SIGN-UP

 
2017 Youth Membership Registration
 
Registration for membership to the Club is only $15.00 annually.  Our programs run on a calendar year (i.e. membership starts on January 1 and ends on December 31). 
 
Please complete the following documents and return to the Club either in person, by email to
(Afterschool Program) UnitDirector@bloomfieldkids.org
(Sports Program) SRDirector@bloomfieldkids.org
or by fax at 505-632-3264.
 
 Member and Parent Handbook  (Please read thoroughly)

With your membership packet please submit a copy of your child(s) most recent report card.
 
 
2017 Summer Registration
 
Our summer program starts on June 5th and ends August 9th.  Several options for attendance and participation in the program.
 
More information, schedules of activities and summer prices will be available in January 2017.
 
Register for the WHOLE SUMMER
2 Days per Week / 3 Days per Week/ 4+ Days per Week
 
 OR

 Register for WEEKLY SESSIONS
Sign-Up for select weeks or ALL
 

Registration information will be available in January 2017
Youth need a 2017 Club membership (If not current, fill out a new membership packet (1 per family)
Call 505.632.0123 for payment information and options.
 
Documents can be requested from the Club at:
In person @ 701 S. 2nd Street, Bloomfield, NM
By email to CPO@bloomfieldkids.org
OR Fax to 505-632-3264
 
 
 
 
2017 Sport Registrations
 
Registration for Club sports require a current membership.
Those without a membership must fill out the forms above and submit with sports registration.
2017 Sport Registration (All Sports) (1 per child, per sport)
All 2016 players MUST register as a NEW or RENEWING Club member to participate in sports programs.
 
Do You Want To Help?
   
Call 505-632-0123 or come by the Club at 701 S. 2nd Street, Bloomfield, NM for more information.

 
 
 
Lego Build-Off Competition
 
 
Air Hockey
 
 
 
 
**REMEMBER**
BREAKFAST and LUNCH
are
FREE
during the Summer Program
 
BREAKFAST is served from
7:30am-9:00am
French Taost, Cereal, Pancakes, Oatmeal, Waffles, Biscuits & Gravy, Pancake-on-a-Stick
LUNCH is served from
11:30pm-12:30pm
 Pizza, Chicken Nuggets, Tacos, Burritos, Spaghetti & Meatballs, Uncrustables, Quesadillas, Sloppy Joes, Grilled Cheese Sandwiches
 
Youth DO NOT have to be registered members to participate in the Summer Feeding Program.
EVERYONE is WELCOME!
 
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or, (3) email: program.intake@usda.gov.  This institution is an equal opportunity provider.  For more information call: Sarah Lorett @ 505-632-0123

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