Mission Youth Outreach Application

Mission: Youth Outreach

Boys & Girls Clubs of Central Minnesota would like to offer free Club memberships to children from military families through Boys & Girls Clubs of America’s Mission: Youth Outreach program. Please complete the form below for your child(ren)’s free Club membership and/or use it for $20 off your KIDSTOP registration processing fee.

You must also register your child for Boys & Girls Club:

If you have any questions, please feel free to contact the administrative office at (320) 252-7616.

Boys & Girls Club registration

KIDSTOP registration

Youth's Name*
First Last
Youth's Age*
Youth's Grade*
Youth's Gender*
- Male
- Female
- Non-binary
- Transgender
Military Parent/Guardian Name*
First Last
Relationship to child*
- Biological parent
- Step parent
- Foster parent
- Guardian
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Branch of Military*
Status*
Duty Station*
Rank*
Distance from home to the nearest Youth Military Center (approximately in miles)?*
Signature*