2024-2025 Break Interest

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Are you interested in full-day enrichment for your child(ren) during the Thanksgiving, Winter, Spring, or Summer breaks? We have you covered!

Completing this form is only expressing interest and does not officially sign you up for the program.

You will be contacted by a Boys & Girls Clubs of Long Beach staff to complete your registration.

Parent Full Name *

Which breaks are you interested in? *

Thanksgiving (November 25-November 27)

Winter (December 23-January 3 - not December 24, 25, 31 or January 1)

Spring (April 14-April 18)

Summer (June 16 - August 15)

Required

Best Contact Phone Number *

Best Contact Email *

Number of Children Attending *

My Child(ren) are already members at Boys & Girls Clubs of Long Beach *

Yes

I don't know

Required

Full name of Child(ren) *

Which Club do you child(ren) attend? *

I am in need of scholarship information *

Yes

Required

Submit

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