Lancer Head Start Registration Form 2021
Please complete the following questions to register your student.  You will receive an email upon the completion of the form for verification and you are able to go back and change your responses until June 14, 2021.
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Student's First Name *
Student's Last Name: *
School Your Child Currently Attends: *
T-Shirt Size? *
Please list below any allergies and/or medical conditions your child has that we should be aware of.
Parent/Guardian - First Name: *
Parent/Guardian - Last Name: *
Parent Contact/Guardian - Phone Number: *
Parent Contact/Guardian - Email: *
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