Lake Zurich Community Unit School District 95 Registration

 This form is for New to District students ONLY

for the 2022-2023 School year.

Student Information

Please complete a separate form for each student being registered.

Instructions for Identification of Race and Ethnicity
We are required by the Federal and State authorities to report each student’s race and ethnicity for the current school year. If you do not supply this information to District 95, a staff member is required to use visual observation techniques to record the missing data. Please call your student’s school if you have questions. Please use the following descriptions to report your race and ethnicity according to the new descriptors from the Federal and State Authorities.

Ethnicity:
•Hispanic or Latino (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.)

Race:
American Indian or Alaska Native (A person having origins in any of the original peoples of North and South America, including Central America, and who maintains tribal affiliation or community attachment.)
• Asian (A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.)
• Black or African American (A person having origins in any of the black racial groups of Africa.)
• Native Hawaiian or Other Pacific Islander (A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.)
• White (A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.)

Boundary School             

Please use the boundary mapped link to locate the school boundary containing the students resident address.  Please note that school placement only occurs after the registration has been completely processed.   

  Boundary Map/Address Lookup  ( Opens in new window)

 If you are not clear of your student's school, you can call the Transportation Department at 847-438-2834 for guidance.

Proof of Residency is required for all new families registering with the District. For returning families, residency will be verified by a 3rd party. If additional information is required to verify your residency you will be contacted directly.

 WARNING: If a student is determined to be a non-resident of the District for whom tuition must be charged, the persons enrolling the student are liable for non- resident tuition from the date the student began attending a District school as a non-resident.

A person who knowingly enrolls or attempts to enroll in this School District on a tuition-free basis a student known by that person to be a nonresident of the District is guilty of a Class C misdemeanor, except in very limited situations as defined in State law (105 ILCS 5/10-20.12b(e)).

A person who knowingly or willfully presents to the School District any false information regarding the residency of a student for the purpose of enabling that student to attend any school in the District without the payment of a nonresident tuition charge is guilty of a Class C misdemeanor (105 ILCS 5/10-20.12b(f)). (Board Policy7:60, Residence.)

KINDERGARTEN TRANSPORTATION FORM

Dear Kindergarten Parent/Guardian,
Transportation is scheduled to and from the home address. If your transportation needs require an alternate pick-up or drop-off location, please fill out the form below. Childcare addresses will be considered only if the stop is on an existing bus route located in the school attendance area to which the student is assigned. Additionally, for safety reasons, District 95 promotes the practice that all Kindergarten students are greeted by a parent/guardian at their bus stop. However, some parents believe that their Kindergarten student is capable of walking home from his/her bus stop independently or with a sibling already riding the school bus. The Transportation Department is seeking clarification concerning drop-off procedures for your Kindergarten student.

My Kindergarten student, MAY be dropped off at the bus stop WITHOUT an adult present. I understand that the Transportation Department/Bus Driver may determine that due to safety concerns such as severe weather or other dangers present, my Kindergarten student will be returned to his/her school if no adult is present at the bus stop. The Transportation Department or school office will attempt to call me before transport back to school occurs. If no personal contact is made, a message will be left and the student will be transported back to the school. If my child is transported back to school, I will need to make arrangements to have him/her picked up from school.

My Kindergarten student, MAY NOT be dropped-off at the bus stop unless I am present (or one of the individuals specified below) to greet and escort my child. In the event that I am not present (or one of the individuals specified below) at my Kindergartener’s bus stop to greet and escort my child, I understand that my child will be returned to his/her school. The Transportation Department or school office will attempt to call me before transport back to school occurs. If no personal contact is made, a message will be left and the student will be transported back to the school. If my child is transported back to school, I will need to make arrangements to have him/her picked up from school.
List three individuals below, other than mother and father, who may greet and escort my Kindergarten student from his/her bus stop. If your Kindergarten student is allowed to walk home with a sibling already on the same school bus, please include the sibling’s name.

******STUDENT PICK-UP AND DROP-OFF LOCATIONS MUST BE THE SAME ALL DAYS OF THE WEEK****** 
District 95 Transportation Department – 66 Church Street - Lake Zurich IL 60047-2459
Phone: (847) 438-2834 FAX: (847) 438-9618 www.lz95.org

ALTERNATIVE TRANSPORTATION FORM  GRADES 1-8 (under age 13)

 
     
Dear Parent/Guardian,
Transportation is scheduled to and from the home address. If your transportation needs require an alternate pick-up or drop-off location, please fill out below. Childcare addresses will be considered only if the stop is on an existing bus route located in the school attendance area to which the student is assigned.

******STUDENT PICK-UP AND DROP-OFF LOCATIONS MUST BE THE SAME ALL DAYS OF THE WEEK******

 I can OPT BACK IN for transportation service by calling the Transportation Department at 847-438-2834 or email transportaitonshared@lz95.org. It can take up to 3 days for transportation services to begin.

