Club Program Registration

Thank you for choosing to complete your Club registration online. At the conclusion of this form, you and your child will be asked to type your name authorizing the processing of this registration and signifying that you agree to the following statements. Please read each policy below:

Open door Policy, Club Policy: I (We) hereby give my (our) permission for my (our) student to become a member of the Boys & Girls Club of Van Buren. I understand that the Boys & Girls Club of Van Buren will make every effort to keep my child from leaving the Club building without permission; however, I also understand that the Club is not a daycare center and is not responsible for the time or manner in which my child may arrive or leave the Club.

Medical Treatment: I permit and authorize the Boys & Girls Club of Van Buren staff member at 1403 City Park Rad, Van Buren, AR to allow necessary examination, anesthetic medical diagnosis, surgery supervision or treatment, and/or hospital care to be rendered to the named minor under the general or special supervision and on the advice of any physician or surgeon licensed to practice medicine. I understand that the care for injuries that may occur during my child's active participation in Boys & Girls Club of Van Buren are the responsibility of me, my family, and/or my insurance. I understand that the Boys & Girls Club of Van Buren does not supply insurance for my child. 

MEMBERSHIP FEES ARE NON-REFUNDABLE