2020 Membership Form

MEMBER INFORMATION

PARENT/GUARDIAN INFORMATION

Parent/Guardian #1 Information

Parent/Guardian #2 Information

EMERGENCY CONTACTS

Please provide two emergency contacts OTHER THAN the parents/guardians listed above.

MEDICAL INFORMATION

Does your child have any special need in the following areas? If yes, please explain further and indicated medications they are taking and diagnoses when applicable.

CUSTODY AND/OR COURT ORDER

If a custody or court order exists, a copy of the order must be given to the Battlefords Boys & Girls Club. The parent/guardian is responsible for providing accurate and up to date information concerning the legal guardianship of the child. Without a custody or court order on files, the Battlefords Boys & Girls Club cannot deny access to the non-enrolling parent. If the non-enrolling parent is not listed as authorized pick-up list, but is able to produce government issued photo ID proving that they are the birth parent of the child, the Battlefords Boys & Girls Club cannot legally deny access without legal documentation (custody or court order) stating otherwise.

MEDIA CONSENT & RELEASE

MEMBERSHIP CONTRACT

Parents/Guardians: Please review these guidelines/rules with your child.

If you want to become a member of Boys & Girls Clubs of The Battlefords (BGCB) and enjoy the privileges a member has you have to respect the staff, volunteers, and the other members. YOU MUST UNDERSTAND THAT BGCB IS A SAFE PLACE FOR ALL MEMBERS, AND IF YOU ACT IN A WAY THAT MAKES SOMEONE FEEL UNSAFE, YOU WILL BE ASKED TO LEAVE. You will follow the rules set by the staff. You also understand that if you do not abide by these rules, you may lose your privileges as a result and may not be able to return to BGCB in the future.

Parents/Guardians please read and agree to, by initialing beside, the following statements:

This membership is valid from January 1st, 2020 to December 31st, 2020. Membership is free for Summer Drop-in Programs for 2020.