Register Your Organization

In order to be eligible to become a provider you must complete the following application. Once you submit the application we will review it and contact you shortly thereafter.

Don’t want to register online? Print our Provider Application, fill it out, and mail it to:

Opportunities for Kids
P.O. Box 2075
Fallbrook, CA 92088

Name of Owner/Contact:

Name of Business (if applicable):

Are you a(n):
Indvidual
Company
Nonprofit Organization
Other

Activity that you will be providing:

Federal EIN:

State or City Licenses:

Years of experience providing this activity:

Other information verifying the legitimacy of your organization:

Business Address

Number and Street:

City: State: Exceeded maximum number of characters. Zip: Exceeded maximum number of characters.

If this address is not the same address where the activities will take place please fill in the following:

Actvity Address

Number and Street

City: State: Exceeded maximum number of characters. Zip: Exceeded maximum number of characters.

Telephone:

Cell Phone:

Email:

I agree to the terms of this registration:

All funds provided by Opportunities for Kids shall be used to support the child in the activity in which they participate as identified on the child’s Application for Assistance.
If the child does not take part in the activity, or if there are any funds that for any reason are unused, the funds shall be promptly returned to Opportunities for Kids.
All information provided by the child on the Application for Assistance shall be anonymous and shall not be revealed to anyone except Opportunities for Kids.
All laws, regulations, codes, and other government requirements pertaining to the organization and/or person(s) that provide and/or conduct the activity in which the child participates shall be complied with.
All laws, regulations, codes, and other government requirements pertaining to the activity in which the child participates shall be complied with.
The organization and/or person(s) providing and/or conducting the activities shall ensure that all requirements necessary for the child to participate in the activity shall be complied with.
To the fullest extent of the law Opportunities for Kids shall not be held liable for any known or unknown injuries or disabilities, or death, or any other damages resulting from the child participating in or having participated in the activities supported by Opportunities for Kids.

I agree to the terms of this registration. You must agree to the terms.