Important Documents & Forms
Many activities at Lakewood Catholic Academy, from
registration to graduation, involve forms or documents! Below you'll find
links to to many of the most commonly used forms as well as some
key documents in easily printable PDF format.
General Forms & Documents
Email Request Form
Complete and return this form in order to receive the weekly
electronic newsletter for parents.
Summer Reading & School Supply List
Facility Request Form
Acceptable Use Policy
Physical Examination Form
Legal Custody Agreement
Agreement & Computer Use Agreement/Parent Permission Form
Release & Lunch Room Form
Saints Service Organization Forms
Expense Reimbursement & Check Request Form
Event & Program Revenue Worksheet
Directory Order Form
2012-13 Cafeteria Order Form (Includes all months)
May 2013 Cafeteria Menu
Questionnaire & Immunization Record Form
Provides LCA with a record of your child's required
Booster Dose Td/Tdap Information Letter & Form
Effective with the 2010-11 school year, the Ohio Department
of Health has revised the School Immunization Requirements to
include a dose of Td or Tdap to be administered before a student
enters the seventh grade. Therefore, your current sixth grader
will need to show proof of having received this booster dose
before returning to school in the fall.
Emergency Medical Authorization Form
This form is required to be completed for each student, every
year. The form is required by law and is used to allow
emergency medical treatment in case of an accident. There is a
line on the form that allows parents to note an allergy issue or
whether the child is currently on any medication, even if it is
not given at school. Emergency room doctors need to know if a
patient is on any medication.
Physician & Parent Request for the Administration of
Medicine by School Personnel
This form permits the administration of medicine to the
student by the school nurse.
Allergy Action Plan
Should your child have food
or other allergies, this form allows your physician to permit the
administration of one or more allergy medications to your
child during school hours.
Authorize Student Possession and Use of an EpiPen
This is a form that allows a student to
carry and self-administer an EpiPen allergy treatment. Please
note that it is required by law that if your child carries an
EpiPen, a second one should be kept under the child's
prescription in the nurse's clinic.
Medication for Asthma Inhalers Form
This form will allow your child to carry
and use an inhaler during school hours. Some parents choose to
keep a back-up inhaler with the nurse in the school clinic. This
form also allows the nurse to provide the inhaler to the child.
Health Care Form
This form provides the nurse with
comprehensive information related to the treatment of a student
This form should be completed for students
being treated for a seizure disorder.
This form is required to be completed prior to participation in
any practice or game. The form is good for one year - if you
submit a form completed by your child's doctor prior to the
start of a school year, the form should be valid for the entire
CYO Coaching Application Form
This form must be completed by all coaching candidates.