2011-12 Pre-Registration Form
Brownsburg Challenger Learning Center
Street Address 1:
Street Address 2:
Zip Code: County:
Contact Phone Number (with area code):
Grade Level Attending Mission:
I need to attend a teacher training workshop.
(You must attend a training workshop if you have never brought a class to
BCLC, or if your group is flying a scenario for which you have not trained.)
Emergency Contact Information
(Note: contact person may be a classroom teacher or principal.)
Home Phone: Cell:
(Please provide a non-school phone number.)
Please return this information
to BCLC by November 19, 2010.