All forms must be completed prior to the first day of school.
Forms are currently uploaded for the 2022/2023 school year. We will update the forms for next school year later this spring. We will send you a reminder to re-visit this page at that time.
You may return completed forms:
- Email attachment to lori.butts@hlccpreschool.org
- Hard copy through the USPS mail
- Fax: 740-964-6333
Fill in every line completely! If the information does not apply to you, you may mark N/A in the space.
Pay special attention to JFS Form 01234. This is a four page form required by the State of Ohio for ALL students. This form is reviewed by ODJFS when they come in and do our inspection, so it must be accurate.
On page 4, there is an Emergency Transportation Authorization. The Program or Home Name is “HLCC”. You must fill out EITHER the left or right side.
- If you authorize emergency services/an ambulance to transport your child for medical care should we need to call them, fill out the LEFT side boxes.
- If you do not want your child transported by emergency services/an ambulance, complete the RIGHT side boxes. This means while we may call 911, we will wait on you to arrive before your child is transported.
Medical forms are due within 30 days of the child’s start date. Medical forms are good for 13 months form the date seen on the Medical form. If you are a returning student, we may have your Medical form already on file.
On the Authorization for Photographs form, initial ONE of the three options for sharing photographs or your child.
- The first allows us to post pictures on the locked website, advertising, and social media.
- The second is locked website only (password protected).
- The third is NO photographs anywhere on social media or the locked website.
You may send all other forms ahead while waiting on the Medical form to be completed.
If you have questions about the forms, please contact HLCC director by email: lori.butts@hlccpreschool.org