• Program Questionnaire for Parents

    Your input is important to us! Please fill out the questionnaire below so we know what programs your children would be interested in and how we can better plan for our upcoming year! Everyone who fills out a survey will be entered into a giveaway to win an Amazon Echo Pop!
  • Would you be interested in having your child/children participate in our programs?*
  • What is your child/children age? Please enter the amount of children you have in each age group*
  • Which schedule would work best for your children and family?*
  • Which day of the week would work best for your family? Please select all that apply.*
  • Would your family be interested in an 8-10 week program running from approximately September 22nd-23rd through the first week of December?*
  • Which activities would your children be most interested in? Select all that apply.*

  • Badge Program

  • We are considering creating a badge program where children can earn and collect badges by completing different activities and learning new skills. How interested would your child be in this?*

  • One-on-One Support

  • Does your child/children require one-on-one support or additional assistance to participate successfully in a group program?*
  • Are there any behavioral, emotional, sensory, communication, or social needs that our volunteers/leaders should be aware of?*

  • Future Programs

  • What are programs or activities would you like to see offered for children and youth in our community?

    For example:

    • Sports
    • Art
    • Music
    • STEM
    • Outdoor activities
    • First aid
    • Babysitting skills
    • Financial literacy
    • Leadership
    • Public speaking
    • Gardening
    • Entrepreneurship
    • Community service

  • Parent Volunteering

  • Would you be willing to volunteer and commit to helping with the club?*
  • What type of volunteer role would interest you?*

  • Parent Ideas

  • Contact

  • Would you like us to contact you with more information about the club and registration?*

  • If yes, or if you would like to be entered into the giveaway please enter in your contact information below:


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  • Format: (000) 000-0000.
  • Should be Empty: