FBLC Registration
Please begin the registration process by proving the following information:
Your Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Your child's name
*
First Name
Last Name
Child's date of birth
*
/
Month
/
Day
Year
Choice of Class
*
18-24 mos
2 year-olds (2 days)
2 year-olds (3 days)
3 year-olds (2 days)
3 year-olds (3 days)
4 year-olds (2 days)
4 year-olds (3 days)
4 year-olds (4 days)
Kindergarten (4 days)
Do you need to add a second child?
*
Yes
No
Name of your second child
*
First Name
Last Name
Second child's date of birth
*
/
Month
/
Day
Year
Choice of Class
*
18-24 mos
2 year-olds (2 days)
2 year-olds (3 days)
3 year-olds (2 days)
3 year-olds (3 days)
4 year-olds (2 days)
4 year-olds (3 days)
4 year-olds (4 days)
Kindergarten (4 days)
Do you need to add a third child?
*
Yes
No
Name of your third child
*
First Name
Last Name
Child's date of birth
*
/
Month
/
Day
Year
Choice of Class
*
18-24 mos
2 year-olds (2 days)
2 year-olds (3 days)
3 year-olds (2 days)
3 year-olds (3 days)
4 year-olds (2 days)
4 year-olds (3 days)
4 year-olds (4 days)
Kindergarten (4 days)
Do you need to add a fourth child?
*
Yes
No
Name of your fourth child?
*
First Name
Last Name
Fourth child's date of birth
*
/
Month
/
Day
Year
Choice of Class
*
18-24 mos
2 year-olds (2 days)
2 year-olds (3 days)
3 year-olds (2 days)
3 year-olds (3 days)
4 year-olds (2 days)
4 year-olds (3 days)
4 year-olds (4 days)
Kindergarten (4 days)
Submit
Should be Empty: