Community. Care. Growth.

Forms and Documents

Re-Enrollment/Withdrawal Form

Parents' Names

For the 2020-2021 School Term:

Please fill in the blanks ONLY if something has changed in the past year.

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Dad's Cell Phone

(###)

###

####

Mom's Cell Phone

(###)

###

####

School District

Church Name

Email Address to be used for Patron List, invoices, etc.

List the name of each student, the anticipated grade level for 2020-2021 and their birthdate.

Student

Anticipated Grade Level For 2020-2021

Birthdate

MM

DD

YYYY

Student 2

Anticipated Grade Level For 2020-2021

Birthdate

MM

DD

YYYY

Student 3

Anticipated Grade Level For 2020-2021

Birthdate

MM

DD

YYYY

Student 4

Anticipated Grade Level For 2020-2021

Birthdate

MM

DD

YYYY

Student 5

Anticipated Grade Level For 2020-2021

Birthdate

MM

DD

YYYY

Children 4 years and younger

Student

Birthdate

MM

DD

YYYY

Student

Birthdate

MM

DD

YYYY

Student

Birthdate

MM

DD

YYYY

There is not a registration fee, however, there is a withdrawal fee. Please return this form to the office by March 31 to ensure that your child has a spot in class for the 2020-21 year. If you choose to with-draw your child from LHCS, you may do so with no fee, prior to March 31. After March 31, you will be charged a $200 fee to withdraw your child.

Form complete by

First Name

Last Name

Date

MM

DD

YYYY