Learning Lab Registration - Laveen School District
Parents – Please complete a separate Learning Lab Registration form for each child. Acceptance will be based on need and capacity within each school site. Acceptance of enrollment must be approved by the school office prior to the student attending the Learning Lab.
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Student's LAST Name *
Student's FIRST Name *
Student's ID Number  (This number can be accessed from ParentVUE.) *
School of Attendance *
Current Grade Level *
Please indicate what support your student needs. *
Required
If your student receives special education services, please indicate what service model he/she receives.
Please indicate which days you would like for your student to attend the Learning Lab. *
Required
How will your student arrive to the Learning Lab? *
How will your student depart from the Learning Lab? *
Health Information:  Does your child take daily medication? *
Health Information:  Please list any health conditions or allergies your child has.
Parent/Guardian email *
Parent/Guardian phone number *
Emergency Contact Information:  Include name, email, and phone number
By adding my name below, I confirm that I am the legal parent/guardian of this student and that all information provided is accurate. (Please type your name below.) *
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