Club Connections

Club Connections 2020-2021 Registration


Would you like to be contacted in addition to your parents?
If yes, please provide your email and phone number below
Special Diet:
If "other" please indicate what that is:

Answering the questions below,  will help our Club Connections Team create lessons that can meet a diverse group of needs.

Any difficulty with sight or hearing?
If yes, please indicate what those are:
Does Club 21 have permission to release photos of your teen:
by clicking "yes" you give your consent
Club Connections Payment Options
Credit Card Information
Visa MasterCard American Express Discover

Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Make this a monthly payment?
Make this a monthly payment?
Your total payment will be