FGSLC Program(s) Registration Form

FGSLC Program(s) Student Registration Form

Fill out the form carefully for registration. Once registered, please contact us at 772.528.9931 to attend our mandatory parent/student orientation and complete a FGSLC, Inc Waiver. A new form MUST be completed annually for programs. ********Program Site Address: 3300 Ave L Ft. Pierce, FL 34947********
Date

MonthDayYear
Date
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Choose the programs you're registering your student for.

FGSLC Afterschool Program & Music Enhancement Program (M-F 3:30-6:00PM)FGSLC Community Drumline (W 4:00-6:00PM)Future-Gen Young Men Boys Group (F 4:00-6:00)FGSLC Summer Program (M-F 8:00-4:00)Girls With Pearls (F 4:00-6:00)
Parent E-mail
example@example.com
School Name/Grade *Required

School Grade
Student ID (school issued 56#) *Required
Parent(s) Name
Mobile Number
Phone Number
Emergency Contact

First NameLast Name
Emergency Contact
Please enter a valid phone number.
Preferred Instrument
Parent(s): Are you on social media (i.e Facebook, Twitter, Instagram, YouTube, TikTok)? We use social media as a means to share information, updates and advertise.

FacebookTikTokInstagramYouTubeTwitter
Medical History: Allergies, chronic illness, medications
I give my permission for the program’s staff or representative to administer first-aid and to authorize and obtain permission for emergency treatment. I understand that all Future Generation’s policies and procedures apply, and I will be responsible for any damages incurred as a result of my child’s actions.

Clear
Media release: By signing this form, you give your child permission to be videotaped and aired on social media platforms and/or television.

Clear
********************FGSLC, Inc. Waiver********************

Please stop by the office (3300 Avenue L Ft. Pierce, FL 34947) and complete Future Generations of St. Lucie County, Inc. Waiver

FGSLC Program(s) Student Registration Form

********************FGSLC, Inc. Waiver********************

FGSLC, Inc. Waiver