Back to School Agreements 25-26

Back to School Agreements

Please review the statements below WITH YOUR CHILD and sign to indicate your consent, understanding, and agreement. One form must be completed for each student by Friday, August 22.
Student Name*

First NameLast Name
Grade*
Homeroom Teacher's LAST Name*
Parent/Guardian Email Address*
Agreement Statements
HANDBOOK*

We agree that we have read or will read the 2025-2026 Parent-Student Handbook (on the LCCS website) by September 5, 2025, and consent to the policies established therein. We understand that the Parent/Student Handbook contains the policies that guide LCCS. Review the handbook at lccs.cc/handbook.
TRANSPORTATION*

We give permission for the above named student to take part in LCCS activities including off-campus trips where transportation is provided by LCCS approved and licensed, adult bus/van drivers. This includes, but is not limited to, field trips, sporting events, rehearsals, class trips, outreaches, IU13 classes, etc. (Individual permission slips will be required for trips where transportation is provided by parent/guardian drivers or in private vehicles.)
TEXTBOOKS*

Pennsylvania makes textbooks and certain instructional materials available to students in private schools. In order for LCCS to receive these materials, parents/guardians must request the loan of these materials for their child’s use. We understand that in order to receive funding from the state to purchase textbooks for all students, we must indicate our agreement by checking this box and signing below.
TECHNOLOGY AGREEMENT*

We understand that the use of LCCS computers, network, and internet is a privilege, not a right, and may only be used under the specific guidelines of a teacher. This privilege may be revoked for anyone who uses the resources inappropriately. We have reviewed the Network & Internet Usage policies established in the Parent-Student Handbook (page 19).
AFTER-SCHOOL CARE

(Preschool-Grade 6) We understand that students need to be enrolled ahead of time or we must notify the receptionist before 12 noon on the day we wish to utilize after-school care. We also understand that preschool-6th grade students who are not picked up from the carpool line by 3:25 pm will automatically be sent to the after-school care program, and we will be charged accordingly. Review the after-school care expectations and procedures at lccs.cc/afterschoolcare.
Continuous Enrollment Agreement
LCCS operates using a “continuous enrollment” model so that there are no lengthy forms or paperwork to complete each year. Families sign a Continuous Enrollment Agreement at their initial enrollment.

A new "Late Withdraw Penalty" policy has been added to this agreement (page 2). Please review and sign to indicate your understanding and consent. The agreement is also posted at lccs.cc/continuous-enrollment.
LCCS Continuous Enrollment Agreement
Check here to confirm that you have read and consent to the Continuous Enrollment Agreement.
Family Directory

The FACTS Family Portal has a Family Directory feature so that LCCS families can easily access each other's contact information. Please note that the family directory information can be accessed by all parents/guardians and students.
Family Directory Consent*

I/we give my consent to have the following information included in the directory. I understand that the Family Portal can be seen by all LCCS parents/guardians and students.I/we do not want to be included in the family directory at this time.
Include the following information in the family directory:

NamesFamily AddressHome PhoneEmail AddressCell Phone
Over-the-Counter Medication

With parent/guardian permission, LCCS nurses are able to administer over-the-counter medications as needed during the school day.
We give permission for LCCS nurses to administer the following medications to my child (the above-named student) as needed. We understand that medications will be administered with dosage as directed per manufacture for weight and age.

Tylenol/Acetaminophen - generic acetaminophen regular-strength tablets or children's dye-free liquid acetaminophenMotrin/Advil/Ibuprofen - generic ibuprofen tablets or children's dye-free liquid ibuprofenBenadryl/Diphenhydramine Allergy - generic tablets or generic liquidTums/Calcium Carbonate - generic calcium carbonate chewable adult tablets or children's tabletsCough Drops - no artificial colors, flavors, or preservatives
Signatures
We have thoroughly reviewed the above statements and agreements and indicated our consent as appropriate. We have discussed the policies and procedures with the above-named student.
Parent/Guardian Signature*

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Student Signature*

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Date*

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Back to School Agreements

Agreement Statements

Continuous Enrollment Agreement

Family Directory

Over-the-Counter Medication

Signatures