After School Registration for 2019-2020 2nd Quarter: December – February

Child's Name *
Child's Name
1. Parent/Guardian *
1. Parent/Guardian
Primary Phone Number *
Primary Phone Number
Days requesting after school services *
Please pick one *
Cancellations of Services *
For the safety and welfare of all children attending programs at Learning Lab, we retain the right to terminate services for the following reasons: • The child’s behavior is destructive, uncontrollable, or threatening or violent to other children or staff members. • A parent/guardian refuses to pay tuition.