Forms

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TO REGISTER A NEW STUDENT

Guide to the Student Registration Process
Pupil Registration Form / Emergency Contact Information Form / Medical/Insurance Information Form
Residency Affidavit for New Enrollments
Residency Affidavit for Students Without a Permanent Address
Questionnaire for McKinney-Vento Homeless Act (for determining residency)
Home Language Survey
Potassium Iodide (KI) Student Medication Authorization Form and related information
Millstone Power Station Readiness Plan
Consent for Release of Information
Kindergarten Parents As Partners
Programs and Services in the Lyme-Old Lyme Public Schools
Information Sources in the Lyme-Old Lyme Public Schools
Placement Agreement for Non-Resident Students

Note: when registering a new student, a copy of the student's birth certificate will be made, and evidence that the student's immunizations are up to date is required. New registrants must provide documentation on the appropriate State of Connecticut Health Assessment Record form of a physical exam that has taken place within 1 year of starting school (see links to forms below).


Call the schools to set up an appointment to register your child:

Lyme-Old Lyme High School (9-12) - 860-434-1651
Lyme-Old Lyme Middle School (6-8) - 860-434-2568

Mile Creek Elementary School (K-5) - 860-434-2209

Lyme Elementary School (K-5) - 860-434-1233


 
TO DOCUMENT A PHYSICAL EXAM OR MEDICAL REQUEST

Medical Requirements for all Students
State of CT Early Childhood Health Assessment Record (for Pre-K physicals)
State of CT Health Assessment Record (for new registrants, Kindergarten, Grades 6 and 9 physicals)
Sports Physical Examination Form
Authorization for the Administration of Medication by School Personnel (must be signed by the prescribing doctor)
Authorization for the Administration of Acetaminophen/Ibuprofen in the Middle and High Schools
Authorization for Emergency Epinephrine Administration to Students Who May Be Exhibiting Signs of Severe Allergic Reaction
Medical Exemption Certification Form
Religious Exemption Statement Form
Field Trip Medication Authorization Form
International Field Trip / Acknowledgement of Physician Consultation

 
DOES YOUR CHILD HAVE HEALTH INSURANCE?

Connecticut's HUSKY Plan offers low-cost or free health care
Student Accident Insurance (voluntary)

 

TO PARTICIPATE IN A MIDDLE OR HIGH SCHOOL SPORT

  1. Student athletes must provide documentation of a physical exam dated within 13 months of participation in a sport.

  2. Have no outstanding obligation to the school.
  3. Meet both academic and core values expectations.
  4. Complete registration through Familyid, which will cover the following forms: 

Permission to Participate in Interscholastic Athletics
Extracurricular Activities Notification Acknowledgement (BOE Policy #3600)
Medical Data Sheet for Coaches
Concussion and Head Injury Student/Parent Informed Consent Form
Sudden Cardiac Arrest Student/Parent Informed Consent Form

 

FREE AND REDUCED-PRICE SCHOOL MEALS OR FREE MILK

Application for Free and Reduced-Price School Meals or Free Milk (English)
Application for Free and Reduced-Price School Meals or Free Milk (Spanish)
Permission Form: Sharing Your Information With Other Programs
Frequently Asked Questions about Free and Reduced-Price School Meals
Income Guidelines for Free and Reduced-Price Meals
Information on SNAP: Supplemental Nutrition Assistance Program

 

OTHER HIGH SCHOOL FORMS

Student/Parent Agreement for District Issued Laptop
Permission for a High School Junior/Senior to Apply for a Parking Permit
Permission for a High School Senior to Apply for a Late Arrival/Early Dismissal

 

LOLHS COUNSELING DEPARTMENT FORMS

Brag Sheet
Educational Records Consent & Release Form
FERPA Consent, Release & Waiver for Letters of Recommendation
Recommendation Information Form

 

Miscellaneous Forms

PTO / PAB FAMILY DIRECTORY PERMISSION FORM