Register for LFC Membership (Afterschool or Program) Membership Signup w Child Registration Form Parent/Guardian Information Guardian's First Name * First Guardian's Last Name * Last Email Guardian's Phone Number * Address * Address Address Address City City State State Zip Zip Child Information Name * Last * Date of Birth Current Grade (next grade if Summer) PreschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th Grade Name of School Gender * Male Female Other Prefer not to say Allergies? * Yes No Describe Allergies plus1 Add Child minus1 Remove Emergency Contact E.C. First Name First E.C. Last Name * Last E.C. Phone Number If you are human, leave this field blank. Submit
