2018-2019 Emergency Information & Photography Release Form

Please take a moment to complete the 2018-2019 Emergency Information and Photography Release form. Please complete the form no later than September 28.

Consent

Knowing that from time to time illnesses and/or accidents occur, I understand that school officials will make every effort to contact me if my child is sick or injured. However, if the school is unable to reach me in a medical emergency, I give permission to the school to call paramedics or any licensed physician or dentist. I consent to any reasonable medical treatment as deemed necessary by a licensed physician.

Weather-Related or Emergency Early Dismissal

For weather-related closings, parents should be on alert for announcements and early dismissal closings from your home school district. If your child(ren) rides the bus and your home school district closes early, please note LCS will release them to their buses when necessary.

If your child(ren) is not a bus rider, please pick him/her up no later thank 3:00 pm. No after-care, sports, clubs or tutoring will be provided in the event of a weather-related or emergency early dismissal.

Photography Release

Thank you for helping us update our records! Please recognize we will never publish personal names students without your permission. Having the ability to showcase the day to day affairs through images of LCS is important to the growth of the our school. Thank you for helping out in this way!

Family Last Name Required

Family Physician Required

Physician Phone Required

Child #1 Name: Required

Child #1 Grade Required

Child #1 Health Concerns Required

Child #2

Child #2 Grade

Child #2 Health Concerns

Child #3

Child #3 Grade

Child #3 Health Concerns

Child #4

Child #4 Grade

Child #4 Health Concerns

Child #5

Child #5 Grade

Child #5 Health Concerns

Parent/Guardian #1 Required

Parent/Guardian #1 Cell Phone Required

Parent Guardian #1 Home Phone

Parent/Guardian #1 Work Phone

Parent/Guardian #2

Parent/Guardian #2 Cell Phone

Parent/Guardian #2 Home Phone

Parent/Guardian #2 Work Phone

List someone who has permission to pick up your child when you are unavailable: Required

Relationship to child(ren) Required

Cell Phone Required

Home Phone

List someone who has permission to pick up your child(ren) when you are unavailable. Required

Relationship Required

Cell Phone Required

Home Phone

I/We grant permission to use photographs for my child(ren) on the LCS website. Required

I/We grant permission to use photographs for my child(ren) on LCS supported social media. Required

I/We grant permission to use photographs for my child(ren) on LCS related promotional material. Required

By clicking below, you agree that you have read and consent to the emergency information form and photo release. Required