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
Sign in to Google
to save your progress.
Learn more
* Required
Group class name
Answer only if you're taking a group class
Your answer
First Name
*
Student
Your answer
Last Name
*
Student
Your answer
Birthdate
MM
/
DD
/
YYYY
School Name
Your answer
Grade
*
Your answer
Age
*
Your answer
Male or Female
Male
Female
Parents' Names
*
Your answer
Teacher's Name
Info needed only for School classes
Your answer
Home Phone
*
Your answer
Cellular Phone
*
Your answer
E-mail address
*
Your answer
Address
Your answer
Emergency Contact Name and Phone number
Your answer
Payment amount
Your answer
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.
Cash
Check
Paypal
Other:
Required
Special Needs/Allergies/Concerns
*
Your answer
PHOTO/VIDEO RELEASE
I give my permission to Lake Norman Language Academy, Inc. to use photos/videos of my child/children on its social media and/or in printed materials, and in electronic forms of communication. By signing your child to this class you agree to this. Gracias!
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
