1. Youth/Child's Name:
Child Age And Grade:
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!