ULC Enrollment Form

  • Current Start
  • Parents / Guardians & Other Family
  • Emergency Contact/ Authorized Pick Up
  • Medical Information
  • Program Terms
  • Parent Consent for Release of Information
  • COVID-19 Waiver
  • Finish
Student Full Name
Does your child attend any after school program? If so, which one?
If your child attends an after school program, will you allow them to be released to the United Learning Center for the duration of their tutoring sessions?
Language spoken at home

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