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Boys & Girls Club Program Participation Fee Payment Page

Participation Fees are paid for each student age seven (7) and above, in addition to the Membership Fees. The Participation Fees are based upon the student's eligibility for the free or reduced lunch programs in the school. If you are unsure about eligibility, please contact the Unit or Branch Director. Thank you.

Name of Child(ren) (include first, middle, and last):
* Child 1:
Child 2:
Child 3:
Child 4:
Child 5:

Parent/Guardian completing this form:
* First Name:
* Middle Name:
* Last Name:
* Phone Number:
* Email Address:
A confirmation of this payment will be sent to this email address
* Please select the site your child(ren) attend:
* Total Amount:
Please include decimal points in your payment amount.
(i.e. 1000.00 and 50.50)
* Card Type:
* Credit Card Number:
* Expiration Date:
* Security 3-digit code/CVV2:
   (new image)
* Required Field
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