LWW Charms Registration
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Student Lincoln-Way ID
Student First Name *
Student Last Name *
Grade for 2021-2022 School Year *
Birth Date *
MM
/
DD
/
YYYY
Gender *
Student Street Address *
Student City *
Student Zip Code *
Student Home Phone *
Primary Family Email Address *
Parent 1 Name *
Parent 1 Address *
Parent 1 Work Phone *
Parent 1 Cell Phone *
Parent 1 Email Address *
Parent 2 Name
Parent 2 Address
Parent 2 Work Phone
Parent 2 Cell Phone
Parent 2 Email Address
List all Ensembles you know student will participate in *
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