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LMSD Registration Form
2022-2023 Online Registration. Please note, you are able to print and manually fill out this form if you'd prefer. All information will be stored securely.
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* Indicates required question
Email
*
Your email
Returning Student?
*
Yes
No
Student Name
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Grade (as of September 1, 2022)
*
Your answer
School District
*
Your answer
Parent/Guardian Name
*
Your answer
Contact Phone Number
*
Your answer
Student Home Address
*
Your answer
Are there any medical or physical limitations for your student that you would like us to be aware of? Please explain below, including your preferred emergency action preferences (ie: Epipen, Asthma, etc)
Your answer
Emergency Contact(s) - Please indicate name, relationship to student and best contact phone number for us to keep on file. (If already answered on sibling registration, please type "See: Student Name"
*
Your answer
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