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) Preschool Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Name of School Gender * Male Female Other Prefer not to say Allergies? * Yes No Describe Allergies Add Child 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
