Lake Norman Language Academy Childrens/ 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
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 *
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!
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy