Program Registration Form
This form should only be used for those registering for PGCR Programs.
Name of Participant *
Your answer
Mailing Address *
Your answer
Participant phone number or email *
Your answer
Please review the online catalog for program descriptions and dates, then select the Program(s) *
Payment is expected prior to the start of any program . Please indicate how payment will be made: *
PGCR Policy Information (please read)
PGCR Policy Information
Deciding what to sign up for
In order to facilitate participant enjoyment, safety, and personal growth, we provide information on staffing rations, skills required and interests essential for most of our programs. Contact us for more information. If considering a program for the first time, you are strongly encouraged to make arrangements to visit a program one time before registering. PGCR reserves the right to determine any individual’s program participation.

Drop Off and Pick Up Policy
Please accompany your member into the program site and make sure there is staff on site. Participants must be signed in and out of a each program. Please be respectful and abide by published start and end times.

PGCR Program Cancellation
If a session is cancelled due to inclement weather or instructor/therapist illness, it is considered an “act of nature” and there will be no fee refunds.

PGCR “Prorating Fees” Policy
There is no prorating of fees for sessions you select to miss or miss due to occasional illness. In the event of prolonged absences, PGCR will consider prorating on a case by case basis.

PGCR Inclement Weather Policy
If Prince George’s County Public Schools are closed for the day or evening there will be no PGCR programs that day/evening. If it is a weekend program and you are not sure, please call 301-442-3708 or email

PGCR provides supervision, according to the level appropriate to each program, only during the published program times.

ALL Program participants must complete and submit the registration form prior to attending ANY program. PGCR must have COMPLETE and CURRENT emergency contact information for each participant.

PGCR assumes the right to the use of any print or film image for publicity purposes. I understand my image will not be sold.

PGCR Late Fee
PGCR will charge a late pick-up fee of $10.00 for every 15 (fifteen) minutes, or part thereof, that a PGCR participant is picked up after the published end of the program. There will be grace period of twenty minutes, after the program has ended, for those traveling by Metro Access. The fee must be mailed to the office before the member can continue to participate in PGCR programs. Drivers picking up multiple participants are responsible for ALL fees for each member.

Information Change
It is the responsibility of the participants or their caregivers to promptly inform PGCR of any changes in contact and/or emergency information. Information changes should be made by resubmitting a completed and updated registration form.

I have read PGCR's Program Policy and will comply to the policy as stated above.
Emergency Contact and phone number during the program *
Your answer
List any needed accommodations that will help the participant to have the best experience with the chosen program (include any allergies).
Your answer
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