{"id":17118,"date":"2025-05-23T14:05:00","date_gmt":"2025-05-23T18:05:00","guid":{"rendered":"https:\/\/bgcgm.org\/programs\/solicitud-para-el-ano-escolar-3\/"},"modified":"2026-06-03T11:03:30","modified_gmt":"2026-06-03T15:03:30","slug":"solicitud-para-el-ano-escolar-3","status":"publish","type":"page","link":"https:\/\/bgcgm.org\/es\/programs\/solicitud-para-el-ano-escolar-3\/","title":{"rendered":"Solicitud para el a\u00f1o escolar"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"17118\" class=\"elementor elementor-17118 elementor-14650\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-14e3e697 elementor-section-full_width elementor-section-height-min-height elementor-section-height-default elementor-section-items-middle\" data-id=\"14e3e697\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;shape_divider_bottom&quot;:&quot;mountains&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t<div class=\"elementor-shape elementor-shape-bottom\" aria-hidden=\"true\" data-negative=\"false\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 1000 100\" preserveAspectRatio=\"none\">\n\t<path class=\"elementor-shape-fill\" opacity=\"0.33\" d=\"M473,67.3c-203.9,88.3-263.1-34-320.3,0C66,119.1,0,59.7,0,59.7V0h1000v59.7 c0,0-62.1,26.1-94.9,29.3c-32.8,3.3-62.8-12.3-75.8-22.1C806,49.6,745.3,8.7,694.9,4.7S492.4,59,473,67.3z\"\/>\n\t<path class=\"elementor-shape-fill\" opacity=\"0.66\" d=\"M734,67.3c-45.5,0-77.2-23.2-129.1-39.1c-28.6-8.7-150.3-10.1-254,39.1 s-91.7-34.4-149.2,0C115.7,118.3,0,39.8,0,39.8V0h1000v36.5c0,0-28.2-18.5-92.1-18.5C810.2,18.1,775.7,67.3,734,67.3z\"\/>\n\t<path class=\"elementor-shape-fill\" 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elementor-element elementor-element-6f462e43\" data-id=\"6f462e43\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e6b6e49 elementor-widget elementor-widget-heading\" data-id=\"e6b6e49\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Curso escolar 2026-2027<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fb85eb0 elementor-widget elementor-widget-heading\" data-id=\"fb85eb0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Application<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-6b7e8056\" data-id=\"6b7e8056\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0ed98f3 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0ed98f3\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9b1ba42\" data-id=\"9b1ba42\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4b489fa elementor-widget elementor-widget-text-editor\" data-id=\"4b489fa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>\u00a1Nuestra solicitud para el Programa del A\u00f1o Escolar 2025-2026 est\u00e1 CERRADA! Ya no aceptamos solicitudes online, y nuestro programa finaliza el martes 16 de junio de 2026. <\/p><p><span style=\"letter-spacing: 0px;\">\u00a1La Solicitud para el Programa del A\u00f1o Escolar 2026-2027 estar\u00e1 disponible el lunes 8 de junio! \u00a1Aseg\u00farate de volver aqu\u00ed para inscribirte en nuestros Programas de Antes y Despu\u00e9s de la Escuela! <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f07c8f0 elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-mobile elementor-widget elementor-widget-text-editor\" data-id=\"f07c8f0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Para inscribir a tu hijo como miembro de nuestro Club y solicitar la programaci\u00f3n de Antes y\/o Despu\u00e9s de la Escuela, rellena la solicitud que aparece a continuaci\u00f3n.<\/p><p><strong>TEN EN CUENTA:<\/strong> Hay numerosos formularios que deben rellenarse y cargarse para presentar la solicitud.  <\/p><p><em>**Te recomendamos que descargues y cumplimentes estos formularios antes de iniciar el proceso de solicitud. Los formularios cumplimentados pueden guardarse en tu ordenador para cargarlos f\u00e1cilmente durante el proceso de solicitud. <strong>Tu solicitud no podr\u00e1 presentarse sin ellos.**<\/strong> <\/em><\/p><ul><li><strong>Obligatorio para todos los afiliados:<\/strong> <a href=\"https:\/\/bgcgm.org\/wp-content\/uploads\/2025\/05\/2025-26-CIP-Supplemental-Information_10.2.25_Fillable.pdf\" target=\"_blank\" rel=\"noopener\">Programa de Mejora de la Comunidad<\/a><\/li><li><strong>Obligatorio para los alumnos que asistan a Highland-Goffe&#8217;s Fall, Jewett Street o al Centro de Enriquecimiento Juvenil Jordan Singer (que incluye Gossler Park, Northwest y Parker-Varney):<\/strong> Formulario de <a href=\"https:\/\/bgcgm.org\/wp-content\/uploads\/2025\/05\/2025-26-child-care-registration-and-emergency-information_Fillable_Rev.-10.3.25.pdf\" target=\"_blank\" rel=\"noopener\">Inscripci\u00f3n en Guarder\u00eda e Informaci\u00f3n de Emergencia<\/a> y presentar una <strong>Declaraci\u00f3n M\u00e9dica y Cartilla de Vacunaci\u00f3n <\/strong> actualizadas (debes obtenerla de la consulta del m\u00e9dico de tu hijo, y debe ser un PDF).<\/li><li>Tambi\u00e9n recomendamos encarecidamente a cada familia que considere la posibilidad de aceptar el <a href=\"https:\/\/bgcgm.org\/wp-content\/uploads\/2025\/05\/REVISED-_New_-2025-26-MSD-Consent-for-Release-Student-Records-Form_Fillable.pdf\" target=\"_blank\" rel=\"noopener\">Consentimiento de los Distritos Escolares de Manchester para la Divulgaci\u00f3n de los Expedientes Escolares<\/a>. Aunque este programa es opcional, nos permite ayudarte a garantizar el \u00e9xito acad\u00e9mico de tu hijo. <\/li><\/ul><p style=\"text-align: center;\"><em><span style=\"text-decoration: underline;\"><strong>Esta solicitud debe rellenarse por cada miembro que asista al programa.<\/strong><\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-26c5bbc elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-mobile elementor-widget elementor-widget-text-editor\" data-id=\"26c5bbc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4 style=\"text-align: center;\"><strong><span style=\"color: #0081c6;\">Novedades para el Programa del A\u00f1o Escolar 2026-2027<\/span><\/strong><\/h4><p>Nos enorgullece expandirnos a la zona oeste de Manchester y abrir una nueva sede de \u00faltima generaci\u00f3n en el Centro Comunitario Mark Stebbins. Este nuevo centro, orgullosamente llamado <b>Jordan Singer Youth Enrichment Center <\/b>(JSYEC), acoger\u00e1 a ni\u00f1os de los cursos K-4 que asisten a las escuelas primarias <b>Gossler Park, Northwest y Parker-Varney<\/b>. Este centro ofrecer\u00e1 programas extraescolares, pero los socios podr\u00e1n utilizar nuestro programa extraescolar en el Clubhouse de Union Street.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a581b6a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a581b6a\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2095bf1\" data-id=\"2095bf1\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ede7d85 elementor-hidden-desktop 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    <h2 class=\"gform_title\">2026-27 Membership and School Year Application<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_23'  action='\/es\/wp-json\/wp\/v2\/pages\/17118#gf_23' data-formid='23' novalidate>\n        <div id='gf_progressbar_wrapper_23' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Paso <span class='gf_step_current_page'>1<\/span> de <span class='gf_step_page_count'>5<\/span><span class='gf_step_page_name'> - Member Information<\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_custom' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_custom percentbar_20' style='width:20%; color:; background-color:#61279E;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_23_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_23' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_23_170\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><\/div><div id=\"field_23_1\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_1'>Member First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_23_1' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_3'>Member Middle Name<\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_23_3' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_4'>Member Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_23_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_5'>Nickname<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_23_5' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_6\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_6'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_6' id='input_23_6' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/aaaa' aria-describedby=\"input_23_6_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_23_6_date_format' class='screen-reader-text'>MM barra DD barra AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_23_6' class='gform_hidden' value='https:\/\/bgcgm.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_23_7\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_7'>Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_7'>As of 9\/9\/2026<\/div><div class='ginput_container ginput_container_number'><input name='input_7' id='input_23_7' type='number' step='any' min='1' max='18' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_23_7 gfield_description_23_7\" \/><div class='gfield_description instruction ' id='gfield_instruction_23_7'>Por favor, escribe un n\u00famero entre <strong>1<\/strong> y <strong>18<\/strong>.