EXPLORER REGISTRATION

OPENING DAY

BCNY’s Fall 2021 afterschool program starts on Tuesday, October 12th.

SCHOOL HOLIDAY CLOSURES

BCNY is closed when NYC public schools are closed. Please view the BCNY calendar included with this form. For closures due to inclement weather, please be on the lookout for messages from BCNY.

ELIGIBLE AGES

Members must be currently enrolled in 4th grade and 5th grade to be eligible to register for membership at Abbe Clubhouse and Gerry Clubhouse.

REQUIRED REGISTRATION DOCUMENTS

• Birth Certificate/Passport (a photocopy is acceptable)
• Updated Immunization Records OR New York Dept. of Education “Medical Request for Immunization Exemption” Form
• Proof of Vaccination for Members age 12 or over
• CACFP Food Form
• Physical Examination Form (signed, dated in 2021 or later, and stamped) 

ATTENDANCE POLICY

Registered members are expected to attend BCNY a minimum of 3 days a week. Members who cannot meet these expectations may have their membership reviewed or suspended.

WAITLIST

Please note that space is limited. Registration is on a first-come, first- served basis. If registration is full, your child will be placed on a waitlist.

ABBE CLUBHOUSE: 133-01 41st Road, Flushing, New York 11355 718.886.5454

GERRYCLUBHOUSE: 321 East 111th Street New York, NY 10029 212.534.2661

PARENT AND MEMBER CONSENT

(required for all. Legal guardian or parent must sign. Members 18 and over must sign themselves)

I have read the completed application; I understand the rules of The Boys' Club of New York [BCNY] and I request that the proposed member be admitted. On his behalf I hereby release, discharge. indemnify and hold harmless The Boys' Club of New York, and any of its affiliates, subsidiaries, officers, agents and employees, from all claims, demands, actions, or liabilities of whatever kind and nature. including but not limited to bodily injury. death or property damage arising from, or in any way connected to, such child's use, operation, or participation in BCNY activities. I understand that BCNY will not administer any medication to members.

I hereby give my permission for photographs and videos of him to be used in BCNY promotional materials and website. and in outside exhibitions, BCNY events. newspaper articles, TV features, online videos, or publications approved by BCNY. I additionally permit his artwork to be used by BCNY for sale or presentation to BCNY board members, supporters. or guestsof any kind without compensation. If he attends boarding school, I give my permission for his registration to remain active until graduation. I also give permission for him to participate in BCNY surveys. I understand that BCNY reserves the right to placehim on an alternate or abridged schedule if it is deemed appropriate. Additionally, I do hereby give consent to BCNY's Program staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible. 

CONSENT FOR EMERGENCY MEDICAL TREATMENT

I do hereby give consent to The Boys' Club of New York staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible.