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Programs
Workforce Development & Education
WayneLinc
Scholarship Program
Youth Leadership Program
Digital Literacy Courses
iCode
Government Civility & Leadership Academy
Public Health
Healthy Living
Infant & Maternal Health
Programs for Families
Programs for Adults
Programs for Youth
ACT Drug Free Community Coalition
Substance Use Prevention
Behavioral Health
Developmental Disabilities & Autism Services
Mental Health Services
Human Services
Resources
About Us
Annual Reports
Who We Serve
Our Mission
Our Roots
Our Family
CEO Corner
Board of Directors
Careers
Events Calendar
MIH
Procurement
Computer Building Registration (4th – 8th Grade)
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Computer Building Registration (4th – 8th Grade)
Name
(Required)
First
Last
Grade Level of Child Attending:
(Required)
Going to the 4th Grade
Going to the 5th Grade
Going to the 6th Grade
Going to the 7th Grade
Going to the 8th Grade
School Name of Child Attending:
(Required)
Emergency Contact Information
Full Name of Parent/Guardian
(Required)
First
Last
Phone Number of Parent/Guardian
(Required)
Email of Parent/Guardian
(Required)
Additional Information
Do you have any prior experience with computer hardware?
(Required)
Yes
No
Do you have any allergies or medical conditions we should be aware of?
(Required)
Yes
No
If yes, please specify:
Is there anything important regarding your child that LAHC should know about? (special needs, etc.)
(Required)
Yes
No
If yes, please specify:
Consent
I agree to the policy.
I hereby give permission for my child to participate in the Build a Computer Workshop.
I understand that the organizers will take all necessary precautions to ensure the safety of the participants.
I agree to allow photographs/videos of my child to be taken during the workshop for promotional purposes.