Club Impact: Registration

Both ParentsFatherMotherGuardian
Part-time/Drop-in: $6.00 per hour, per childAM &/or PM- $70 a weekNone of these

It is the parent’s/guardian’s sole responsibility to provide all necessary information on this form. It is also the sponsor’s responsibility to assign, delete, and maintain only those names which are listed on this form. Any changes made on this form can only be made by the sponsor. Any changes must be submitted in writing to the program director.

Please note that your child will only be released to those people listed on your authorization list. Please BE PREPARED to present a valid picture ID at time of pick-up.