<\/div><\/div><\/div><fieldset id=\"field_23_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_9'>\n\t\t\t<div class='gchoice gchoice_23_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Male'  id='choice_23_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_9_0' id='label_23_9_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Female'  id='choice_23_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_9_1' id='label_23_9_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_9_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Transgender'  id='choice_23_9_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_9_2' id='label_23_9_2' class='gform-field-label gform-field-label--type-inline'>Transgender<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='gf_other_choice'  id='choice_23_9_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_9_3' id='label_23_9_3' class='gform-field-label gform-field-label--type-inline'>Otro<\/label><br \/><input id='input_23_9_other' class='gchoice_other_control' name='input_9_other' type='text' value='Otro' aria-label='Si es otro, especif\u00edcalo, por favor'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_23_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Member Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_10'>\n\t\t\t<div class='gchoice gchoice_23_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='New Member'  id='choice_23_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_10_0' id='label_23_10_0' class='gform-field-label gform-field-label--type-inline'>New Member<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Former Member'  id='choice_23_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_10_1' id='label_23_10_1' class='gform-field-label gform-field-label--type-inline'>Former Member<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_23_11\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ethnicity<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_23_11'>Check all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_23_11'><div class='gchoice gchoice_23_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='Black'  id='choice_23_11_1'   aria-describedby=\"gfield_description_23_11\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_23_11_1' id='label_23_11_1' class='gform-field-label gform-field-label--type-inline'>Black<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_11_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.2' type='checkbox'  value='White'  id='choice_23_11_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_11_2' id='label_23_11_2' class='gform-field-label gform-field-label--type-inline'>White<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_11_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.3' type='checkbox'  value='Hispanic'  id='choice_23_11_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_11_3' id='label_23_11_3' class='gform-field-label gform-field-label--type-inline'>Hispanic<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_11_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.4' type='checkbox'  value='European'  id='choice_23_11_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_11_4' id='label_23_11_4' class='gform-field-label gform-field-label--type-inline'>European<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_11_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.5' type='checkbox'  value='Other'  id='choice_23_11_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_11_5' id='label_23_11_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_23_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-two-thirds field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_12'>Ethnicity (Other)<\/label><div class='gfield_description' id='gfield_description_23_12'>Please specify<\/div><div class='ginput_container ginput_container_text'><input name='input_12' id='input_23_12' type='text' value='' class='large'  aria-describedby=\"gfield_description_23_12\"    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_23_16\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Primary Language<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_16'>\n\t\t\t<div class='gchoice gchoice_23_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='English'  id='choice_23_16_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_16_0' id='label_23_16_0' class='gform-field-label gform-field-label--type-inline'>English<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Spanish'  id='choice_23_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_16_1' id='label_23_16_1' class='gform-field-label gform-field-label--type-inline'>Spanish<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_16_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Other'  id='choice_23_16_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_16_2' id='label_23_16_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_23_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-two-thirds field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_15'>Primary Language (Other)<\/label><div class='gfield_description' id='gfield_description_23_15'>Please specify<\/div><div class='ginput_container ginput_container_text'><input name='input_15' id='input_23_15' type='text' value='' class='large'  aria-describedby=\"gfield_description_23_15\"    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_23_20\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Home Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_23_20' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_23_20_1_container' >\n                                        <input type='text' name='input_20.1' id='input_23_20_1' value=''    aria-required='true'    \/>\n                                        <label for='input_23_20_1' id='input_23_20_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_23_20_2_container' >\n                                        <input type='text' name='input_20.2' id='input_23_20_2' value=''     aria-required='false'   \/>\n                                        <label for='input_23_20_2' id='input_23_20_2_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_23_20_3_container' >\n                                    <input type='text' name='input_20.3' id='input_23_20_3' value=''    aria-required='true'    \/>\n                                    <label for='input_23_20_3' id='input_23_20_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_23_20_4_container' >\n                                        <select name='input_20.4' id='input_23_20_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Samoa Americana' >Samoa Americana<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Islas Marianas del Norte' >Islas Marianas del Norte<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Islas V\u00edrgenes de los Estados Unidos' >Islas V\u00edrgenes de los Estados Unidos<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_23_20_4' id='input_23_20_4_label' class='gform-field-label gform-field-label--type-sub '>Provincia<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_23_20_5_container' >\n                                    <input type='text' name='input_20.5' id='input_23_20_5' value=''    aria-required='true'    \/>\n                                    <label for='input_23_20_5' id='input_23_20_5_label' class='gform-field-label gform-field-label--type-sub '>C\u00f3digo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_20.6' id='input_23_20_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_23_153\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_153'>School in Fall 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_153' id='input_23_153' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>School in Fall 2026<\/option><option value='Elementary School: Bakersville' >Elementary School: Bakersville<\/option><option value='Elementary School: Beech Street' >Elementary School: Beech Street<\/option><option value='Elementary School: Gossler Park (JSYEC)' >Elementary School: Gossler Park (JSYEC)<\/option><option value='Elementary School: Green Acres' >Elementary School: Green Acres<\/option><option value='Elementary School: Highland-Goffe&#039;s Falls' >Elementary School: Highland-Goffe&#039;s Falls<\/option><option value='Elementary School: Jewett Street' >Elementary School: Jewett Street<\/option><option value='Elementary School: McDonough' >Elementary School: McDonough<\/option><option value='Elementary School: Northwest (JSYEC)' >Elementary School: Northwest (JSYEC)<\/option><option value='Elementary School: Parker-Varney (JSYEC)' >Elementary School: Parker-Varney (JSYEC)<\/option><option value='Elementary School: Smyth Road' >Elementary School: Smyth Road<\/option><option value='Elementary School: Webster' >Elementary School: Webster<\/option><option value='Elementary School: Weston' >Elementary School: Weston<\/option><option value='Middle School: Hillside' >Middle School: Hillside<\/option><option value='Middle School: McLaughlin' >Middle School: McLaughlin<\/option><option value='Middle School: Parkside' >Middle School: Parkside<\/option><option value='Middle School: Southside' >Middle School: Southside<\/option><\/select><\/div><\/div><div id=\"field_23_163\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_163'>Grade in Fall 