Teen Registration

Complete this form to register your teen for our after school program.

Print our Registration Form (Spanish and English versions provided) and send to development@triumphtlc.org.

Before registering, please be sure to review our Parent and Student handbook.

If you have any questions, please reach out to our Team anytime at development@triumphtlc.org.

Student First Name

Date of Birth

Student Last Name

Student Email Address

Student Phone

Check All That Apply:

Migrant

Free & Reduced Lunch

IEP/504

Other

School

Grade

Primary Parent/Guardian Full Name

Phone

Email Address

Address (Street, City, State, & Zip)

Secondary Parent/Guardian Full Name

Phone

Email Address

Emergency Contact Full Name

Relation to Student

Phone

Consent for Triumph to post photos and/or videos of you or your student online on Trimph website or social media.

Yes

Please check this box to indicate that you and your student have reviewed the handbook and understand and agree to abide by Triumph's policies and expectations.

Parent Signature

Student Signature

Thank you for registering! We'll be in touch soon.

Teen Registration

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