INVOICE
2022-2023 School Year
(Fee is payable at time of registration) 

To ensure proper credit, please complete and submit this invoice with your registration form to the student’s assigned school.
• Fee is payable at time of registration. Fee is applicable to all students attending district schools or special education out placement.
• PLEASE DO NOT SEND CASH. If paying by check or money order, please make the check payable to: Lake Zurich CUSD 95. Your canceled check serves as your receipt.
• Credit card/Debit card payments can be made after the Home Access login ID and password are issued. Please contact your school for more information.
• All payments by mail should be sent to your student’s assigned school.

Fee Schedule

Late Fees
$25.00 – if payment is received after September 15, 2022
$40.00 – if payment is received after October 30, 2022

Each student is assessed an annual school registration fee, which is used to offset the cost of items currently supplied by the District for all students. Examples of such materials include textbooks, workbooks, consumables, art supplies, materials for science unit experiments, library resources, paper and copying costs, student screening materials, printer supplies and other items. Please note: Students who qualify for free fee waiver are exempt from this fee. Students that qualify for a reduced fee waiver are required to pay 25% of the school fee. Waivers must be applied for annually and applications are not available until August 1, 2022.

* The Mobile Learning Initiative fee supports the iPad 1:1 program. This required fee, in part, offsets the cost of the theft/damage deductible program. Failure to pay this fee will result in a charge for the full amount of repair or replacement of the issued device.

Participation fees (such as Band, Orchestra, Chorus, Course and Athletics) are assessed upon your child’s enrollment in the program. Other school related fees are assessed on an individual or school basis. These fees will be posted and available for payment through PushCoin or by sending a check to your child’s school.

The following forms allow you to consent to certain items regarding your child’s enrollment in Lake Zurich Community Unit School District No. 95, including but not limited to charges for checks returned due to insufficient funds, an agreement to abide by the Access to Electronic Networks Policy, and a release of photographs. This document provides a brief summary of these items and references the relevant Board policies. All Board policies may be accessed on the District’s website at www.lz95.org. You may also request a hard copy of these policies by contacting the Building Principal. By marking below, you acknowledge that you have read the applicable Board policies.

Check Writing and Collections Policy:

As a result of the increased cost of attempting to collect NSF checks, District 95 now uses the services of outside agencies in the recovery of returned checks. An additional processing fee of $25 (or the maximum allowed by law) will be charged for any NSF checks. In addition, the District uses outside agencies to collect any unpaid fees that are more than 30 days past due. The District will charge a processing fee of $25 (or the maximum allowed by law) for any account turned over for collections on the District’s behalf. (Board Policy 4:45, Insufficient Fund Checks.)

Past Due Fee Agreement:

I have read the Fee Schedule and understand that all current and past registration fees are required to be paid before students may participate in extra-curricular activities, obtain a parking pass, or receive an official transcript.

Electronic Network Access

Student Responsibility

I have read, understand and agree to abide by the District’s Authorization for Access to the District’s Electronic Networks. I understand that the District uses network access that is designed for educational purposes solely and that the District has taken precautions to eliminate controversial material. However, I also recognize it is impossible for the District to restrict access to all controversial and inappropriate materials. I understand that I have no expectation of privacy in any material that is stored, transmitted, or received via the District’s electronic network or District computer. I further understand that the District and/or its agents may access and monitor my use of the Internet, including my e-mail and downloaded material, without prior notice to me. I further understand that should I commit any violation, my access privileges may be revoked, and school disciplinary action and/or appropriate legal action may be taken. In consideration for using the District’s electronic network connection and having access to public networks, I hereby release the School District and its Board members, employees, and agents from any and all claims and damages arising from my use of, or inability to use the Internet. (Board Policy 6:235, Access to Electronic Networks.)             

Parent Responsibility

I have read this Authorization for Access to the District’s Electronic Networks. I recognize that the District will create accounts for my child as required for participation in the curriculum, these accounts are to be used for school purposes only and include but are not limited to a student Apple ID and Google Apps for Education. I understand that the District uses network access that is designed for educational purposes solely and that the District has taken precautions to eliminate controversial material. However, I also recognize it is impossible for the District to restrict access to all controversial and inappropriate materials. Therefore, I hold harmless the District, its employees, agents, or Board members, for any harm caused to my child because of materials or software obtained via the District’s electronic network or by suspension from that network. I accept full responsibility for supervision if and when my child’s use is not in a school setting. I have discussed the terms of this Authorization with my child. (Board Policy 6:235, Access to Electronic Networks.)

*Students are required to have a parent/guardian read and agree to the above. 