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_163' id='input_23_163' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Grade in Fall 2026<\/option><option value='K' >K<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_23_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_23_2' class='gform_page' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_23_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_23_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_23'>Legal Guardian First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_23_23' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_24'>Legal Guardian Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_23_24' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_121\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_121'>Relation to Child<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_121' id='input_23_121' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a Relation to Child<\/option><option value='Mom' >Mom<\/option><option value='Dad' >Dad<\/option><option value='Stepmother' >Stepmother<\/option><option value='Stepfather' >Stepfather<\/option><option value='Grandmother' >Grandmother<\/option><option value='Grandfather' >Grandfather<\/option><option value='Aunt' >Aunt<\/option><option value='Uncle' >Uncle<\/option><option value='Foster Parent' >Foster Parent<\/option><option value='Family Friend' >Family Friend<\/option><option value='Neighbor' >Neighbor<\/option><option value='Sibling' >Sibling<\/option><option value='Social Worker' >Social Worker<\/option><option value='Other Relative' >Other Relative<\/option><\/select><\/div><\/div><div id=\"field_23_27\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_27'>Primary Cell Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_27' id='input_23_27' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_28\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_28'>Primary Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_28' id='input_23_28' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_23_29\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_29'>Secondary Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_29' id='input_23_29' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_30'>Legal Guardian Employer<\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_23_30' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_31\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_31'>Work Phone Number<\/label><div class='ginput_container ginput_container_phone'><input name='input_31' id='input_23_31' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_32\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_32'>Secondary Legal Guardian First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_23_32' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_33\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_33'>Secondary Legal Guardian Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_23_33' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_122\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_122'>Secondary Legal Guardian Relation to Child<\/label><div class='ginput_container ginput_container_select'><select name='input_122' id='input_23_122' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a Relation to Child<\/option><option value='Mom' >Mom<\/option><option value='Dad' >Dad<\/option><option value='Stepmother' >Stepmother<\/option><option value='Stepfather' >Stepfather<\/option><option value='Grandmother' >Grandmother<\/option><option value='Grandfather' >Grandfather<\/option><option value='Aunt' >Aunt<\/option><option value='Uncle' >Uncle<\/option><option value='Foster Parent' >Foster Parent<\/option><option value='Family Friend' >Family Friend<\/option><option value='Neighbor' >Neighbor<\/option><option value='Sibling' >Sibling<\/option><option value='Social Worker' >Social Worker<\/option><option value='Other Relative' >Other Relative<\/option><\/select><\/div><\/div><div id=\"field_23_38\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_38'>Secondary Legal Guardian Cell Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_38' id='input_23_38' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_40\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_40'>Secondary Legal Guardian Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_40' id='input_23_40' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_23_36\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_36'>Secondary Legal Guardian Employer<\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_23_36' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_39\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_39'>Secondary Legal Guardian Work Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_39' id='input_23_39' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_23_41\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Members Lives With<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_41'>\n\t\t\t<div class='gchoice gchoice_23_41_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Both'  id='choice_23_41_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_41_0' id='label_23_41_0' class='gform-field-label gform-field-label--type-inline'>Both<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_41_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Primary Guardian'  id='choice_23_41_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_41_1' id='label_23_41_1' class='gform-field-label gform-field-label--type-inline'>Primary Guardian<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_41_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Secondary Guardian'  id='choice_23_41_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_41_2' id='label_23_41_2' class='gform-field-label gform-field-label--type-inline'>Secondary Guardian<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_41_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Grandparent'  id='choice_23_41_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_41_3' id='label_23_41_3' class='gform-field-label gform-field-label--type-inline'>Grandparent<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_41_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='gf_other_choice'  id='choice_23_41_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_41_4' id='label_23_41_4' class='gform-field-label gform-field-label--type-inline'>Otro<\/label><br \/><input id='input_23_41_other' class='gchoice_other_control' name='input_41_other' type='text' value='Otro' aria-label='Si es otro, especif\u00edcalo, por favor'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_23_18' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_23_18' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_23_3' class='gform_page' data-js='page-field-id-18' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_23_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_23_42\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_42'>Please explain medical, physical, emotional or behavioral issues<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_42' id='input_23_42' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_23_43\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please check all that apply<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_23_43'><div class='gchoice gchoice_23_43_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.1' type='checkbox'  value='Asthma'  id='choice_23_43_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_1' id='label_23_43_1' class='gform-field-label gform-field-label--type-inline'>Asthma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.2' type='checkbox'  value='Diabetes'  id='choice_23_43_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_2' id='label_23_43_2' class='gform-field-label gform-field-label--type-inline'>Diabetes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.3' type='checkbox'  value='Hearing Impairment'  id='choice_23_43_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_3' id='label_23_43_3' class='gform-field-label gform-field-label--type-inline'>Hearing Impairment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.4' type='checkbox'  value='Visual Impairment'  id='choice_23_43_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_4' id='label_23_43_4' class='gform-field-label gform-field-label--type-inline'>Visual Impairment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.5' type='checkbox'  value='ADHD'  id='choice_23_43_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_5' id='label_23_43_5' class='gform-field-label gform-field-label--type-inline'>ADHD<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.6' type='checkbox'  value='Autism'  id='choice_23_43_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_6' id='label_23_43_6' class='gform-field-label gform-field-label--type-inline'>Autism<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.7' type='checkbox'  value='Seizures'  id='choice_23_43_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_7' id='label_23_43_7' class='gform-field-label gform-field-label--type-inline'>Seizures<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.8' type='checkbox'  value='Anxiety\/Depression'  id='choice_23_43_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_8' id='label_23_43_8' class='gform-field-label