Elementary Application

Elementary ApplicationMVAmainLDC2022-05-09T16:09:45+00:00

The elementary program at Lighthouse is designed for children up to age 12 to have fun, educational opportunities during their summer break, after school and during days off school. Please provide us with the information below.

Go to Preschool Application

Main Email Address for Parents/Guardians

Does this child live at more than one address weekly? (For example shared custody) *

Yes

Child Age

Child's Grade in the Fall

Child's Full Name *

Gender *

Male

Female

Parent/Guardian #1

Name *

Phone Number *

Relationship to Child *

Parent/Guardian #2

Name *

Phone Number *

Relationship to Child *

Please list any food allergies your child has.

Does your family qualify for assistance with tuition thorough Connect or Link Resource Referral?

Yes

Not Sure

If unsure, please contact Connect Link (Putnam County) 304 523-9540.

Tell us about your child's personality. *

Does your child have any special needs? (Understanding these needs will help us better care for your child.)

What kind of care will you need during the summer months? *

Full Time (5 days per week)

Part Time (2-3 days per week)

Part Time (Every other week)

Partial Full Time (Only custody weeks)

Please further explain care needed (if applicable)

Does your child have any siblings who attend one of our centers or have previously attended?

Yes

If yes, please list their names.

Thank you for your interest in Lighthouse's Elementary Care program. Someone from our staff will be in touch with you as soon as possible regarding your application.

There was an error trying to send your message. Please try again later.

Lighthouse Christian Academy
and Daycare Center

2440 Route 60
Hurricane, WV

304 562-3900

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