Lighthouse Baptist Church - MI

LBC LEAF Co-Op Registration Form

Before signing up please refer to the sample schedule and class descriptions to know what you are signing up for. If classes need to be changed in any way, we will let you know as soon as possible.

Payment will be due by August 1st to ensure teachers are able to purchase supplies and to have reimbursement for materials purchased. If you need to pay in three installments, please contact Heather Gunderson for payment schedule.

Registration will be open until June 30th.

PARENT SECTION:

Parent First Name

Parent Last Name

Email

Phone Number

Preferred Method of Contact:

Text

Phone Call

Email

Preferred Time of Contact:

Morning

Afternoon

Evening

How many students are you registering?

Do you have any kids that will need to be in the nursery?

Yes

No

Child Name:

Birthdate

Select one of the following:

Nap Times:

Allergies:

Select one of the following:

Any known behavioral issues we should be aware of?

Medical or health concerns (including developmental delays)?

< Back

Next >

Submit

LBC LEAF Co-Op Registration Form

Service Times

Phone : 616.355.7027

Address : 501 E. 24th St. Holland, MI 49423