gform-field-label--type-inline'>Anxiety\/Depression<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.9' type='checkbox'  value='Oppositional Defiant Disorder'  id='choice_23_43_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_9' id='label_23_43_9' class='gform-field-label gform-field-label--type-inline'>Oppositional Defiant Disorder<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.11' type='checkbox'  value='Learning Disability'  id='choice_23_43_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_11' id='label_23_43_11' class='gform-field-label gform-field-label--type-inline'>Learning Disability<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_23_43_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.12' type='checkbox'  value='Other'  id='choice_23_43_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_43_12' id='label_23_43_12' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_23_44\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_44'>Other (Please Specify)<\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_23_44' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_45'>Allergies<\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_23_45' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_79\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_79'>Medications to be administered while attending BGCGM Program<\/label><div class='gfield_description' id='gfield_description_23_79'>If you enter information into this field, please download the <a href=\"https:\/\/bgcgm.org\/wp-content\/uploads\/2025\/02\/Medication-Policy-Information_Rev.2.5.25.pdf\" target=\"_blank\">BGCGM Medication Policy Information form<\/a> and return it when completed by the guardian and physician. <em>Child cannot attend our program until this is completed.<\/em><\/div><div class='ginput_container ginput_container_text'><input name='input_79' id='input_23_79' type='text' value='' class='large'  aria-describedby=\"gfield_description_23_79\"    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_48\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><b>EMERGENCY CONTACT PERSON(S)<\/b>\n<p>You are required to list <b><i>two additional people, who are not listed above as guardians<\/i><\/b> who live nearby and could assume responsibility for your child if you cannot be reached immediately in an emergency.<\/div><div id=\"field_23_129\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Emergency Contact #1<\/h3><\/div><div id=\"field_23_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_49'>Emergency Contact #1  - First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_23_49' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_123\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_123'>Emergency Contact #1 - Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_123' id='input_23_123' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_126\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_126'>Emergency Contact #1 - Relation to Child<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_126' id='input_23_126' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a Relation to Child<\/option><option value='Mom' >Mom<\/option><option value='Dad' >Dad<\/option><option value='Stepmother' >Stepmother<\/option><option value='Stepfather' >Stepfather<\/option><option value='Grandmother' >Grandmother<\/option><option value='Grandfather' >Grandfather<\/option><option value='Aunt' >Aunt<\/option><option value='Uncle' >Uncle<\/option><option value='Foster Parent' >Foster Parent<\/option><option value='Family Friend' >Family Friend<\/option><option value='Neighbor' >Neighbor<\/option><option value='Sibling' >Sibling<\/option><option value='Social Worker' >Social Worker<\/option><option value='Other Relative' >Other Relative<\/option><\/select><\/div><\/div><div id=\"field_23_51\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_51'>Emergency Contact #1 - Cell Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_51' id='input_23_51' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_128\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Emergency Contact #2<\/h3><\/div><div id=\"field_23_52\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_52'>Emergency Contact #2 - First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_23_52' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_125\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_125'>Emergency Contact #2 - Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_125' id='input_23_125' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_124\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_124'>Emergency Contact #2 - Relation to Child<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_124' id='input_23_124' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a Relation to Child<\/option><option value='Mom' >Mom<\/option><option value='Dad' >Dad<\/option><option value='Stepmother' >Stepmother<\/option><option value='Stepfather' >Stepfather<\/option><option value='Grandmother' >Grandmother<\/option><option value='Grandfather' >Grandfather<\/option><option value='Aunt' >Aunt<\/option><option value='Uncle' >Uncle<\/option><option value='Foster Parent' >Foster Parent<\/option><option value='Family Friend' >Family Friend<\/option><option value='Neighbor' >Neighbor<\/option><option value='Sibling' >Sibling<\/option><option value='Social Worker' >Social Worker<\/option><option value='Other Relative' >Other Relative<\/option><\/select><\/div><\/div><div id=\"field_23_54\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_54'>Emergency Contact #2 - Cell Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_54' id='input_23_54' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_55\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>In addition to legal\/secondary guardian and emergency contacts listed, the following people are <strong>ALLOWED<\/strong> to pick up my child<\/p><\/div><div id=\"field_23_132\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Pickup Contact #1<\/h3><\/div><div id=\"field_23_56\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_56'>Pickup #1 - First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_23_56' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_130\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_130'>Pickup #1 - Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_130' id='input_23_130' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_131\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_131'>Pickup #1 - Relation to Child<\/label><div class='ginput_container ginput_container_select'><select name='input_131' id='input_23_131' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a Relation to Child<\/option><option value='Mom' >Mom<\/option><option value='Dad' >Dad<\/option><option value='Stepmother' >Stepmother<\/option><option value='Stepfather' >Stepfather<\/option><option value='Grandmother' >Grandmother<\/option><option value='Grandfather' >Grandfather<\/option><option value='Aunt' >Aunt<\/option><option value='Uncle' >Uncle<\/option><option value='Foster Parent' >Foster Parent<\/option><option value='Family Friend' >Family Friend<\/option><option value='Neighbor' >Neighbor<\/option><option value='Sibling' >Sibling<\/option><option value='Social Worker' >Social Worker<\/option><option value='Other Relative' >Other Relative<\/option><\/select><\/div><\/div><div id=\"field_23_59\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_59'>Pickup #1 - Cell Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_59' id='input_23_59' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_133\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Pickup Contact #2<\/h3><\/div><div id=\"field_23_60\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_60'>Pickup #2 - First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_23_60' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_134\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_134'>Pickup #2 - Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_23_134' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_135\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_135'>Pickup #2 - Relation to Child<\/label><div class='ginput_container ginput_container_select'><select name='input_135' id='input_23_135' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a Relation to Child<\/option><option value='Mom' >Mom<\/option><option value='Dad' >Dad<\/option><option value='Stepmother' >Stepmother<\/option><option value='Stepfather' >Stepfather<\/option><option value='Grandmother' >Grandmother<\/option><option value='Grandfather' >Grandfather<\/option><option value='Aunt' >Aunt<\/option><option value='Uncle' >Uncle<\/option><option value='Foster Parent' >Foster Parent<\/option><option value='Family Friend' >Family Friend<\/option><option value='Neighbor' >Neighbor<\/option><option value='Sibling' >Sibling<\/option><option value='Social Worker' >Social Worker<\/option><option value='Other Relative' >Other Relative<\/option><\/select><\/div><\/div><div id=\"field_23_136\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_136'>Pickup #2 - Cell Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_136' id='input_23_136' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_63\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>The following people are <strong>NOT ALLOWED<\/strong> to pick up my child. Please submit any supporting legal documentation stating person cannot pick up.