LCCS Summer Program Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in Lake Center Christian School summer programs and camps. Please complete a registration form for each student you are registering.

You will receive a confirmation email and any applicable contracts via email once this registration is processed. Please direct any questions to Kelly Carlson, Summer Program Coordinator, 330-877-2049 ext. 3020 kcarlson@lccs.com

Email *

Parent/Guardian first name *

Parent/Guardian last name *

What is the best way to contact you? *

E-mail

Home Phone

Cell Phone

Required

What is your home phone number?

What is your cell phone number?

How are you related to the student/s? *

Guardian

Grandparent

Parent

Other:

Required

Emergency Contact Name and relation to student *

Emergency Contact Phone Number *

Clear form

Never submit passwords through Google Forms.

This form was created inside of Lake Center Christian School. Report Abuse

Forms