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Club Registration 2026

What are you looking for?

Summer Camp Registration

New Heights Adventure Camp: June 15 – July 31, 2026
(About the camp)

Apply for one or more weeks at a time. 10% off discount offered for each additional child.

Complete the registration form using form below or in person.
Pay fee at the Club *

Questions or need assistance? Contact us at info@labgc.org or 323-221-9111.

* Weekly fees are in accordance with our Income Guidelines & Fee Schedule. We offer a sliding scale based on income. The registration form will calculate your personalized fees.

** Additional discounts and scholarships are available.

Club Registration Form

"*" indicates required fields

Step 1 of 7

14%

STEP 1: Program Selection

Select Your Programs:*

Choose which programs your child needs for the weeks you selected above. All programs run during the same weeks.

Day Camp - Core Program (9:00 AM - 4:00 PM)

Select Your Before/After programs:

Choose which programs your child needs for the weeks you selected above. All programs run during the same weeks.

Early Birds (Before Care)

Afternoon All-Stars - After Care (4:00 PM - 6:00 PM)

Select Camp Weeks:*

Week 1: WOW Week (June 15-19)

Week 2: Inventors' Workshop (June 22-26)

Week 3: City Stars & Stripes (June 29-July 3)

Week 4: Imagination Station (July 6-10)

Week 5: Artapalooza (July 13-17)

Week 6: 3...2...1...Blast Off! (July 20-24)

Week 7: Go for the Gold (July 27-31)

Optional Add-Ons:

Select one or more add-ons at no additional charge.

Basketball Skills Clinic

Baseball Clinic

Hip-hop Dance Program (4:00-6:00pm, Mondays & Wednesdays)

Los Angeles Boys & Girls Club Membership Fee:

Club Membership is a one-time $15 fee per child for camps and our after-school program. Please speak with our staff if you are experiencing financial hardship.

After-School Schedule Preferences:

This field is hidden when viewing the form

Transportation needed?

Yes

No

STEP 2: Add Family Information

Parent/Guardian #1 Name*

First Last

Parent/Guardian #1 Phone*

Parent/Guardian #1 Email

Parent/Guardian #1 Address*

Street Address City State ZIP Code

Add a Parent

Yes

No

Parent/Guardian #2 Name

First Last

Parent/Guardian #2 Phone

Parent/Guardian #2 Email

Parent/Guardian #2 Address

(If different than first address)

Street Address City State ZIP Code

STEP 3: Add Club Member / Camper Information (Up to 4 Children)

Child #1 Full Name*

First Last

Child #1 Age*

Child #1 Date of Birth*

MM slash DD slash YYYY

Child #1 Medical Conditions*

Heart

Respiratory

Allergies

Seizures

Hi/Lo Blood Pressure

Orthopedic

Diabetes

None of the above

Child #1 Special Needs*

ADD/ADHD

Learning Disability

Autism/Asperger's

Developmental Delays

DHH

Visual Impairment

Emotional/Behavioral

OHI - Other Health Impairment

None

Child #1 Health Insurance Policy #

Child #1 Health Insurance Carrier

Child #1 - Does your child currently require any medication?*

Yes

No

Child # 1 - Medications and dosage required*

Child #1 - Does your child have allergies?*

Yes

No

Child #1 Allergies*

I will provide an Epi Pen*

Yes

No

Child #1 Special dietary exclusions/needs

Would you like to enroll a second child?