<\/p><\/div><div id=\"field_23_141\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Non-Pickup #1<\/h3><\/div><div id=\"field_23_64\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_64'>Non-Pickup #1 - First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_23_64' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_137\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_137'>Non-Pickup #1 - Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_137' id='input_23_137' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_138\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_138'>Non-Pickup #1 - Relation to Child<\/label><div class='ginput_container ginput_container_select'><select name='input_138' id='input_23_138' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a Relation to Child<\/option><option value='Mom' >Mom<\/option><option value='Dad' >Dad<\/option><option value='Stepmother' >Stepmother<\/option><option value='Stepfather' >Stepfather<\/option><option value='Grandmother' >Grandmother<\/option><option value='Grandfather' >Grandfather<\/option><option value='Aunt' >Aunt<\/option><option value='Uncle' >Uncle<\/option><option value='Foster Parent' >Foster Parent<\/option><option value='Family Friend' >Family Friend<\/option><option value='Neighbor' >Neighbor<\/option><option value='Sibling' >Sibling<\/option><option value='Social Worker' >Social Worker<\/option><option value='Other Relative' >Other Relative<\/option><\/select><\/div><\/div><div id=\"field_23_67\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_67'>Non-Pickup #1 - Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_67' id='input_23_67' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_142\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Non-Pickup #2<\/h3><\/div><div id=\"field_23_69\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_69'>Non-Pickup #2 - First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_23_69' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_139\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_139'>Non-Pickup #2 - Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_139' id='input_23_139' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_140\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_140'>Non-Pickup #2 - Relation to Child<\/label><div class='ginput_container ginput_container_select'><select name='input_140' id='input_23_140' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select a Relation to Child<\/option><option value='Mom' >Mom<\/option><option value='Dad' >Dad<\/option><option value='Stepmother' >Stepmother<\/option><option value='Stepfather' >Stepfather<\/option><option value='Grandmother' >Grandmother<\/option><option value='Grandfather' >Grandfather<\/option><option value='Aunt' >Aunt<\/option><option value='Uncle' >Uncle<\/option><option value='Foster Parent' >Foster Parent<\/option><option value='Family Friend' >Family Friend<\/option><option value='Neighbor' >Neighbor<\/option><option value='Sibling' >Sibling<\/option><option value='Social Worker' >Social Worker<\/option><option value='Other Relative' >Other Relative<\/option><\/select><\/div><\/div><div id=\"field_23_71\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_71'>Non-Pickup #2 - Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_71' id='input_23_71' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_23_68\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_23_68'>Legal Documentation<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_23_68' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_23_68&quot;,&quot;container&quot;:&quot;gform_multifile_upload_23_68&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_23_68&quot;,&quot;filelist&quot;:&quot;gform_preview_23_68&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/?gf_page=ffe50fa45683e9b&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Archivos permitidos&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;8388608b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:23,&quot;field_id&quot;:68,&quot;_gform_file_upload_nonce_23_68&quot;:&quot;1978b15013&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_23_68&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_23_68' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Suelta archivos aqu\u00ed o <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_23_68' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_23_68\"  >Selecciona archivos<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_23_68'>Tipos de archivos aceptados: pdf, Tama\u00f1o m\u00e1ximo de archivo: 8 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_23_68'><\/ul> <div id='gform_preview_23_68' class='ginput_preview_list'><\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_23_19' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_23_19' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_23_4' class='gform_page' data-js='page-field-id-19' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_23_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_23_72\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>I agree to follow the rules and policies explained in the Member Behavioral Expectations of Boys & Girls Clubs of Greater Manchester (BGCGM). I realize that membership to BGCGM is a privilege, and if my child\/children or myself, can't follow the rules and policies, the Club membership could be in jeopardy, leading to possible removal. I understand that if a member is suspended or expelled from BGCGM\u2019s programs, a refund is not guaranteed and is at the discretion of management. I understand that under the behavior management protocol, BGCGM reserves the right to suspend a member from the program and bussing effective the next day, so it is my responsibility to make alternative care arrangements in advance. I know BGCGM has an open-door policy for their Union Street Clubhouse for members in grades 6-12.<\/p>\n\n<p>I understand that:<\/p>\n<ul>\n<li>BGCGM Union Street Clubhouse is not subject to licensure under RSA 170-E:4. Parents or guardians must go through the Unit Director and Program Director at (603) 625-5982 with all grievances concerning the Club\u2019s program, who will inform the appropriate Club contact. <\/li>\n<li>Photographs in which my child appears have the chance to be used in Club marketing materials, promotions, recognition, displays, and other Club-related publicity. In addition, the Club can upload all photographs and videos in which my child may appear on official BGCGM social media sites and websites.<\/li>\n<li>Members whose parents\/guardians give permission to attend a Club field trip, consent to their child potentially having their photograph\/video taken by the host of the field trip during the activity. <\/li>\n<li>My child will have the opportunity to complete Club surveys used to measure the effectiveness of the Club program. <\/li>\n<li>I realize my child\/children may participate in activities and programs that are physical and, as a result, may be at risk for injury. In consideration for being allowed to participate in any activities, I agree to assume such risk and further agree to hold harmless BGCGM, its staff, and volunteers from any claims, suits, losses, or related causes of actions for damages including, but not limited to, such claims that may result from injury or death, accidental or otherwise, during, or arising in any way from the participation in the activities of the program. <\/li>\n<li>The Club Tax ID is on receipts given at the time of payment and can be found on our website. We will share information about how to locate your year-end tax statements in January. <\/li>\n<li>For member security and safety, individuals in our facilities and riding in our vehicles may be under video surveillance. <\/li>\n<li>Grade K-Grade 5 members are not allowed to use their internet-capable devices while at the Club, and grade 6-12 members are permitted under staff supervision. All members using a Club internet-capable device will only be allowed under staff supervision and is subject to site filtering. <\/li>\n<li>Continued membership to BGCGM is determined based on the child\u2019s behavior and the behavior of the parent\/guardian. <\/li>\n<li>If I need to withdraw my child from a program, a two-week written notice is required and can be sent to frontdesk@bgcgm.org. <\/li>\n<li>The membership fee is non-refundable. <\/li>\n<\/ul>\n<br>\n<p>\n    <strong>School Program Payments:        <\/strong> All weekly fees are due on Friday for School Year program payments. If payments are late, a $10 late fee will be added to your account. If you are late three times, you will be required to enroll in autopay with a valid checking\/savings account or credit\/debit card. If autopay is declined twice, your only option to remain in the program is to pre-pay the fees for the remainder of the year. If you miss your payment two weeks in a row, we will remove your child\/children from our program. Payments can be made through your account, in person, or by calling the office.