2024 Summer Program Membership Application
ATTENTION!
Registration is now closed for our Edgewood Site as we are at capacity at that location. Registration will remain open for Moriarty until we reach capacity at that site as well.
The Boys & Girls Club of Santa Fe/Las Vegas has an obligation to the community to provide a safe environment for our children and to stand by our motto by being "A Positive Place for Kids".
I acknowledge an awareness of the late pick-up policy and understand $5.00 will be charged for the first five (5) minutes after the pick-up time of 6:00 pm and $1.00 charged every minute thereafter. For the second late pick-up, the same fees apply and you must attend counseling with BGCSF/DN staff. If a third late pick-up occurs, the same fees apply and CYFD will be notified. If you are going to be late, you must speak to the Site Director to avoid late fees.
It is mandatory that every member has a fully completed application. Be sure to fill out every applicable section of the membership application.
THE FOLLOWING MEDICAL/EMERGENCY INFORMATION IS REQUIRED:
MEMBERSHIP:
I have read the completed application and the Boys & Girls Clubs of Santa Fe/Las Vegas (BGCSF/LV) Member Handbook and understand the rules of the Club and request that my child/ren be admitted into membership. I have explained the rules to my child/ren and we agree that all rules of the Club will be followed.
SUPERVISION POLICY: I understand that once my child/ren is signed out of the program/premises, they are no longer under the supervision of the BGCSF/LV staff.
MEDIA CONSENT: I hereby give permission to BGCSF/LV to utilize photos or videos of my child in Club publicity. I consent to such uses and hereby waive all rights of compensation.
TECHNOLOGY: I understand that all BGCSF/LV members are expected to follow all rules and regulations for using the Internet and technology center, including mobile devices like e-readers and tablets, for any activity that involves technology. Rules and guidelines are posted at each site and in the Club computer lab. Failure to abide by the rules and guidelines may result in temporary or permanent loss of access to any technology at the Club.
ASSURANCE OF CONFIDENTIALITY: The information collected about your child will be kept private and locked in a secure area.
FEES: All Registration Fees are Non-Refundable.
* 4 Contacts/Pick-up persons required for valid application per guidelines
#1 Main Emergency/Pick-Up Person:
#2 Main Emergency/Pick-Up Person:
Additional person who may pick up child:
PLEASE COMPLETE THE FOLLOWING IF APPLICABLE. YOU WILL BE REQUIRED TO
PROVIDE A COPY OF OFFICIAL COURT-ISSUED PAPERWORK.
Person/s NOT AUTHORIZED to pick up child:
Please click one of the PayPal options to complete payment and submit the form.