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members

 

Membership forms, the $5 fee, and an orientation all must be done before a member can attend the Club.

 

If you are unable to pay the $5 membership fee scholarships are available. Please reach out to the unit director for scholarship information.

As of Monday, February 3rd, we are at maximum capacity for our 1s – 4th-grade members  
Elementary) at our Southside (Central) and Northside. If you are interested in joining the waitlist, please complete the membership form and select the waitlist option. We will be reevaluating the status on March 14th. If you have any questions, please contact the unit directors individually at each site.
A partir del lunes 3 de febrero, estamos al máximo de capacidad para nuestros miembros de 1º a 4º grado.  En nuestro sitio del sur (central) y sitio norte. Si está interesado en unirse a la lista de espera, complete el formulario de membresía y seleccione la opción de lista de espera. Reevaluaremos el estado el 14 de marzo. Si tiene alguna pregunta, comuníquese con los directores de unidad individualmente en cada sitio.
Pay Now
Formulario de membresía en español
Epic Member Only Application

Membership Application 24-25

"*" indicates required fields

*Elementary Waitlist Notice*

As of Monday, February 3rd, we are at maximum capacity for our 1s – 4th-grade members Elementary) at our Southside (Central) and Northside. If you are interested in joining the waitlist, please complete the membership form and select the waitlist option. We will be reevaluating the status on March 14th. If you have any questions, please contact the unit directors individually at each site.
Desired Club Location * Required

Child Information

An annual parent orientation is required if you have a child in the 1st-5th grade, or a child in the 1st-7th grade who will be a new member for the first time. The parent or guardian will be contacted to set-up an orientation time & date” and “The $5 membership fee covers one membership year (September 1 – August 31) and must be renewed each year
Child's Name * Required
Address * Required
Please enter a number from 6 to 20.
Select date MM slash DD slash YYYY
Please enter a number from 1 to 12.
The grade they are attending during 2023-2024 school year. If your child is in the 1st grade, you might be asked for verification. *Please note their is a current waitlist for 1-4th graders at our South & North Side Units.
If your child is a teen are they interested in participating in EPIC, the Club's life readiness program?
First Guardian's Name * Required
Second Guardian's Name * Required

Emergency Contacts

Must be filled out
Name * Required
Name * Required

Medical Information

Epi pens, insulin and inhalers are the only medications allowed on Club property. There is a special medical release form that must be filled out and returned to the Club.

Member Status * Required
Race/Ethnic Background * Required
Who Does The Child Live With? * Required
Free or Reduced Lunch * Required
Annual Hosehold Income * Required

Member Pledge Principles

* Required
Type Name
* Required
Type Name

Policy Agreement & Medical Consent To Treatment

I give permission for my son/daughter to receive medical care in case of an emergency. This might include x-ray, anesthetic, medical and surgical treatment. * Required
Does your child have permission to take public transportation home (MAX or InterUrban) * Required
Is your child allowed to walk/bike home (1st—12th grade)? * Required
Does your child or teen have an IEP at school? * Required
Do you give your 8th—12th grader permission to leave the Club unattended? * Required
Does your child have an assigned ParaPro for behavioral issues at school? * Required
I give permission for my son’s/daughter's image to be used in Club social media pages/videos/marketing. * Required

Consent For Club/School Communications

I give the Boys & Girls Club staff permission to communicate and exchange information with the schools regarding my child’s academic (progress and grade reports), social and emotional behavioral development. * Required
Type Name
Select date MM slash DD slash YYYY

Youth Services

At the Boys & Girls Club we have Wellness support staff available to meet the additional behavioral and emotional needs or your child. The sessions can occur one on one or in a small group setting. Please check if your child is allowed to receive these services. * Required
Type Name
Select date MM slash DD slash YYYY

Please Pay Before Submitting (https://secure.givelively.org/donate/boys-girls-club-of-greater-holland/membership)

I understand I will need to pay a membership fee of $5. * Required
I give permission for Club Staff to text/ call me for schedule updates. * Required

If your child is in the 1st-5th grade (even if they have attended the Club before) or a first time member who is 6th-12th grade,the child along with a parent or guardian will be required to attend an orientation before the child or teen can access club programming.

South Side Orientation Options
If you are signing your 1-5th grader up or a first-time club member up for the South Side Club please select which orientation works best for you.
Heights Orientation Options
If you are signing your 1-5th grader up for the Heights extension site please select which orientation works best for you.
This field is for validation purposes and should be left unchanged.

Gateway Preschool

Investment in early childhood school education is an investment in our future workforce and leaders. Our partnership with the Gateway preschool program and Holland’s Ready for School initiative provides opportunities for our Club families to enroll their children in a high-quality preschool experience.

Apply Today
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