\n<\/p>\n\n<p>\n    <strong>Summer Program Payments:<\/strong> All weekly fees are due on Monday for summer program payments. If payments are late, a $10 late fee will be added to your account. If your payment and late fee are not paid by the end of day on Wednesday, your deposit will be forfeited, and your spot will not be held. Payments can be made through your account at myprocare.com, in person, or by calling the office. \n<\/p>\n\n<p>\n   Please direct any questions regarding your account to the Front Desk at (603) 625-5982 x225 or <a href=\"mailto:frontdesk@bgcgm.org\">frontdesk@bgcgm.org<\/a>\n<\/p><\/div><div id=\"field_23_74\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_74'>Total Number Living in Household<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_74' id='input_23_74' type='number' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_23_75\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please select your total household income<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_75'>\n\t\t\t<div class='gchoice gchoice_23_75_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='$0-21,000'  id='choice_23_75_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_75_0' id='label_23_75_0' class='gform-field-label gform-field-label--type-inline'>$0-21,000<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_75_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='$21,001-35,000'  id='choice_23_75_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_75_1' id='label_23_75_1' class='gform-field-label gform-field-label--type-inline'>$21,001-35,000<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_75_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='$35,001-55,950'  id='choice_23_75_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_75_2' id='label_23_75_2' class='gform-field-label gform-field-label--type-inline'>$35,001-55,950<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_75_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='$55,951+'  id='choice_23_75_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_75_3' id='label_23_75_3' class='gform-field-label gform-field-label--type-inline'>$55,951+<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_23_76\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-three-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_76'>Guardian Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><input type='hidden' value='' name='input_76' id='input_23_76_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_23_76_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_23_76' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/bgcgm.org\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_23_76_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_23_76_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_23_76_data' name='input_23_76_data' value=''><\/div><\/div><div id=\"field_23_77\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_77'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_77' id='input_23_77' type='text' value='06\/04\/2026' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/aaaa' aria-describedby=\"input_23_77_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_23_77_date_format' class='screen-reader-text'>MM barra DD barra AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_23_77' class='gform_hidden' value='https:\/\/bgcgm.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_23_80' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_23_80' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_23_5' class='gform_page' data-js='page-field-id-80' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_23_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_23_161\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><strong>BGCGM provides Before School transportation from the Union Street Clubhouse to all MSD elementary and middle schools.<\/strong><\/p>\n\n<p><strong>BGCGM provides After School transportation from all MSD elementary and middle schools to the Union Street Clubhouse or the Jordan Singer Youth Enrichment Center, with the exception of Highland-Goffe's Falls and Jewett Street - which each have their own After School Program onsite.<\/strong><\/p><\/div><div id=\"field_23_162\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_162'>School the member will be attending in Fall 2026:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_162' id='input_23_162' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>School the member will be attending in Fall 2026:<\/option><option value='Elementary School: Bakersville' >Elementary School: Bakersville<\/option><option value='Elementary School: Beech Street' >Elementary School: Beech Street<\/option><option value='Elementary School: Gossler Park (JSYEC)' >Elementary School: Gossler Park (JSYEC)<\/option><option value='Elementary School: Green Acres' >Elementary School: Green Acres<\/option><option value='Elementary School: Highland-Goffe&#039;s Falls' >Elementary School: Highland-Goffe&#039;s Falls<\/option><option value='Elementary School: Jewett Street' >Elementary School: Jewett Street<\/option><option value='Elementary School: McDonough' >Elementary School: McDonough<\/option><option value='Elementary School: Northwest (JSYEC)' >Elementary School: Northwest (JSYEC)<\/option><option value='Elementary School: Parker-Varney (JSYEC)' >Elementary School: Parker-Varney (JSYEC)<\/option><option value='Elementary School: Smyth Road' >Elementary School: Smyth Road<\/option><option value='Elementary School: Webster' >Elementary School: Webster<\/option><option value='Elementary School: Weston' >Elementary School: Weston<\/option><option value='Middle School: Hillside' >Middle School: Hillside<\/option><option value='Middle School: McLaughlin' >Middle School: McLaughlin<\/option><option value='Middle School: Parkside' >Middle School: Parkside<\/option><option value='Middle School: Southside' >Middle School: Southside<\/option><\/select><\/div><\/div><fieldset id=\"field_23_155\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What grade will the member be attending in Fall 2026?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_23_155'>Members in grades 6-8, who DO NOT need transportation are eligible for the one-time $10 Tween\/Teen annual membership. Please complete the Tween\/Teen Membership Application.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_155'>\n\t\t\t<div class='gchoice gchoice_23_155_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='K-1'  id='choice_23_155_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_23_155\"   \/>\n\t\t\t\t\t<label for='choice_23_155_0' id='label_23_155_0' class='gform-field-label gform-field-label--type-inline'>K-1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_155_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='2-3'  id='choice_23_155_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_155_1' id='label_23_155_1' class='gform-field-label gform-field-label--type-inline'>2-3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_155_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='4-5'  id='choice_23_155_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_155_2' id='label_23_155_2' class='gform-field-label gform-field-label--type-inline'>4-5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_155_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='6-8'  id='choice_23_155_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_155_3' id='label_23_155_3' class='gform-field-label gform-field-label--type-inline'>6-8<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_23_156\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-third gfield_price gfield_price_23_156 gfield_product_23_156 gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What program will the member need?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_156'>\n\t\t\t<div class='gchoice gchoice_23_156_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='After School Program Only ($105)|105'  id='choice_23_156_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_156_0' id='label_23_156_0' class='gform-field-label gform-field-label--type-inline'>After School Program Only ($105)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_156_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='Before School Program Only ($75)|75'  id='choice_23_156_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_156_1' id='label_23_156_1' class='gform-field-label gform-field-label--type-inline'>Before School Program Only ($75)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_156_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='Before &amp; After School Programs ($140)|140'  id='choice_23_156_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_156_2' id='label_23_156_2' class='gform-field-label gform-field-label--type-inline'>Before &amp; After School Programs ($140)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_156_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='Sites Only: Part Time - 10 Days|0'  id='choice_23_156_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_156_3' id='label_23_156_3' class='gform-field-label gform-field-label--type-inline'>Sites Only: Part Time - 10 Days<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_23_176\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-third gfield_price gfield_price_23_176 gfield_product_23_176 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Sites Only: Part Time - 10 Days<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_176'>\n\t\t\t<div class='gchoice gchoice_23_176_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_176' type='radio' value='Sites Only: Part Time - 10 Days ($210)|210'  id='choice_23_176_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_176_0' id='label_23_176_0' class='gform-field-label gform-field-label--type-inline'>Sites Only: Part Time - 10 Days ($210)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_23_157\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-third gfield_price gfield_price_23_157 gfield_product_23_157 gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What program will the member need?