Virtual Club Registration Page Virtual Club Registration Name of Youth* First Last Age*Select Age56789101112131415161718Gender*MaleFemaleAre you a Club member? If so, which site do you attend?Choose ClubI do not attend a Boys & Girls Clubs of Central MN Club in person.Eastside Boys & Girls ClubRoosevelt Boys & Girls ClubSouthside Boys & Girls ClubSauk Rapids Middle SchoolAthlos KIDSTOPClearview KIDSTOPDiscovery KIDSTOPKennedy KIDSTOPMadison KIDSTOPMississippi HeightsOak Hill KIDSTOPOak Ridge KIDSTOPPine Meadow KIDSTOPPleasantview KIDSTOPTalahi KIDSTOPWestwood KIDSTOPDo you have a parent in the military?*Yes / NoYesNoDo you have a parent in the military? We are collecting this information to support a partnership with Boys & Girls Clubs of America supporting military families.Military sponsor first and last name* First Last Branch of military*Choose BranchArmyAir ForceNavyMarine Corps.Coast GuardStatus*Choose StatusGuardReserveActive DutyDuty station*Rank*Parent/Guardian first and last name* First Last Mobile phone numberYour parent's mobile phoneBest email address* Your parent's email address. We may use this to send out information about live Virtual Club programming events.I grant permission to share my name and email address with www.Tutor.com to register for their tutoring services as part of my membership benefits.* Yes - share my information with Tutor.com No - do not share my information with Tutor.com I have my parent's permission to visit the Virtual Club* Please make sure you have your parent's permission to visit the Virtual Club.By checking here, you are informing the Boys & Girls Clubs of Central Minnesota that you have received parent permission to visit the Virtual Club and participate in virtual programming.NameThis field is for validation purposes and should be left unchanged.