Student Forms

REQUIERED FORMS: please complete and return the following forms for ALL NEW STUDENTS

• Emergency Form – physician signature required if your child has a medical condition
• Health Inventory Form
  • Part I – parent/guardian must complete and sign
  • Part II – physician must complete and sign
• Immunizations Record – attach a computer generated immunization record or complete this Immunization Certificate with your physician. Click here to view Maryland vaccination requirements by age.
• Blood Lead Testing Certificate – complete this certificate with your physician
• LCYC Student Allergy Form – must be completed for ALL students whether or not a student has known allergies
• If your child has allergies, food sensitivities, asthma, seizures, or will require medication (e.g. EpiPen, Benadryl, etc.) to be given at school, please complete the appropriate forms below with your physician.

ADDITIONAL FORMS: please complete and return the following forms as needed

• Food Sensitivity/Allergy Form (No Medication/Treatment Required, no physician signature required)
• Allergy Action Plan
• Medication Administration Authorization (separate forms required for each medication, e.g. separate forms for EpiPen and Benadryl)
• Asthma Action Plan and Medication Administration Authorization
• Seizure Medication Administration Authorization

ALL Forms must be completed and returned to LCYC before your child can start school. You may scan and send them via email to admin@lcycpreschool.org, fax: (301) 933-7704, or mail to LCYC Preschool, 10123 Connecticut Ave., Kensington, MD 20895