May 4th Registration Form

Complete the form below to register your child for our debut event on May 4th, 2013.

LLS is focused on the needs of girls ages 9 through 12 but age is not a requirement to participate.

Online Registration Form:

* Indicates required field

Participant's Name *

First

Last

Birthdate *

Grade *

Guardian's Name *

First

Last

Email Address *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Choose One *

Cell Home Other

How did you hear about LLS? *