Yes

No

Child #2 Information

Child #2 Full Name*

First Last

Child #2 Age*

Child #2 Date of Birth

MM slash DD slash YYYY

Child #2 Medical Conditions*

Heart

Respiratory

Allergies

Seizures

Hi/Lo Blood Pressure

Orthopedic

Diabetes

None of the above

Child #2 Special Needs*

ADD/ADHD

Learning Disability

Autism/Asperger's

Developmental Delays

DHH

Visual Impairment

Emotional/Behavioral

OHI - Other Health Impairment

None

Child #2 Medical Conditions*

Heart

Respiratory

Allergies

Seizures

Hi/Lo Blood Pressure

Orthopedic

Diabetes

None of the above

Child #2 Health Insurance Carrier

Child #2 Health Insurance Policy #

Child #2 - Does your child currently require any medication?*

Yes

No

Child #2- Medications and dosage required*

Child #2 - Does your child have allergies?*

Yes

No

Child #2 Allergies*

Child #2 - Does your child have allergies?*

Yes

No

I will provide an Epi Pen*

Yes

No

Child #2 Special dietary exclusions/needs

Would you like to enroll a third child?

Yes

No

Child #3 Information

Child #3 Name*

First Last

Child #3 Age*

Child #3 Date of Birth*

MM slash DD slash YYYY

Child #3 Medical Conditions*

Heart

Respiratory

Allergies

Seizures

Hi/Lo Blood Pressure

Orthopedic

Diabetes

None of the above

Child #3 Special Needs*

ADD/ADHD

Learning Disability

Autism/Asperger's

Developmental Delays

DHH

Visual Impairment

Emotional/Behavioral

OHI - Other Health Impairment

None

Child #3 Health Insurance Carrier

Child #3 Health Insurance Policy #

Child #3 - Does your child currently require any medication?*

Yes

No

Child #3- Medications and dosage required*

Child #3 - Does your child have any allergies?*

Yes

No

Child #3 Allergies*

I will provide an Epi Pen*

Yes

No

Child #3 Special dietary exclusions/needs

Would you like to enroll a fourth child?

Yes

No

Child #4 Information

Child #4 Name*

First Last

Child #4 Age*

Child #4 Date of Birth*

MM slash DD slash YYYY

Child #4 Medical Conditions*

Heart

Respiratory

Allergies

Seizures

Hi/Lo Blood Pressure

Orthopedic

Diabetes

None of the above

Child #4 Special Needs*

ADD/ADHD

Learning Disability

Autism/Asperger's

Developmental Delays

DHH

Visual Impairment

Emotional/Behavioral

OHI - Other Health Impairment

None

Child #4 Special Needs*

ADD/ADHD

Learning Disability

Autism/Asperger's

Developmental Delays

DHH

Visual Impairment

Emotional/Behavioral

OHI - Other Health Impairment

None

Child #4 Health Insurance Carrier

Child #4 Health Insurance Policy #

Child #4 - Does your child currently require any medication?*

Yes

No

Child #4- Medications and dosage required*

Child #4 - Does your child have any allergies?*

Yes

No

Child #4 Allergies*

I will provide an Epi Pen*

Yes

No

Child #4 Special dietary exclusions/needs

STEP 4: Calculate Total Fees Based on Income

Household Information

Part 1: Select your family size*

How many people live in your household?

Part 2: Select your household income*

Total household income (before taxes):

Part 2: Select your household income (2 members)*

Total household income (before taxes):

Part 2: Select your household income (3 members)*

Total household income (before taxes):

Part 2: Select your household income (4 members)*

Total household income (before taxes):

Part 2: Select your household income (5 members)*

Total household income (before taxes):

Part 2: Select your household income (6 members)*

Total household income (before taxes):

Part 2: Select your household income (7 members)*

Total household income (before taxes):

Part 2: Select your household income (8 members)*

Total household income (before taxes):

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Income Level (Hidden calculation)

This field is hidden when viewing the form

Early Birds Before Care Rate (Hidden Calculation)

This field is hidden when viewing the form

Day Camp Rate (Hidden Calculation)

This field is hidden when viewing the form

Summer Camp After Care Rate (Hidden Calculation)

This field is hidden when viewing the form

Weeks Count (Hidden calculation)

This field is hidden when viewing the form

Early Birds Total (Hidden calculation)

This field is hidden when viewing the form

Day Camp Total (Hidden calculation)

This field is hidden when viewing the form

After Care Total (Hidden calculation)

Number of Children

Subtotal

Sibling Discount

Club Membership Fees

$15 per child

Total Amount Due

How to Pay: Pay fees at the Club: 2635 Pasadena Avenue, Los Angeles, CA 90031

STEP 5: Permissions & Releases

Does your Child #1 (12 yrs or older) have permission to walk home?*

Yes, I authorize my Child #1 named above to depart from the Club and walk home. I am aware that once my child leaves the club facility, there is no adult supervision and I accept all associated risks.