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_157'>\n\t\t\t<div class='gchoice gchoice_23_157_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='After School Program Only ($65)|65'  id='choice_23_157_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_157_0' id='label_23_157_0' class='gform-field-label gform-field-label--type-inline'>After School Program Only ($65)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_157_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='Before School Program Only ($65)|65'  id='choice_23_157_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_157_1' id='label_23_157_1' class='gform-field-label gform-field-label--type-inline'>Before School Program Only ($65)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_157_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='Before &amp; After School Programs ($75)|75'  id='choice_23_157_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_157_2' id='label_23_157_2' class='gform-field-label gform-field-label--type-inline'>Before &amp; After School Programs ($75)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_23_120\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Military Household<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_120'>\n\t\t\t<div class='gchoice gchoice_23_120_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_120' type='radio' value='No'  id='choice_23_120_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_120_0' id='label_23_120_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_120_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_120' type='radio' value='Yes'  id='choice_23_120_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_120_1' id='label_23_120_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_23_165\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-half gfield_price gfield_price_23_165 gfield_product_23_165 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Membership Fees<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_23_165'>Membership fees are non-refundable<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_23_165'>\n\t\t\t<div class='gchoice gchoice_23_165_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='First Member ($25)|25'  id='choice_23_165_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_23_165\"   \/>\n\t\t\t\t\t<label for='choice_23_165_0' id='label_23_165_0' class='gform-field-label gform-field-label--type-inline'>First Member ($25)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_165_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='Second Member ($20)|20'  id='choice_23_165_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_165_1' id='label_23_165_1' class='gform-field-label gform-field-label--type-inline'>Second Member ($20)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_23_165_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='Third Member ($15)|15'  id='choice_23_165_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_23_165_2' id='label_23_165_2' class='gform-field-label gform-field-label--type-inline'>Third Member ($15)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_23_168\" class=\"gfield gfield--type-quantity gfield--input-type-number gfield--width-half gfield_price gfield_price_23_156 gfield_quantity gfield_quantity_23_156 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Este campo est\u00e1 oculto cuando se visualiza el formulario\"><\/i><span>Este campo est\u00e1 oculto cuando se visualiza el formulario<\/span><\/div><label class='gfield_label gform-field-label' for='input_23_168'>Quantity<\/label><div class='gfield_description' id='gfield_description_23_168'>K-1; 2-3; 4-5<\/div><div class='ginput_container ginput_container_number'><input name='input_168' id='input_23_168' type='number' step='any'   value='2' class='large'      aria-invalid=\"false\" aria-describedby=\"gfield_description_23_168\" \/><\/div><\/div><div id=\"field_23_169\" class=\"gfield gfield--type-quantity gfield--input-type-number gfield--width-half gfield_price gfield_price_23_157 gfield_quantity gfield_quantity_23_157 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Este campo est\u00e1 oculto cuando se visualiza el formulario\"><\/i><span>Este campo est\u00e1 oculto cuando se visualiza el formulario<\/span><\/div><label class='gfield_label gform-field-label' for='input_23_169'>Quantity<\/label><div class='gfield_description' id='gfield_description_23_169'>6-8<\/div><div class='ginput_container ginput_container_number'><input name='input_169' id='input_23_169' type='number' step='any'   value='2' class='large'      aria-invalid=\"false\" aria-describedby=\"gfield_description_23_169\" \/><\/div><\/div><div id=\"field_23_159\" class=\"gfield gfield--type-total gfield--input-type-total gfield--width-full gfield_price gfield_price_23_ gfield_total gfield_total_23_ field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" ><label class='gfield_label gform-field-label' for='input_23_159'>Total Fee Due at Time of Registration: Membership Fee + Two Weeks of Program Fees<\/label><div class='gfield_description' id='gfield_description_23_159'>Payment will not be collected online. A BGCGM member will contact you to ensure the application is completed, and collect payment over the phone or in person.<\/div><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_159' id='input_23_159' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_23' \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_23_96\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><strong>GUARDIANS - IMPORTANT - PLEASE READ CAREFULLY.<\/strong>\n<ul>\n<li>Weekly payments are due by 6PM on Fridays every week regardless of the number of days your child attends or the number of days of school that week. Please see the provided Operating Calendar for when payments are due.\n<li>A $10 late fee will be added to all accounts paid late. Consistent late payments can be reason for suspension from the program. \n<li>Should the Club or site be closed at the end of a week, then payments will need to be made no later than the first day the Club or site is open for the following week.\n<li>Payments may be placed in the drop box at the program site. If paying by check, please put the member\u2019s name in the memo area of the check for clear identification. No receipt is given for payment by check. If you pay by cash, please enclose it in an envelope with the member\u2019s name on it and request a receipt from a member of the site staff.  \n<li>All cancellations must be submitted in writing to the Union Street Clubhouse Administrative Office or frontdesk@bgcgm.org. You will be billed for services until written notification is received. \n<li>In the event of a mistake in logging your payment, you must provide the canceled check or cash receipt to verify payment.  \n<li>There are 38 payments for the School Year Program. The first two weeks of programming are paid for at the time of registration. Weekly fees remain the same regardless of how many days of the week we are open. \n<li>If you choose to pay by the month, please be aware that some months may have 5 payments due during that month. It is your responsibility to make the appropriate payment for the month. Should you not make the correct payment, you will receive a late payment notice for the fifth week, and you will be obligated to pay the associated late fee.  \n<li>All payments are entered, and late payment notices are prepared at the Administrative Office. All questions regarding the status of your child\u2019s account should be directed to the Administrative Office, which can be reached at (603) 625-5982, ext. 225. Please email frontdesk@bgcgm.org if you need a receipt for childcare reimbursement funds\/programs.\n<\/ul><\/div><div id=\"field_23_117\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-two-thirds gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_117'>Guardian Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><input type='hidden' value='' name='input_117' id='input_23_117_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_23_117_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_23_117' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/bgcgm.org\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_23_117_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_23_117_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_23_117_data' name='input_23_117_data' value=''><\/div><\/div><div id=\"field_23_118\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_118'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_118' id='input_23_118' type='text' value='06\/04\/2026' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/aaaa' aria-describedby=\"input_23_118_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_23_118_date_format' class='screen-reader-text'>MM barra DD barra AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_23_118' class='gform_hidden' value='https:\/\/bgcgm.