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Student Information
Annual Membership form for Mahomet Area Youth Club.  This form is required for all participants attending programs in any calendar year.
This does NOT = program registration.  Each program (spring break, winter break, summer camp & Jr. High afterschool program) each have registration forms required for participation.

*Please be advised and understand that Mahomet Area Youth Club's facility and programming are not licensed or regulated by DCFS*
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Email *
Today's Date *
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DD
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Student First Name *
Student Last Name *
Has student ever been enrolled at MAYC before? *
Student Street Address *
Student City *
Student Birthday *
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DD
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Current Grade in School *
Student Race *
Student Gender *
Student Cell Phone #
Does your child have a disability or IEP? *
If your student has a disability or IEP, do you give MAYC permission to communicate with MS-CUSD about this?
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