Inside Out Club Series Registration

Inside Out Club K-5th Series Registration

We’re so excited to have you join us! If you have questions contact Lauren at lauren@insideoutclub.org

Step 1 of 8

Additional Parent or Guardian

Adult Name(Required)

First Last

Relationship to Child(ren)(Required)

Email(Required)

Phone(Required)

Phone Type(Required)

Text Message Reminders

We send out club meeting reminders and updates via text. If you would not like these text messages, please select the circle below.

Please don't text me

Address

If the second adult has a different address from the one already provided, enter it here.

Street Address Address Line 2 City State ZIP Code

Child Information

How will your student(s) go home?(Required)

After club, your child(ren) will:

Be Picked Up

Walk/Bike Home

Go to On-Site After-School Program

Go to Their Classroom (only for clubs that meet before or during school)

Other

Please Note: If someone other than the adult(s) registered via this form today will be picking up your child from an in-person Inside Out Club each week (nanny, grandparent, etc.), please email their name and phone number to lauren@insideoutclub.org.

Child #1's Name(Required)

First Last

Nickname

Gender(Required)

Race(Required)

Grade(Required)

2022-2023 school year.

Child's High School Graduation Year(Required)

Example: 2026

School(Required)

Please select your school from the list below. If you do not see your school, please choose NOT LISTED and enter your school name.

Child's School(Required)

Please type the full school name.

Hidden

Supply Box Pickup

Supply boxes will be provided for all participants taking part virtually. You will be emailed about the supply box pick-up date, time and location 10-14 days before the session begins.

N/A - I didn't register for a virtual session

I'll be there to pick up the supply box

I am not local, please ship my box for a $10 shipping fee

Hidden

Supply Box Shipping Address

Where should we send your supply box?

Street Address Address Line 2 City State ZIP Code

Medical Information

Please include medical or allergy information we need to be aware of.

Child #2 Information

Child's Name(Required)

First Last

Nickname

Gender(Required)

Race(Required)

Grade(Required)

2022-2023 school year.

Child's High School Graduation Year(Required)

Example: 2026

School(Required)

Child's School(Required)

Please type the full school name.

Medical Information

Please include medical or allergy information we need to be aware of.

Child #3 Information

Child's Name(Required)

First Last

Nickname

Gender(Required)

Race(Required)

Grade(Required)

2022-2023 school year.

Child's High School Graduation Year(Required)

Example: 2026

School(Required)

Child's School(Required)

Please type the full school name.

Medical Information

Please include medical or allergy information we need to be aware of.

Child #4 Information

Child's Name(Required)

First Last

Nickname

Gender(Required)

Race(Required)

Grade(Required)

2022-2023 school year.

Child's High School Graduation Year(Required)

Example: 2026

School(Required)

Child's School(Required)

Please type the full school name.

Medical Information

Please include medical or allergy information we need to be aware of.

Child #5 Information

Child's Name(Required)

First Last

Nickname

Gender(Required)

Race(Required)

Grade(Required)

2022-2023 school year.

Child's High School Graduation Year(Required)

Example: 2026

School(Required)

Child's School(Required)

Please type the full school name.

Medical Information

Please include medical or allergy information we need to be aware of.

Inside Out Club K-5th Series Registration

Additional Parent or Guardian

Child Information

Child #2 Information

Child #3 Information

Child #4 Information

Child #5 Information

Terms of Participation & Release of Liability

Video & Photo Release

COVID-19 Guidelines