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_23_171\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><strong>DOCUMENT UPLOAD<\/strong>\n<p>\n<\/div><div id=\"field_23_143\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_23_143'>CHILD CARE REGISTRATION &amp; EMERGENCY REGISTRATION FORM<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_143'><p>The State of NH requires the Child Care Registration & Emergency Registration Form to be completed and returned to the state for each child attending one of our sites: Highland-Goffe\u2019s Falls, Jewett Street, or the Jordan Singer Youth Enrichment Center (which includes Gossler Park, Northwest, and Parker-Varney). We will return the completed form to the State on your behalf.<\/p><\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_23_143' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_23_143&quot;,&quot;container&quot;:&quot;gform_multifile_upload_23_143&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_23_143&quot;,&quot;filelist&quot;:&quot;gform_preview_23_143&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/?gf_page=ffe50fa45683e9b&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Archivos permitidos&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;8388608b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:23,&quot;field_id&quot;:143,&quot;_gform_file_upload_nonce_23_143&quot;:&quot;79d38b4a06&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_23_143&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_23_143' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Suelta archivos aqu\u00ed o <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_23_143' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_23_143 gfield_description_23_143\"  >Selecciona archivos<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_23_143'>Tipos de archivos aceptados: pdf, Tama\u00f1o m\u00e1ximo de archivo: 8 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_23_143'><\/ul> <div id='gform_preview_23_143' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_23_173\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_23_173'>PHYSICIAN\u2019S STATEMENT &amp; IMMUNIZATION RECORD<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_173'><p>State law requires BGCGM to collect and file <strong>medical examinations and immunization records for every member. The physical examination must have been completed in the last 24 months.<\/strong> We do not keep medical records from previous years or programs, even if they aren't expired. All medical documents are due at the time of registration. If you do not upload the forms below, we will be unable to register your child for the program. There are no exceptions.<\/p><\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_23_173' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_23_173&quot;,&quot;container&quot;:&quot;gform_multifile_upload_23_173&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_23_173&quot;,&quot;filelist&quot;:&quot;gform_preview_23_173&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/?gf_page=ffe50fa45683e9b&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Archivos permitidos&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;8388608b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:23,&quot;field_id&quot;:173,&quot;_gform_file_upload_nonce_23_173&quot;:&quot;bae71c40b7&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_23_173&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_23_173' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Suelta archivos aqu\u00ed o <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_23_173' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_23_173 gfield_description_23_173\"  >Selecciona archivos<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_23_173'>Tipos de archivos aceptados: pdf, Tama\u00f1o m\u00e1ximo de archivo: 8 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_23_173'><\/ul> <div id='gform_preview_23_173' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_23_172\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_23_172'>COMMUNITY IMPROVEMENT PROGRAM<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_172'><p>Our program has benefited from funding provided by the City of Manchester Community Improvement Program, through the U.S. Housing and Urban Development Community Development Block Grant Program. The Program requests income verification and other statistics from applicants. This information will not be shared and will remain confidential.<\/p><\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_23_172' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_23_172&quot;,&quot;container&quot;:&quot;gform_multifile_upload_23_172&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_23_172&quot;,&quot;filelist&quot;:&quot;gform_preview_23_172&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/?gf_page=ffe50fa45683e9b&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Archivos permitidos&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;8388608b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:23,&quot;field_id&quot;:172,&quot;_gform_file_upload_nonce_23_172&quot;:&quot;fa7020b18e&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_23_172&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_23_172' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Suelta archivos aqu\u00ed o <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_23_172' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_23_172 gfield_description_23_172\"  >Selecciona archivos<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_23_172'>Tipos de archivos aceptados: pdf, Tama\u00f1o m\u00e1ximo de archivo: 8 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_23_172'><\/ul> <div id='gform_preview_23_172' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_23_174\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_23_174'>MANCHESTER SCHOOL DISTRICT: CONSENT FOR RELEASE OF STUDENT RECORDS<\/label><div class='gfield_description' id='gfield_description_23_174'><p>By completing this form you are agreeing for our Educational Director, Director of Teen Engagement & Resources, and Director of Programs & Leadership to access the members student records. While this is NOT required, we highly encourage families to enroll in this program so our team can assist for the well-being of the member.<\/p><\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_23_174' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_23_174&quot;,&quot;container&quot;:&quot;gform_multifile_upload_23_174&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_23_174&quot;,&quot;filelist&quot;:&quot;gform_preview_23_174&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/?gf_page=ffe50fa45683e9b&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/bgcgm.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Archivos permitidos&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;8388608b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:23,&quot;field_id&quot;:174,&quot;_gform_file_upload_nonce_23_174&quot;:&quot;d7d4fa5bc8&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_23_174&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_23_174' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Suelta archivos aqu\u00ed o <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_23_174' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_23_174 gfield_description_23_174\"  >Selecciona archivos<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_23_174'>Tipos de archivos aceptados: pdf, Tama\u00f1o m\u00e1ximo de archivo: 8 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_23_174'><\/ul> <div id='gform_preview_23_174' class='ginput_preview_list'><\/div><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_23' class='gform_previous_button 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Ya no aceptamos solicitudes online, y nuestro programa finaliza el martes 16 de junio de 2026. \u00a1La Solicitud para el Programa del A\u00f1o Escolar 2026-2027 estar\u00e1 disponible el lunes 8 de junio! \u00a1Aseg\u00farate de volver aqu\u00ed para inscribirte en nuestros [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":0,"parent":12200,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-17118","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Boys &amp; Girls Clubs of Greater Manchester Solicitud para el A\u00f1o Escolar<\/title>\n<meta name=\"description\" content=\"Los Boys &amp; Girls Clubs of Greater Manchester ofrecen programas antes y despu\u00e9s de la escuela para padres ocupados que necesitan un entorno seguro para sus hijos.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/bgcgm.org\/es\/programs\/solicitud-para-el-ano-escolar-3\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Boys &amp; 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