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After-School Application 2021-2022
Please fill out the form below to register your student for the afterschool program.  Slots are limited this year as we are still following the CDC COVID-19 guidelines.  You will be notified of your students acceptance into the afterschool program by the JBGC Team.  Please call the front desk if you have any questions or concerns!
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Student Full Name *
Student Gender *
Student Ethnicity *
Student DOB *
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Student SSN *
Student Age *
Student School (We understand the schools are changing, please select the school that you assume that your student will be assigned) *
Student Grade *
Has your student previously attended the Boys & Girls club of Jacksonville? *
Will your student need transportation from their school to the Boys & Girls Club? *
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