Lake Norman Language Academy                  Children's/ Teens Registration Form
We appreciate your interest in the classes! Muchas gracias!
You can reach us at info@LKNLanguageAcademy.com Phone: 704-253-3361 www.LKNLanguageAcademy.com 
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Group class name
Answer only if you're taking a group class
First Name *
Student
Last Name *
Student
Birthdate
MM
/
DD
/
YYYY
School Name
Grade *
Age *
Male or Female
Parents'  Names *
Teacher's Name
Info needed only for School classes
Home Phone *
Cellular Phone *
E-mail address *
Address
Emergency Contact Name and Phone number
Payment amount
Payment Type *
Payment must be made in order to complete your registration process. Please make checks payable to Lake Norman Language Academy and mail it to 104 Trotter Ridge Dr. Mooresville, NC 28117.
Required
Special Needs/Allergies/Concerns *
Using Photos or Videos on Social Media/Website

During our awesome classes or events, we might take photos or videos to share the fun on our social media, website or promotional material.

By participating, you agree that we can use any photos or videos featuring you. This could include sharing on our social media, website, publications, advertisement, or in promotional materials.

We won't sell these images or videos, and you won't get paid for them. But we promise to use them to show how amazing our classes and events are!

If you're under 18, please ask your parent or guardian to give their okay.

Let us know if you have any concerns or don't want your images shared. Just send us an email.

Thanks for being part of our Family!


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