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Naperville youth club
Virtual after school program
Registration-Permission Form 2020-2021

  • MM slash DD slash YYYY
  • Emergency Contacts
  • In order to participate in virtual after-school, you will need to provide:
    • A Zoom compatible device (computer, tablet, smartphone) with audio and video always on
    • Current email address to receive video meeting invitations
    • Current phone numbers of parent/guardian and student that staff can use to coordinate meetings
    • Appropriate attire and decorum
  • Parental Consent for Zoom Virtual Tutoring

    Naperville Youth Club (NYC) will provide a virtual after-school program using web-based Zoom as the video platform. NYC’s tutorial staff will monitor student activity on this platform and adhere to Zoom’s safety and privacy standards. As the Parent/Guardian of the above student, I give my permission for my child’s participation in this distance-based online tutoring program. I also agree to allow release of my child’s grades from his/her school to monitor success in this program.

  • Need submit /apply and payment options here.

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Phone Number:


Company Address:

P.O. Box 9190
Naperville, IL 60567