Lumberjack Learning League  Enrollment Form
Please fill out the following information to enroll your child in the learning program by the deadline of May 31st, 2024. 
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Date
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DD
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YYYY
Student Name 
Your child's date of birth
MM
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DD
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YYYY
School your child attends
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Your child's  address
Parent/Guardian Name
Parent/Guardian address- if different from the student's
Parent/Guardian Phone number
My child will attend the following session(s): Check all that applies
Transportation will be provided to and from the program.  Please indicate your child's mode of transportation. 
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Bus Riders only:   Please list your address your child will need to be dropped off at if attending the after school program
Individuals with permission to pick my child up or check my child out
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Name of person, other than parent/guardian, authorized to act for the parent/guardian in case of emergency:
Any allergies or medical needs:
I understand that my child is required to participate at least 75% of the time.  I have received, read, and understand the student handbook.  I understand my child must attend 75% of the time in order to attend field trips. 
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