• Club Ed 2021-2022 Application

  • If you prefer to manually fill out this application and email it to Club Ed, please download the application here.

  • Student Information

  •  -  - Pick a Date
  • Primary Parent/Guardian Information

  • Secondary Parent/Guardian Information

  • Registration Payment

    A non refundable registration fee ($50 per child), first month's tuition, and last month's deposit are all due at the time of registration. By entering your account information below, your account will NOT be charged when you click "Submit". Payment will be processed after your information is entered into our system. This may take a few days.
  • Click your School District for Payment Information

    Fort Lee      Edgewater      North Bergen      Fairview      Palisade Park

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  • Please place 4 digits of your credit/debit card in each box.

    For American Express Cards, please disregard the 4th box.

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  • By choosing YES, you authorize JFCS to charge your credit card or checking account monthly.

    By choosing NO, you will have monthly invoices emailed to you for online payment.

  • Emergency Contacts

    My child may be released to the following people in case of an emergency or following emergency medical care. The following authorized individuals may be called during program hours if I am not available.

  • 1.

  • 2.

  • Child Release of Child

    Please list any additional authorized individuals who may pick up your child from Club Ed. You can add or remove inidividuals at any time by emailing clubed@jfcsnnj.org. 

  • 1.

  • 2.

  • 3.

  • Do NOT release my child to the following people:

  • 1.

  • 2.

  • Medical/Health Information

  • Children requiring an EpiPen must provide Club Ed with 2 EpiPens in their original box with the pharmacy label and an emergency action plan from their doctor prior to their first day. If the action plan states the use of Benadryl, you must also provide Club Ed with Benadryl and a dosing cup.

  • Policies and Procedures Acknowledgement

  • Click here to view the Club Ed Parents/Guardians Manual

    Please keep a copy of this manual for your records as it contains all policies and procedures for the Club Ed Afterschool Program.

  • By signing below, I agree I have received and understand the following information which is stated in the Club Ed Parents/Guardians Manual:

    1. General Program Information
    2. Department of Children and Families, OOL, Information to Parents Acknowledgement
    3. Release of Children
    4. Student Behavior Guidelines
    5. Discipline Guidelines
    6. Expulsion Guidelines
    7. Management of Communicable Diseases
    8. Phot/Video/Interview Disclosure
    9. Screen.TV/Video Guidelines
    10. Social Media/Technology
    11. Methods used to communicate to parentss
    12. Medication Administration
    13. Waiver of Liability Related to Coonavirus/COVID-19 Assumption of the Risks
    14. Tuition and Fees
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