2025-2026 Enrollment & Emergency Form Zion Lutheran School

2025-2026 Enrollment & Emergency Form Zion Lutheran School

Zion Lutheran School provides quality Christ-centered education to equip students to serve others and to proclaim Jesus Christ in their families, community, and world. Zion Lutheran School admits students of any race, color, national and ethnic origin, to all the rights, privileges, programs, and activities generally accorded or made available to the students of the school. It does not discriminate on the basis of race, color, national, or ethnic origin in administration of its educational policies, admission policies, and athletic and other school administered programs.
Family Last Name:*
Number Of Children:*
This family belongs to:

Zion Lutheran Church served by schoolNo ChurchOther
HOME PHONE:*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Language Spoken at Home:
Parental Status:*
FATHER:
Name

First NameLast Name
Email*
example@example.com
Cell Number:*

Area CodePhone Number
Employer:
Work Number:

Area CodePhone Number
MOTHER:
Name

First NameLast Name
Email*
example@example.com
Cell Number:*

Area CodePhone Number
Employer:
Phone Number

Area CodePhone Number
CHILDREN:
1.
Sex:

MALEFEMALE
Baptized:

YESNO
RACE:

American IndianAsianBlackPacific IslanderWhite
2.
Sex:

MALEFEMALE
Baptized:

YESNO
RACE:

American IndianAsianBlackPacific IslanderWhite
3.
Sex:

MALEFEMALE
Baptized:

YESNO
RACE:

American IndianAsianBlackPacific IslanderWhite
4.
Sex:

MALEFEMALE
Baptized:

YESNO
RACE:

American IndianAsianBlackPacific IslanderWhite
EMERGENCY CONTACT:
In case of emergency, we will attempt to contact parent/guardian first. In the event we cannot do this, please provide the name of a relative or close friend that we may contact:
AUTHORIZED PICKUP:

Parents entrust their children to our care and supervision; therefore, Zion Lutheran School requires advance notification in writing if a child needs to leave school before dismissal. A signed note from the parent should accompany a student who will have to leave for any reason during the school day. The note should include the reason for leaving, the time the student will be absent, and the name of the person who will be picking the student up. If we do not have a note, parents must sign their child out in the school office before he or she will be allowed to leave.

Please list the persons you authorize to pick up your child:
Daycare:
Phone Number

Area CodePhone Number
Others authorized to pick up your child:
Name:
Phone Number

Area CodePhone Number
Name:
Phone Number

Area CodePhone Number
Name:
Phone Number

Area CodePhone Number
RELEVANT INFORMATION:
- Please provide the school office with any applicable court documents.
- Please note that a copy of your child’s birth certificate and immunization record must be on file in the school office.
- Please use this space to provide any information you feel is relevant. Please include any health issues and food allergies.
Relevant Info, Health Issues, Food Allergies:
WEEKLY NEWSLETTER:

We wish to receive via email address listed aboveWe wish to receive via hard copy sent home
I attest that the information contained herein is correct to the best of my knowledge. *

Clear
(Legal Parent/Guardian Signature) (Date)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

2025-2026 Enrollment & Emergency Form Zion Lutheran School

FATHER:

MOTHER:

CHILDREN:

EMERGENCY CONTACT: