ENGAGE! Enrichment Course Registration
Fill out the form carefully for registration. A separate form is required for each student.
LOCATION:
LAMA Learning Center
6001 Lakeside Ave.
Suite 26
Richmond, VA 23228
Parent/Adult Student Name
*
First Name
Last Name
Parent/Adult Student Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Parent/Adult Student Phone Number
*
-
Area Code
Phone Number
Parent/Adult Student E-mail
*
Best time to contact
*
Morning
Afternoon
Evening
Student Name (Under 18)
First Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
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13
14
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31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
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2003
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1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Student Address (if different)
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Current School/Homeschool
*
Current Grade
*
Please Select
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Select Desired Course and Time
*
Cursive - Grades 3-5: July 24, 10am - 1pm
Cursive - Grades 6-8: July 24, 2pm - 5pm
Cursive - Grades 3-5: August 14, 10am - 1pm
Cursive - Grades 6-8: August 14, 2pm - 5pm
Registration Fee - Required
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Course Payment (Includes materials)
$
40.00
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