Enroll Now

Thank for your interest in enrollment at the Boys & Girls Clubs of the Sioux Empire! We're excited to get to know your family. Upon completion of the enrollment form, you can expect to hear from one of our Family Engagement Coordinators who will gather any additional information necessary.

Welcome to the Club!

General Information
Child Information
Parent 1 Information
Parent/Guardian 2 Information
Emergency Contacts
Medical Information
Permissions & Release Agreements

General Information

Start Date

Child First Name

Child Last Name

Age

Date of Birth

Gender MaleFemaleOther

Preferred Email

Address

City

Zip Code