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Boys & Girls Club of the Heartland's 

Mission Mondays and Afterschool Programs will be held at

First General Baptist Church located at 601 Barrett Drive, Malden, MO 63863.

Please read the policy and procedures below for more information.

Member Information:
Will your child be attending Holcomb R-III "In School" classes for the 2024-2025 School Year?
First, Middle, Last
Month/Day/Year
Sex

MISSION MONDAYS

On Mondays, during the 2024 - 2025 school year, we will hold our Full Day Mission Monday program. Mission Mondays will be held at the First General Baptist Church, located at 601 Barrett Drive, Malden, MO from 7:30 am - 6:00 pm.

When is your child planning on attending?
Ethnicity
Street, City, State, Zip
Parent / Guardian Contact Information
Member Lives With:
Please check if applicable
Does your child have an IEP (individual education plan) or attend specialized classes for behavior management?
Does your child have a companion aide at school?
Are you interested in being part of the BGC Advisory Committee
Authorization for Emergency Medical Care
Name & Phone
Name & Phone

*Please note that the above personal information is vital and necessary for our records and the funding that our organization receives. The answers you provide will be kept completely confidential. Your cooperation for providing this information is both appreciated and vital.

Authorization for School Release

I give permission to my child's home school district to share all progress reports with the Boys & Girls Club of the Heartland to further enhance my child’s education.  I give permission for my child's home school district to release any information to BGCPB.  I give permission for the BGCPB to communicate with my child’s teacher, view and copy progress reports, and discuss strategies that will help my child to become a successful student.  I understand that Boys & Girls Club of the Heartland is not responsible for personal injury or lost or stolen property.  By signing this form, I agree to allow my child to be photographed, videotaped, or interviewed for Boys & Girls Club media purposes only.  Having been informed that Boys and Girls Club of the Heartland provide supervised athletic, recreational, educational, cultural, and guidance programs for boys and girls, I/We, the Parent/Guardian of the child above, named candidate for membership in Boys & Girls Club of the Heartland, do hereby agree and give consent for his/her participation in any and all activities conducted by the club while he/she is a member.  In consideration of permission given to my child/children listed below by the Boys & Girls Club of the Heartland, to participate in all activities, I release and discharge the BGCPB, its agents, employees, commissioners, and officers, from all claims, demands, actions, judgments, and executions, which I ever had, or now have, or may have, or which my heirs, personal representatives, or assigns may have or claim to have against the Boys & Girls Club of the Heartland, its successors, or assigns for personal injuries to my child listed below, known or unknown and injuries to property, real or personal, caused by, arising out of, the activity or activities offered by the Boys & Girls Club of the Heartland.  I/We likewise release from responsibility any person transporting my/our child to or from all activities sponsored or conducted by Boys & Girls Club of the Heartland. I have read this release and understand all its terms.  I sign it voluntarily and with full knowledge of its significance.  I consent to my child participating in all activities as stated above and assume all risks.  I have received a copy of this facility’s policies pertaining to the admission, care and discharge of the children. I understand that all sites are licensed exempt. The provider and I have agreed on a plan for continuing communications regarding my child’s development, behavior and individual needs. When my child is ill, I understand and agree that s/he may not be accepted for care or remain in care. I give permission for my child to attend field trips/excursions. I understand that I will be notified in advance when they are planned. I/We agree that the Boys & Girls Club of the Heartland may transport my child off their sites campus (examples other sites, field trips, etc.)  When my child is ill, I understand and agree that he/she may not be accepted for care or remain in care. Staff at BGCPB will communicate regarding my child’s development, behavior, and individual needs.  I understand that I will be notified at once in case of an emergency with my child, and I will make arrangements for medical care of my child with the physician or hospital of my choice.  If I cannot be reached to make necessary arrangements, or in a critical emergency requiring medical care, I authorize Boys & Girls Club of the Heartland to contact the physician or hospital of my choice.  I give my permission to the Boys & Girls Club of the Heartland to collect information via online or written surveys, questionnaires, interviews, and focus groups from the minor child listed on this application. Any and all information received will be kept strictly confidential. Data gathered through these means will be summarized in the aggregate and will exclude all references to any individual responses. The aggregated results of these analyses may be shared with Club staff, Boys & Girls Clubs of America (BGCA), funders, and other community stakeholders to evidence program effectiveness and/or Club impact on our members. I give permission for my child to participate in all prevention programs (i.e. Smart Moves, METH Smarts, Smart Girls, Passport to Manhood, etc.) offered by BGCPB.  I understand that the Boys & Girls Club of the Heartland may share information about the minor child listed on this application with Boys & Girls Clubs of America (BGCA) for research purposes and/or to evaluate the program’s effectiveness. Information that will be disclosed to BGCA may include the information provided on this membership application form, information provided by the minor child’s school or school district, and other information collected by Boys & Girls Club of the Heartland, including data collected via surveys or questionnaires. All information provided to BGCA will be kept confidential.  I have read this release and understand all its terms.  I sign it voluntarily and with full knowledge of its significance.  I consent to my child participating in all activities as stated above and assume all risks.

