If you would like to inquire about your child/children becoming a member(s) of the Boys & Girls Club After School Enrichment Program, please submit the below information and a member of our team will be in touch with you shortly.

Note: Completing the below inquiry does not automatically guarantee your child will be admitted.

*If you have any questions regarding our Miracle 21st Century Learning Centers, click the button below to learn more.

Miracle 21st Century Learning Centers

After School Enrichment Inquiry

"*" indicates required fields

MM slash DD slash YYYY
Has your child ever attended a Boys & Girls Club of Collier County program?*
Which location are you applying for?*
Child Name*
Child Gender*
MM slash DD slash YYYY
Child-2 Name
Child-2 Gender
MM slash DD slash YYYY
Child-3 Name
Child-3 Gender
MM slash DD slash YYYY
Parent Name*
Parent Address
This field is for validation purposes and should be left unchanged.