BOYS & GIRLS CENTER
Please complete all forms. Applications with missing information will not be accepted. Information gathered from this application will only be used to improve our services, ensure state/federal compliance and funding.
Parent / Guardian Information
Please fill out both sections if child lives with two parents/guardians.
Additional adult authorized to pick up child:
Child's Medical History
Transportation and Release
My child is authorized to be picked up by:
Rate & Payment Agreement
Homework First Program