Back to School with LBC Registration Form
Please complete all required boxes to reserve your spot
Email *
Name *
Date of Birth *
MM
/
DD
/
YYYY
Grade *
Gender *
Address *
Email *
Parent's Phone number
Subjects *
Required
In Submitting This Application, I agree to the following: that the camp reserves the right to photograph and/or videotape all camp programs and use the images for promotional purposes, unless notified by the parent/guardian in writing on or before the first day of camp; that the information in the camper application is true and correct. Sign your name below:
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