5 Year Old Member Agreement


While each Club is unique, some Units allow 5 year old members. When you have these lil gems, sometimes they might have a difficult time adapting to the Club environment. Informing parents/guardians about Club expectations and allowing 5 year old members to attend the Club on a trial basis is a great way to determine if a new 5 year old member can be successful! Here are some things you could include in your own agreement:

5 Year Old & Under Member Agreement

MISSION: The mission of the Boys & Girls Clubs of Springfield is to provide programs that guide and direct youth from all backgrounds with special concern for those from at-risk circumstances. Through social, physical and educational development activities, the Boys & Girls Clubs of Springfield teaches youth the values of life, strengthens their self-esteem and makes them better citizens of our community.

TRADITION: Traditionally, the Boys & Girls Clubs of Springfield serve members ages 6-18. In special circumstances, however, Clubs make exceptions to allow 5 year old members. 5 year old members are able to attend under the discretion of the Unit Director and will undergo a two week trial membership. During this trial membership, 5 year old members must be able to do the following:

  • Function in the Club environment

  • Function under a 1:25 staff: member ratio

  • Follow behavior expectations and standards as outlined in the Club’s discipline policy.

Your member’s trial membership begins on ______________ and ends on ______________.

Right before the end of your member’s trial, your Unit Director will set up a meeting to discuss your member’s trial membership and whether or not your 5 year old member is able to continue attending the Club.

If at any time before the end of your member’s trial, your member is unable to follow the above outlined standards, your Unit Director will communicate with you.

By signing below, you:

  • Agree to enrolling your member in the trial membership,

  • Understand that if your member does not meet the above outlined standards, he or she will be unable to attend the Club until he or she turn 6 years old,

  • Understand that full payment must be made and if your member is unable to attend the Club after the trial basis, you will be reimbursed.

If you have any questions, comments, or concerns, please do not hesitate to speak to your Unit Director.

___________________________________________ ________________________ Parent/Guardian Signature Date

___________________________________________ ________________________ Unit Director Signature Date

5 Year Old & Under Member Agreement Review Form

Thank you for choosing the Boys & Girls Clubs of Springfield this summer. At the beginning of the summer, you completed a 5 Year Old & Under Member Agreement (included) outlining the expectations of your member while at the Club. Traditionally, the Boys & Girls Clubs of Springfield serve members ages 6-18. In special circumstances, however, Clubs make exceptions to allow 5 year old members.

5 year old members are able to attend under the discretion of the Unit Director and will undergo a two week trial membership. During this trial membership, 5 year old members must be able to do the following:

  • Function in the Club environment

  • Function under a 1:25 staff: member ratio

  • Follow behavior expectations and standards as outlined in the Club’s discipline policy.

Now that your member’s trial period is complete, below is an outline of member successes and difficulties.

Member Successes

I.E.: Respectful and kind at all times

I.E.: Trying new things and becoming very confident

I.E.: Color War competition participation

I.E.: Not being scared at the Club

I.E.: Able to go to an area without staff supervision/help

Member Difficulties

I.E.: Relaying frustrations or concerns with staff or being able to speak with a staff or director if he is sad, concerned, etc. He has improved greatly in this area, just still needs some work.

I.E.: Becomes overwhelmed in largely populated areas

Based on this review, your member has/has not qualified to complete the summer program at the Boys & Girls Clubs of Springfield-Sertoma Unit. You will be notified if the above difficulties become cause for concern. We ask that you work with both your member and the Club in order to ensure success. If you have any questions, comments, or concerns, please do not hesitate to speak to your Unit Director.

___________________________________________ ________________________ Parent/Guardian Signature Date

___________________________________________ ________________________ Unit Director Signature Date


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