Back-to-School Forms · 2026–2027

Family Information

Tell us about your family for the 2026–2027 school year. This form updates your household, student, medical, and emergency-contact information on file with the school office. When you submit, a copy is sent to the office and a confirmation is emailed to you.

Fields marked are required.

Family

Family last name

Students

Add each child enrolling this year. They share the family last name above unless you enter an alternate last name.

Student 1

First nameMiddle namePreferred nameAlternate last name (if not family name)

Date of birthGenderGrade (2026–27)Primary language spoken

Ethnic originBirthplace (city, state)

Parent / Guardian 1

First nameLast name

Physical address (street, city, ZIP)Mailing address (if different)

Primary phonePrimary phone typeSecondary phoneSecondary phone type

OccupationEmployer / workplace

Address of workplace

Workplace phoneWork schedule (hours you work)

Parent / Guardian 2

Optional — complete if there is a second parent or guardian.

First nameLast name

Physical address (street, city, ZIP)Mailing address (if different)

Primary phonePrimary phone typeSecondary phoneSecondary phone type

OccupationEmployer / workplace

Address of workplace

Workplace phoneWork schedule (hours you work)

Family details

Parents’ marital statusIf divorced, legal custodyRemarried?

Church attendanceName of church

Child has been baptized?Baptized at (church)Child has been dedicated?Dedicated at (church)

Medical & health

Physician (name / address / phone)Dentist (name / address / phone)Preferred hospital

Any known allergies?If yes, please list allergies

Any medical conditions we should know?If yes, please list

Is there a health plan on file in the office?

Emergency contacts

To be used only if a parent cannot be reached. These individuals are also authorized to drop off / pick up your child and should have photo ID available. Please list at least two, in order of preference.

Emergency contact 1

Name

Address & phoneRelationship to child

Emergency contact 2

Name

Address & phoneRelationship to child

Authorization

I hereby give my consent to any staff of Trinity Lutheran to call and authorize the above doctors or any certified physician or medical staff to provide medical or surgical care for my child should an emergency arise. It is understood that a conscientious effort will be made to locate the parents/guardians first.Electronic signature (type your full name)

Signing electronically today records your consent with today’s date.