C-Hill Club Request
View the club guidelines at http://www.chs.4j.lane.edu/clubs. NOTE: The staff adviser MUST be present for ALL meetings.
Name of Club *
Students Requesting Club
5-student minimum - you can use current members. All club members must possess a student ID card with an ASB sticker and pay any club fees.
1. *
2. *
3. *
4. *
5. *
Total Number of Members
Adviser
*Adviser must be a school staff member or approved adult over the age of 21.*
Non-4J employees MUST complete a district volunteer and criminal background check form.
Adviser Signature *
By typing my name below, I acknowledge that I have read the club formation guidelines (http://www.chs.lane.edu/students/student-resources/clubs/) and agree to serve in the capacity of club adviser for this club.
Adviser Phone *
Clear selection
Adviser Email Address *
Club President/Captain
President Name *
President Phone *
President Email *
Club Details
Purpose of the Club *
Membership Requirements *
Meeting Time and Location *
Example: Mondays at lunch in J12
Club Sports Insurance *
A certificate of insurance must be submitted to the office before a club sport can be approved.
Will you be fundraising?
Fundraisers held at the school must be pre-approved by the Operations Committee.
Clear selection
Funding Amount Requested from ASB
Optional
Submit for Approval
Check with the Administrator in charge of clubs (Misael Flores) in one week for approval.
Submit
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