Logos Registration

1. Youth/Child's Name:

Child Age And Grade:

Child Birthday:

Child School:

Parents'/Guardians' Names*:

Church Affiliation:

Primary Phone:

Secondary Phone:

Address:

Email*:

Emergency Contact Name:

Emergency Contact Number:

List and allergies your children may have to food, medicines:

List of special needs your child(ren) may need:

I agree to keep my child home when they are sick. 

I authorize LOGOS program personnel to take my child to the hospital in case of a medical emergency. 

Parents permission for photographed/video taped/posted online?:YesNo

Contact me as I would like more information or have questions or concerns. 

I will need childcare for my child under the age of 3 years old. 

I have agreed to assist the LOGOS Program in the following ways: (Your call)

LOGOS Program Fees are $35/Semester for Lil LOGOS (Ages 3-Kindergarten) and $80/Semester for LOGOS (Grades 1st -12th) For scholarship or payment plan, contact the LOGOS Director. All financial arrangements are kept confidential. Scholarships and payment plans are offered to all and we turn no one away!