FORM

*This form is for active members only*
PLEASE READ: IF YOUR CHILD HAS A VOUCHER, PLEASE COPY AND PASTE THIS LINK AND FILL OUT THAT FORM

https://form.jotform.com/210775935886169
Child's Information
Name *
Date of Birth *

Month Day Year
Date
Grade in Fall *
Parent Guardian Information
Name *
Home Phone # *
Cell Phone # *
E Mail *
example@example.com
Select weeks and days you are registering for:

If you would like every day during the week please select the ALL WEEK option
Week #1-Party in the USA

MON 6/28 ($67) TUES 6/29 ($67) WED 6/30 ($67) THUR 7/1 ($67) FRI 7/2 ($67)
ALL WEEK ($310)
Total Balance Week #1
Week #2-All About Nature (Monday 7/5 CLOSED)

TUES 7/6 ($67) WED 7/7 ($67) THUR 7/8 ($67) FRI 7/9 ($67)
Total Balance Week #2
Week #3-Animal Adventures

MON 7/12 ($67) TUES 7/13 ($67) WED 7/14 ($67) THUR 7/15 ($67) FRI 7/16 ($67)
ALL WEEK ($310)
Total Balance Week #3
Week #4-Space Galaxy

MON 7/19 ($67) TUES 7/20 ($67) WED 7/21 ($67) THUR 7/22 ($67) FRI 7/23 ($67)
ALL WEEK ($310)
Total Balance Week #4
Week #5-Superhero's

MON 7/26 ($67) TUES 7/27 ($67) WED 7/28 ($67) THUR 7/29 ($67) FRI 7/30 ($67)
ALL WEEK ($310)
Total Balance Week #5
Week #6-Fiesta of Colors

MON 8/2 ($67) TUES 8/3 ($67) WED 8/4 ($67) THUR 8/5 ($67) FRI 8/6 ($67)
ALL WEEK ($310)
Total Balance Week #6
Week #7-It's a Bug's Life

MON 8/9 ($67) TUES 8/10 ($67) WED 8/11 ($67) THUR 8/12 ($67) FRI 8/13 ($67)
ALL WEEK ($310)
Total Balance Week #7
Week #8-Working It Out

MON 8/16 ($67) TUES 8/17 ($67) WED 8/18 ($67) THUR 8/19 ($67) FRI 8/20 ($67)
ALL WEEK ($310)
Total Balance Week #8
Summer Deposit & Payment Agreement

I understand the following:
- Deposits are due at time of registration. Deposits are non-refundable.
- I understand the weekly balance is due 2 weeks prior to the week your child is attending. For example, the remaining balance for Week # 1 is due on June 14, 2021.
- If payment is NOT received on time, your child will be removed from the program and replaced by a child on the waitlist.
- Registration changes must be done in writing via email or letter. We require 2 weeks written notice.
- Without 2 weeks written notice, you will be responsible for the full week's camp payment.
- There will be no refunds, credits or pro-rating for missed days.
Parent/Guardian Signature *

Clear
Date (Valid for Current School Year) *

Month Day Year
Date
TOTAL ALL DAYS & WEEKS $
Total Deposit Due TODAY $ (Total Balance X 20%)

Total Deposit Due Today *

USD Description

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

www.bgcmetrowest.org discovery@bgcmetrowest.org
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Boys & Girls Clubs of MetroWest

DISCOVERY CLUB - SUMMER 2021 SCHEDULE REQUEST FORM

PLEASE READ: IF YOUR CHILD HAS A VOUCHER, PLEASE COPY AND PASTE THIS LINK AND FILL OUT THAT FORM

Child's Information

Parent Guardian Information

www.bgcmetrowest.org discovery@bgcmetrowest.org