MYO ENROLLMENT FORM
Mission: Youth Outreach memberships are an opportunity for children & dependents of active duty, guard, and reserve youth to get free access to Boys & Girls Club facilities & programs.  You will be contacted by a BGC staff after completing the registration form to help get set up with the membership and give you more information about specific programs.  All information collected is for verification purposes only. If you have any questions, please email megan@bgcstoneham.org

MYO Membership currently includes the following:
Daily Drop-In programs at Teen Centers (Ages 10+)
One week of summer camp (Ages 5+)
Summer Pool Membership (Family Membership)
All other benefits of Club Membership like special open gym times, travel sports, teams, and special events.
If you are interested in a program, but do not see it listed, please let us know and we will try to accomodate.

Benefits may be added or removed periodically, please check in at myo@bgcstoneham.org if you have any questions or for the latest information.
Sign in to Google to save your progress. Learn more
Is this a New Club Membership or Membership Renewal?  *
Required
Military Sponsor Name *
Branch *
Status *
Duty Station of Service Member *
Military Rank of Service Member *
Do you agree to show your sponsor ID card to verify your membership? Please bring your ID card the first day you visit the pool or club location.  *
Youth/Teen Complete Name (First & Last) *
Relationship of Sponsor to Youth 1 *
Youth/Teen #2 Complete Name (First & Last)
Relationship of Sponsor to Youth #2
Clear selection
Youth/Teen (#3) Complete Name (First & Last) *
Relationship of Sponsor to Youth #3 *
Parent Guardian Contact Name                                            *can be different from military sponsor *
Parent Guardian Contact Phone Number *
Contact Email *
Is this youth registered at any Youth Center on the nearest Base/Installation?
Clear selection
Distance from home to the nearest Military Youth Center (in miles)
15 Mile Reason (For Air Force Only)

Please list the reason the youth cannot attend or does not want to attend the installation youth center if they are less than 15 miles away from that youth center. If the reason is not listed in the drop down menu, please select other.

 *
Mailing Address *
How did you hear about the MYO membership?
All the answers provided are true and accurate to the best of my knowledge *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Boys & Girls Club of Stoneham. Report Abuse
Google Forms