Richman Pre-Teen/Teen Center School Year 2021-22
Please complete this form to register your child for the 2021-22 School Year.

THIS FORM IS FOR 6TH THROUGH 12TH GRADERS. PLEASE COMPLETE A SEPARATE FORM IF YOU HAVE A CHILD ATTENDING OUR MAIN BRANCH.

- Transportation is available for drop off and pick up to/from school. PLEASE NOTE: We will only be servicing schools in the Fullerton School District.

- We are open Monday-Friday with the following hours:
- Morning Transportation: 6:30am-8:30am at our Main Branch  
- After school pick up or parent drop off 2pm-6pm, Wednesdays 1-6pm.

Cost:
$25 School Year 2021-22 Registration Fee
Before School $30/week at Main Branch
After School 6th-8th Grade: $70/week 1st child   $60/week 2nd child
After School Teens: FREE
$35/week Walk-Ins 6th-12th Grade (No transportation)

PLEASE NOTE: All payments must be submitted by Friday at 1pm in order to attend the following week. We are currently not accepting new members the week of completing their registration. ALL MEMBERS WILL BEGIN AS EARLY AS THE FOLLOWING MONDAY AFTER ENROLLING AT THE BOYS AND GIRLS CLUBS OF FULLERTON.
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Email *
When would you like your child(ren) to start at the Boys & Girls Clubs of Fullerton? *
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First Name (Child 1) *
Last Name (Child 1) *
Gender (Child 1) *
Birth Date (Child 1) *
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Race/Ethnicity *
Grade (2021-2022 School Year) *
School *
Will you be utilizing our morning transportation services offered at our Main Branch? *
Please check all of the days you will need AFTER-SCHOOL transportation: *
Required
If your child has an accommodation plan with their school please state (IEP, 504 Plan, etc.)
Allergies (Child 1) *
Permission for Doctor/Hospital in the event of an emergency *
Media Permission *
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