The Lebanon Lantern The Lebanon Lantern Spring 2019 | Page 13

2019
PARK SCHOOL REGISTRATION FORM
Child’s Name
Age
Grade in Sept. 2019 In Town Out of Town
1.______________________________________________________ $250.00 $300.00
2.______________________________________________________ $225.00 $275.00
3.______________________________________________________ $225.00 $275.00
4.______________________________________________________ $225.00 $275.00
CIT_______________________________________________________
Counselor in Training (Grades 7 &8)
$100.00
Total Enclosed ___________
In order for our staff to assure your child a happy, meaningful experience at our program, please share any special needs
your child may have. (I.e. learning disabilities, limitations, etc.)
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
EMAIL ADDRESS:_____________________________________________________________________________________
Permission to walk home:
I give my child permission to walk home alone:
Yes: ______
No: _______