Registration

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Child's Name (first & last)

Your Email

Your Name (first & last)

Your Contact Number

School? State?

Yes! I'd like to register a child for New York or Boston Program!

Are you a?

Parent

Teacher

Counselor

Other

Yes! I'd like to register a child for the Buddy Up House Party! (additional fee)

How did you hear about the program?

From school

From a parent

From the website

Other

I agree for my son(s) to participate in The Boys Room.

Thanks for submitting!

**All costs and fees associated with The Boys' Room and Buddy Up House Party Programs are non-refundable.

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