EYH Lake County On-Site Registration
Student First Name *
Your answer
Student Last Name *
Your answer
Street Address *
Your answer
City/Town *
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Zip Code *
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Phone Number w/ Area Code *
Your answer
Parent Name *
Your answer
Parent Phone Number w/ Area Code *
Your answer
Parent Email Address *
Your answer
Which school does the student attend? *
Your answer
Grade *
Who is attending? *
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