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Registration Forms

These forms must be turned into LALC prior to your start date and are updated on an annual basis. 

  • Emergency Contact Form
    ~Update due 2nd week of Aug.  Don't leave anything blank. If it does not apply write N/A.

     
  • Permission Form & Illness Policy
    ~Update due 2nd week of Aug.

     
  • Yearly Physical Form & Immunization Certificate
    ~Physicals are due 1 year from the previous form and the immunization certificate should be updated every time new shots are given. Immunizations must say "Iowa Dept of public health, certificate of immunization."  Must be signed by doctor/nurse.

     
  • Food Allergy Action Plan
    ~Update due 2nd week of Aug. This is only required if your child has an allergy. 
  • Must be filled out and signed by a doctor.
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  • Asthma Action Plan
  • ~Updated yearly and only required if your child has asthma.  Must be filled out and signed by a doctor.
     
  • Tuition Express Electronic Funds Transfer Authorization
    ~Update if bank account changes

Child and Adult Food Program Forms

These forms must be turned into LALC prior to your start date and are updated on an annual basis in the fall. Please fill out the application and enrollment form even if you don't qualify. You do NOT have to put your salary down or your social security number. We still get a small reimbursement even if you are over the income limits so it is important that this is turned in.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.

USDA is an equal opportunity provider, employer, and lender.

 

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