I have read and understand the authorization for school release form. Please enter name above

Holcomb R-III

2024-2025 School Year Policy & Procedures

Our Mission: To enable all young people, especially those who need us the most, to reach their full potential as productive, caring, and responsible citizens.

Enrollment Requirements: Sign all forms, all delinquent charges must be paid, and pay the first monthly membership fee of $25.00 per child.

Afterschool Dates: Our 2024-2025 After School Program starts on Tuesday, August 20, 2024 and ends the last full day of school.

Misson Monday Dates: Our 2024-2025 Mission Monday Program starts on August 26, 2024 and ends May 19, 2025. Mission Mondays are our full day Monday program. We will be closed for Mission Mondays on September 2nd, November 25th, December 23rd and December 30th. Members can get dropped off at the First General Baptist Church from 7:30-9:00am. Pick up will be from 3:30-5:30pm. Members will get served breakfast, lunch, and snack on these days.

Who can attend Boys & Girls Club of the Heartland: Malden, Campbell, Clarkton, Gideon, Holcomb, Risco, and Bernie students enrolled in “in person” classes who are enrolled in Kindergarten – 8th grade are eligible for BGC membership.

How much will Boys & Girls Club cost 2024-2025 School Year? Enrolling parents/guardians will be not be charged a membership fee.

Programming: BGC offers programming in character and leadership development, education and career development, health and life skills, the arts, and sports, fitness, and recreation. Club members will be in groups for Power Hour and programming based on the grade they are enrolled in the 24-25 school year. A schedule will be posted on the parent board at each site for more specific information that will be taking place.  BGC is not responsible for making transportation arrangements with the school. It is the parent’s responsibility to inform the school of changes in afterschool transportation arrangement.

Operational Hours and Facilities: ALL SITES will be open until 6:00 pm afterschool. Campdays will be at the First General Baptist Church open 7:30a.m.-5:30 p.m. to any members who are enrolled in the 24-25 school year. Drop off time during Campdays will be 7:30-9:00am and pick up will be from 3:30-5:30. There is a charge of $1.00 per child for every minute after 6:30 pm during regular school days and 5:30 during camp days that your child is not picked up. After 30 minutes, BGC is required to call authorities. Camp Days MUST be pre-registered and pre-paid to attend. NO EXCEPTIONS!

Meals:  BGC will provide a full meal and or snack to members at all of our locations.

Drop Off & Pick Up Policies: Parents will drive up to the First General Baptist Church gymnasium door to drop off/pick up their children. If a person is not listed on your child’s membership forms as an authorized person to pick up your child, we cannot release your child to them. Please make sure to bring a photo ID the first few times you pick up a member.

Discipline Procedures: Step 1 will be a warning to the child. Step 2 is sentences or other appropriate consequences for the child. Step 3 will be a time out of program or In-Club Service. Step 4 your child will have an administrative meeting with the child and a parent. Step 5 is suspension. Fighting, destruction of property, refusal to cooperate with staff, theft, or vandalism will result in immediate suspension. If a member poses a threat to their own safety or safety of others, they may be placed on a behavior management plan. This plan provides notice and accountability to avoid permanent suspension.  If your child is suspended from their attending school district, they are not allowed to attend BGC due to club being on school property.

Member Safety: Your Child’s Safety is paramount at the Boys & Girls Club. It is necessary to keep updated information on our club members and their parents. Please inform BGC front desk staff any member information changes such as phone number, address, authorized pick up list, etc. In the event of an emergency causing evacuation, BGC has an emergency preparedness plan in place at each site that will be followed. Do not send your child to club if they are sick. BGC cannot store, dispense, or apply medicine. If your child has a temperature over 98.6, parents will be notified. Once a child’s temperature reaches 100 degrees the child must be picked up immediately. In the event of an emergency, BGCPB will follow best practices per state licensing guidelines. 

Other Notes: Do not allow your child to bring personal technology devices to club. BGC is not responsible for lost or stolen items. If a child changes schools, please inform BGC to check for availability. (We cannot guarantee there will be a spot available at their new school.) Follow us on Twitter, Facebook, and visit bgcpb.org. You will be notified by Friday, August 16th if your child has been accepted into our program.

*Due to ongoing changes with the CDC guidelines, above procedures are subject to change at any time.

I have read and understand the 2024-2025 School Year Policy & Procedures. Please enter name above