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Club Connections

Club Connections Registration

2022-2023 Club Connections Registration

Club Connections Beyond is FULL. Please fill out the waitlist form here.

If you would like to register for Club Connections High School, continue to the registration below. 

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
If you are requesting funding from your Regional Center, please check this box:

If you are using Self Determination funds, please fill out this information:

Payment Option
Credit Card Information
Visa MasterCard American Express Discover
Make this a monthly payment?
Make this a monthly payment?
Your total payment will be
Your credit balance will cover
Your credit card will be charged
Your bank account will be charged