No I do not authorize my Child #1 named above to walk home.

Does your Child #2 (12 yrs or older) have permission to walk home?*

Yes, I authorize my Child #2 named above to depart from the Club and walk home. I am aware that once my child leaves the club facility, there is no adult supervision and I accept all associated risks.

No I do not authorize my Child #2 named above to walk home.

Does your Child #3 (12 yrs or older) have permission to walk home?*

Yes, I authorize my Child #3 named above to depart from the Club and walk home. I am aware that once my child leaves the club facility, there is no adult supervision and I accept all associated risks.

No I do not authorize my Child #3 named above to walk home.

Does your Child #4 (12 yrs or older) have permission to walk home?*

Yes, I authorize my Child #4 named above to depart from the Club and walk home. I am aware that once my child leaves the club facility, there is no adult supervision and I accept all associated risks.

No I do not authorize my Child #4 named above to walk home.

Does your child have your permission to swim at summer camp?*

Yes, my child has my permission to swim at summer camp.

No, my child does not have my permission to swim at summer camp.

Student Records Release*

I give permission for Los Angeles Boys & Girls Club to retrieve my child's school records and for my child's school to release all records including grades, attendance, behavior and academic performance for the purpose of program and child outcome evaluation.

Liability and Photo Release*

I have read and consent to the Los Angeles Boys & Girls Club Release and Waiver of Liability and Indemnity Permission and Medical Agreement.

COVID-19 Waiver*

I have read and consent to the Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19.

STEP 6: Add Emergency Contacts & Additional Authorized Individuals

Emergency Contact & Authorized Pickup #1*

(In case of emergency and the parents cannot be reached)

First Last

Phone - Emergency Contact & Authorized Pickup #1*

Emergency Contact & Authorized Pickup #2*

First Last

Phone - Emergency Contact & Authorized Pickup #2*

Emergency Contact & Authorized Pickup #3*

First Last

Phone - Emergency Contact & Authorized Pickup #3*

Is there anyone who is UNAUTHORIZED to pick up your child(ren) from summer camp?*

Yes

No

Please enter the name(s) of the individual(s) that are UNAUTHORIZED to pick up your child(ren).

STEP 7: Upload Required Documents

You may submit these required documents online or in-person at The Club. A scanned document or photo of document(s) are acceptable. (Accepted files include jpg, png, pdf.)

Club staff will your verify annual income and confirm your personalized weekly rate.

Once all documents have been received and any balance due has been paid, your registration will be finalized.

Income Verification

Please upload a file showing your most recent pay stub to verify your income and camp fee rate. (e.g. Scanned document or photo of pay stub)

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 20 MB.

Date of Birth (DOB) Verification

Please upload a document that contains your child's date of birth i.e. school report card, medical card, immunization record, birth certificate, or other official document. If you are signing up multiple children, please upload a document for each child

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 20 MB.

Address Verification

Please upload a document that contains your current address. i.e. recent gas bill, electricity bill, or any other bill with your name and address on it

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 20 MB.

Recent Photo of Child

Please upload a recent photo of the applicant.

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 50 MB.

Parent ID Verification

Please upload a photo of a Government Issued ID for a parent.

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 20 MB.

Los Angeles Boys & Girls Club

2635 Pasadena Avenue, Los Angeles, CA 90031 (323) 221-9111 | info@labgc.org

The The Los Angeles Boys & Girls Club provides a safe environment for kids (ages 5 to 17 yrs.) and propels them to learn social skills, identify potential opportunities, as well as achieve personal, academic, athletic and other worthy goals.

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