BGC Jackson - Parent Interest Form (East Unit)
Thank you for your interest in the Boys & Girls Club of Jackson! We enroll youth ages 5-18 years old. Please complete and submit the form below. (*Must have COMPLETED kindergarten)
Parent/Guardian's Name
*
First Name
Last Name
Child's Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Child's Age
*
Child's School Grade
*
Completed Kindergarten
*
Yes
No
School's Name
*
Additional Information/Questions:
Apply here
Should be Empty: