STEP 1: Please fill out this form and click submit.
STEP 2: After submitting, a pop-up window will appear. Click on the "payment" link to pay the $50 program fee.
Please fill out a separate form for each child.
STEP 1 - REGISTRATION AND MEDICAL RELEASE
Primary Contact Information
Enter the best contact number below.
FPLC's Little Lamb's Medical Release
Medical Release: In the event that I cannot be reached in an emergency, I give the program’s coordinator permission to secure and administer treatment, including hospitalization, for the child whose name is listed below:
STEP 2 - PAYMENT (REGISTRATION FEE IS $50.)
Once you click the submit button at the bottom of this form, a pop-up window with a link to our payment page will appear. At this point, you have the option of clicking the link to continue to pay online or you can pay by check. (Follow the instructions in the pop-up window.)
