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Attached is our Registration Package. Please print the registration and release waiver (if required) and bring it with you on registration night. Registration costs are $125 per child. (Fees can be waived for those families that qualify for Jumpstart or Kidsport NL. Applications can be picked up at the Club). Payment is required at the time of registration. Our afterschool program runs from 3pm to 5pm on the specified dates. If the school is closed due to adverse weather, the club will be closed as well.
Please note the following items:
St.Anthony & Area Boys & Girls Club
(709) 454-2582(CLUB) www.stanthonybgclubcyn.com
Date Of Birth:___________________
P.O. Box: _______________________
MCP #: __________________________
Cell Phone #:__________________________
Health History: Medical, (i.e. Asthma, epilepsy, etc.) Please specify)________________________________________________________
Allergies: (i.e. Peanuts, milk, etc.) Please specify: ___________________________________________________________________
Behavioural: (i.e. ADD, ADHD, etc.) Please specify:___________________________________________________________
Does your child take any medication for the conditions outlined above? Yes / No
If Yes, Please state the name of the drug and the frequency of use:______________________________________________________________
Would he/she be required to take the drug while at the Club? Yes / No
Please note that staff are not permitted to administer medication.
Does your child have a special need/require one-on-one care?
Parent / Guardian Information
Home Ph. Number:
Business/Cell Ph. Number:
Are you a single parent? Yes / No IF Yes, with whom does the child reside?
Alternative Contact (Other than Parent)
Relationship to the Child:______________________________________
People with permission to sign child out/pick child up:_____________________________________________________________