Buffalo Grove Park District On-Line Registration

 

To register for Buffalo Grove Park District programs on-line, an on-line account needs to be created.  Once you complete the form below we will issue you a Family Account Number and individual Participant Identification Codes for each member of your household.  You will need both these numbers to complete the registration process on-line.  

If you are new to the Buffalo Grove Park District you may be asked to provide proof of residency.

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 Household Information:

 
  Street Address*                                                                         Town*

            
  Home Phone*                                             Household's Main Contact Email Address*


  Alternate Phone*                                       Note: Household's Main Contact must be parent or head of household 
                                                                           and listed as Family Member 1 below.

Family Members: (must live at address listed above)

 Family Member 1* 
 Last Name*                           First*                        Date of Birth*       Current Grade         Gender*
                                                                               (i.e. 1/17/68)            (for children only)
                                  

 Family Member 2
 Last Name                            First                           Date of Birth          Current Grade        Gender
                                                                               (i.e. 1/17/68)            (for children only)
                                  
 If different than above

 Family Member 3 
 Last Name                            First                           Date of Birth          Current Grade        Gender
                                                                               (i.e. 1/17/68)            (for children only)
                                  
 If different than above

 Family Member 4
 Last Name                            First                           Date of Birth          Current Grade        Gender
                                                                               (i.e. 1/17/68)            (for children only)
                                  
 If different than above

 Family Member 5
 Last Name                            First                           Date of Birth          Current Grade        Gender
                                                                               (i.e. 1/17/68)           (for children only)
                                  
 If different than above

 Family Member 6
 Last Name                            First                           Date of Birth          Current Grade        Gender
                                                                               (i.e. 1/17/68)            (for children only)
                                  
 If different than above

 Family Member 7
 Last Name                            First                           Date of Birth          Current Grade        Gender
                                                                               (i.e. 1/17/68)           (for children only)
                                  
 If different than above

 Family Member 8
 Last Name                            First                           Date of Birth          Current Grade        Gender
                                                                               (i.e. 1/17/68)            (for children only)
                                  
 If different than above

 * Indicates a required field
  Please also note that First Name, Date of Birth, Gender and Grade (for kids) is required for all family members listed.

If you prefer to manually fill out a form and fax it in or drop it off at the Alcott Center, here is a printable form:

Buffalo Grove Online Registration Form**
**Adobe Acrobat Format - PDF (Adobe.com)

The information submitted above will be sent via email to the Buffalo Grove Park District.  This information will be utilized by the Buffalo Grove Park District for the purpose of establishing your online account, and will not be distributed to any other agency or organization.

If any of your information changes in the future, please contact Robin Racusen at 847-850-2103.