2025-2026 CLUB ED Registration  Logo
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  • English (US)
  • Spanish (Latin America)
  • CLUB ED REGISTRATION FORM

    CLUB ED REGISTRATION FORM

    for School Year Sept 2025- June 2026
  • PAYMENTS

    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. Once this application has been submitted you will be contacted to submit payment information. Failure to pay the fees below will delay your child's start date.
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  • PARENT/LEGAL GUARDIAN INFORMATION

  • Primary Parent/Guardian #1 (Enrolling Child)

    • Will receive all Club Ed emails (including billing)
    • Sign up for Remind System alerts
    • Will be the first person contaced in an Emergency
    • Incident Notify
    • Can Pick Up 
  • Primary Parent/Guardian #2 

    • Will be the second person contaced in an Emergency 
    • Incident Notify
    • Can Pick Up 
    • Must opt in to receive emails or remind invite 
  • ADDITIONAL EMERGENCY CONTACTS/CARE

  • My child may be released to the following people in case of an emergency or following emergency medical care. Below are two authorized individuals who may be called during program hours if both Primary contacts are not available. Please indicate below if they have permission to pick up.

  • ADDITIONAL DESIGNATED PICK UPS

    (not listed above)
  • **Children below 5th grade are NOT ALLOWED to walk home alone.**

  • DO NOT RELEASE STUDENT TO       .

  • DO NOT RELEASE STUDENT TO       .

  • DO NOT RELEASE STUDENT TO       .

  • MEDICAL/ HEALTH INFORMATION

  • Children requiring an EPIPEN must provide Club Ed with 2 EPIPENS AND AN EMERGENCY ACTION PLAN prior to the child's 1st day of participation. It must be in its original box and there must be TWO EPIPENS.

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  • As parent/guardian of the above child, / certify that he/she is in good physical health and may participate in the normal activities of the program and has no conditions or specific needs that require specific accommodations, unless otherwise indicated in the medical information provided above or an attached Care Plan for Children. 

  • If my child requires emergency medical care, I give my consent to Club Ed Afterschool Program to obtain the necessary medical care for my child. I agree to pay all the costs associated with the emergency medical care that my child receives. I understand that every effort will be made to contact me before and after medical care is provided.

  • MEDIA CONSENT/ TERMS AND CONDITIONS

  • POLICIES AND PROCEDURE ACKNOWLEDGEMENT

    I give my child permission to participate in Club Ed Afterschool Program for the 2025-2026 school year. I understand that this consent will be effective as of the date of my signature and will remain in effect as long as my child is enrolled in the afterschool program.

    By signing below, I confirm that I have received, understood, and agree to comply with all policies and procedures regarding my child's enrollment in the 2025-2026 Club Ed Afterschool Program.

    1. General Program Information

    2. Department of Children and Families, OOL

    3. Release of Children

    4. Student Behavior Guidelines

    5. Discipline Guidelines

    6. Expulsion

    7. Management of Communicable Diseases

    8. Injury & Medical Emergency Notification

    9. Waiver of Liability & Assumption of the Risks

    10. Medication Administration

    11. Photo/Video Disclosure

    12. Social Media/ Technology

    13. Screen/TV/Video Guidelines

    14. Methods of Parental Communication/Notification

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