AMOUNT FUNDRAISED


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ENROLL YOUR CHILD AT LKLC!

 

*Please fill out one form per child*

If you're expecting and unsure of name,
please put "Baby (insert last name)" Ex: Baby Smith.

We will require a non-refundable $100 deposit per child. Please send this to us at: LKLC PO Box 672 Dysart, IA 52224 when you submit your enrollment below.

 

 
 
Parent Name *
Parent Name
Child's Name *
Child's Name
Child's Birthdate *
Child's Birthdate
Start date for child *
Start date for child
Would child be *
Will your child be attending
Check all that apply
What is the best way to contact you?