Boys & Girls Club of Alachua County - Member Application
2019-2020 Application for Club Membership. Please fill out the form completely.
Member/Child Information
First Name *
Last Name *
Address *
City *
Zip Code *
Phone number *
Email *
Age *
Date of Birth *
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DD
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Gender *
Race: *
Did your child attend Boys & Girls Club of Alachua County during the Summer Camp 2019? *
Did your child attend Boys & Girls Club of Alachua County during last years school year 2018-2019? *
School attending - Fall 2019 *
Grade entering - Fall 2019 *
Is your child enrolled in a Special Education Program at school? *
Does your child receive free and reduced lunch at school? *
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