Mobile Learning Initiative Registration Acknowledgement

 I acknowledge participation of my child in District 95 Mobile Learning Initiative whereby my child will be issued an iPad by the District for the sole purpose of enhancing his or her educational experience.
I am wholly and entirely responsible for loss or damage to this District-owned device. My child will only use this device in accordance with all applicable policies and procedures of the District, the Terms and Conditions of the Mobile Learning Initiative, and the Mobile Learning Guidelines for Students and Parents. 
The Mobile Learning Initiative program fee includes accidental damage coverage to help families mitigate the risk of iPad loss and damage. This coverage will protect you from paying the full cost to repair or replace your student’s device subject to a cumulative, year to year, per-occurrence deductible.
This fee is due at registration. 

 Benefits of this plan include:
 • Incidents of damage (over a four year period) covered by $50.00 (each incident) deductible.
 • Replacement of lost or stolen iPad with a $200 deductible and a copy of the filed police report of the incident.
 • A web portal to allow parents a timely and efficient method to file claims and pay for damage or loss. I understand there are certain conditions not covered by this damage waiver which include:
 • Any dishonest, fraudulent, malicious, intentional or criminal acts.
 • Catastrophic damage or unauthorized modifications. In such cases, the parent(s)/guardian(s) will be required to pay for the replacement of the device.
 • Any loss of software, data, documents, music, videos, recordings or other personal information on the device.
 • Any device lost or stolen that is not reported to local law enforcement.         

 • Any use not in accordance with District policies and procedures.
 • Replaceable parts item such as case, cables, charging adapters, or batteries will not be replaced/covered by this plan.
 • Any device with removed or altered serial numbers.
 • The district may opt not to repair cosmetic damage which does not affect the functionality. 

DEDUCTIBLE FEE PER CLAIM: Damage incident - $50 each. Loss or theft - $200. I understand that I am responsible for a per occurrence deductible, cumulative from year to year, for all claims covered under this damage waiver to be paid immediately upon confirmation of a loss, such confirmation being at the District’s sole discretion. All current and past registration fees and any other outstanding fees to the District (including the iPad damage waiver or replacement fee) are required to be paid before students are allowed to participate in Athletics and extra-curricular activities requiring a fee to participate, eligible for a student high school parking permit, or have off campus (high school) privileges. Official transcripts are not released until all fees owed to the District are paid. 

Account Creation Acknowledgment

I recognize that the District will create accounts form my child as required for participation in the curriculum. These accounts are to be used for school purposes only and include but are not limited to a student Apple ID and Google Apps for Education.

 PARENT-STUDENT HANDBOOK 

The Parent-Student Handbook contains important information for all parents and students about the District’s rules on student conduct and discipline and other policies and procedures, and is available (1) on the District’s website at www.lz95.org under the “Parents” menu, and (2) in print, upon request to the building principal. I understand how to access the Parent-Student Handbook electronically and in print and agree to access the Handbook, read it, and review it with my child. I understand that if my child violates the rules, (s)he can be disciplined. Discipline may include a loss of privileges, detention, suspension, expulsion, or other consequences. By signing below, I certify that I will access the Parent-Student Handbook, read it, and review it with my child. By signing below, I further certify that I agree to abide by the Board/District policies, rules and procedures contained in the Handbook.

View Student Handbook  ( Opens in new window)

PHOTO/VIDEO RELEASE

Students and student work may occasionally appear in photographs and recordings taken by District staff members, other students, or other individuals authorized by a District administrator, the Building Principal, or designee. The District may use these pictures and recordings, without identifying the student, in various publications, including school yearbooks, school newspapers, and the District website.

At times, the District may want to identify a student or student work in a publication. For example, the District may wish to acknowledge students who participate in a school activity or deserve special recognition, including in a news release or District-sponsored material, publication, recording, or website. In order for the District to publish a picture or recording of a student or of a student’s work while the student is enrolled in the District, the student’s parent/guardian must sign this consent form below or otherwise subsequently grant consent.

By signing below, I understand that I am granting the District consent to use my child’s full name, photographic or video image, voice, statements, work, or writing; identify my child; and identify the school my child attends in any District-sponsored material, publication, recording, or website. This consent form is valid only for the school year in which it is signed. Consent must be given annually. I understand that I may revoke this consent at any time by notifying the Building Principal in writing.

 
I further understand that, while the District limits access to school buildings by outside photographers, it has no control over news media or other entities that may publish a picture of a named or unnamed student from a school event.

IHSA Concussion Information Sheet and Sports Medicine Consent:  My student and I have read and understand the IHSA Concussion Information Sheet and Sports Medicine Consent.   ( Click HERE to view)

STEP 1

*Complete Step 1 (Online registration form) by clicking the Submit Button at bottom of this page.