COVID-19 Qualifying Questionairre for our After-School Program

Dear Parent/Guardian,

Due to COVID-19, your Boys & Girls Club will be opening a modified non-traditional Club program. Because we will open in a limited capacity in order to maintain safe social distancing and keep members 6ft apart, we are only able to register a maximum of 90 children in all (40 Distance Learning and 50 after-school program). Because of this, we will have limited space designated for grade levels and/or schools. Members must qualify to participate and will be accepted on a first come/first serve basis.

Qualifications include:

1st day of after-school program is August 17th.
Members must be in 1st grade through 5th grade
We will serve Distance Learning students from all schools
Members served in our after-school program will be limited to Smryna Primary, David Youree, and Thurman Francis
Members must be able to comply with social distancing, following directions, behave positively and safely, and does not require physical assistance or intervention
Members must attend school on the day they participate at the Club and arrive via Club escort (parent drop-offs will not be accepted)
Members will have their temperature checked before entering
Departure from the Club will be "curb side" (parents must pull through pick-up line and remain in the vehicle)
Hours of operation are 2:30pm-6:00pm, Monday-Friday and 7:00am-6:00pm on non-school days
$40 registration fee per child and $40/week per child (includes afternoon snack and dinner)
- Registration fee due at time of registering and weekly fee due two (2) weeks in advance
- All payments must be made electronically
- Weekly fees must be paid, regardless of attendance, in order to hold a spot for your child
- Two (2) weeks "vacation" allowed without payment if arranged in advance
- If a members does not attend for two (2) consecutive weeks, or payments become two (2) weeks late, the child will be placed on our waiting list and will not be able to attend until a spot opens up again
- Two (2) weeks notice and payment required for members exiting the program
- Non-school days (such as holidays and teacher in-service days) will be an additional $15 per day per child
- School breaks (such as Fall, Winter, and Spring Breaks) will be $85/week per child
Be able to pick your child up (or have someone designated to) within 30 minutes in the event of illness or behavioral challenges
For previous members, files may be reviewed as part of qualification
Accounts with previous balances must be paid to date, or have an active payment plan in place

Registration information will be emailed to members who qualify for our modified non-traditional program

Those who qualify will receive an email with registration information.

Our modified non-traditional after-school program is subject to change in the event of increased illness in our community.

*Each participating member is able to bring their own supplies, but may not share them with other Club members..

COVID-19 Qualifying Questionairre for our After-School Program - Smyrna Club

Was your child a member during the 2020 summer program or 2019-2020 after-school program?
Required answer

Please select the grade levels of your children. You may select all that apply.
Required answer

How many children do you intend to register?
Required answer

What are your children's name(s)?
Required answer

What school will your child be attending?
Required answer

Are you an Essential Worker? Please select from below.
Required answer

The $40 registration fee per child is due at the time of online registration.
Required answer

Is your child in one of the following programs? Verification is required.
Required answer

Our weekly fee of $40 per child will be required at least two (2) weeks in advance by NOON in order to maintain your child's spot (up to 2 weeks "vacation" is allowed without fees charges).
Required answer

If a child misses more than two consecutive weeks, or falls two weeks behind in payment, they may be placed on the waiting list and will not be able to attend until a spot opens back up.
Required answer

We require two (2) weeks notice, with payment, should a child exit our program.
Required answer

Additional criteria necessary to participate in our modified non-traditional after-school program includes all mentioned below. Please read and select each to verify understanding of requirements and expectations, and that your child can comply.
Required answer

What is your name? (Must be a custodial parent or legal guardian.)
Required answer

What is the best phone number to contact you?
Required answer

What is your email address? There will only be email communication should your family qualify for the after-school program.
Required answer

In the event that capacity is maximized would you like your child(ren) to be placed on a waiting list?
Required answer

Please provide any information you'd like to share with us (not required).

Was your child a member during the 2020 summer program or 2019-2020 after-school program? Required answer

Please select the grade levels of your children. You may select all that apply. Required answer

How many children do you intend to register? Required answer

What are your children's name(s)? Required answer

What school will your child be attending? Required answer

Are you an Essential Worker? Please select from below. Required answer

The $40 registration fee per child is due at the time of online registration. Required answer

Is your child in one of the following programs? Verification is required. Required answer

Our weekly fee of $40 per child will be required at least two (2) weeks in advance by NOON in order to maintain your child's spot (up to 2 weeks "vacation" is allowed without fees charges). Required answer

If a child misses more than two consecutive weeks, or falls two weeks behind in payment, they may be placed on the waiting list and will not be able to attend until a spot opens back up. Required answer

We require two (2) weeks notice, with payment, should a child exit our program. Required answer

Additional criteria necessary to participate in our modified non-traditional after-school program includes all mentioned below. Please read and select each to verify understanding of requirements and expectations, and that your child can comply. Required answer

What is your name? (Must be a custodial parent or legal guardian.) Required answer

What is the best phone number to contact you? Required answer

What is your email address? There will only be email communication should your family qualify for the after-school program. Required answer

In the event that capacity is maximized would you like your child(ren) to be placed on a waiting list? Required answer