Please fill out the form below to contact us regarding any of the programs offered at
The Backpack Club.

Name: 
Address:
City: 
State:      Zip: 
Phone: 
E-mail: 
   
Child's Name: 
Child's Age: 
(as of Sept 1st)
Program(s) you are interested in: 


printable forms below

Before and After Program    Before and After Parent Contract Form   
Emergency Care Form    Emergency Contact Form    School Parent Contract Form
Registration Form