Back to School Forms

1. Handbook Agreement Form - This form documents parent and student acknowledgement of the St. Ambrose Student/Parent Handbook and its contents. The Student Parent Handbook serves as the primary starting point when issues or concerns arise throughout the year. If you have more than one student, please submit an individual agreement for each student.  *This document must be signed and dated AFTER the handbook is published for the current school year*

2. Media Release for Minors - You have the right to prohibit the use of your child’s name, picture and voice in school/parish/Diocesan media and may do so by completing this form. Please read the options below carefully as you consider your decision and electronically sign this form for each child. If you do not submit a form, we will assume that you give permission for all options listed on the form.

3. HHU, Permission for Emergency Care/Extended Day registration- This is required annually, and prior to the first day of school, for every student and provides an opportunity for parents to alert the school of any changes in a student’s medical conditions. Without this form your child cannot be seen in the clinic for any reason. The parent will be called as opposed to being treated by the nurse.  

4. Commonwealth of Virginia School Entrance Form - New students and rising kindergartners only. Due prior to the first day of school. The physical exam should be dated within the current calendar year.  *Must be printed and signed*

Optional Forms:

1. Medication Authorization Form - If your child uses over the counter or prescription medications and needs them during school hours, please fill out this form.  Please note: over the counter medications do not require a physician’s signature.  *Must be printed and signed*

2. Allergy & Anaphylaxis Care Plan - If your child has a life-threatening allergy with a prescription for an epipen as part of his/her allergy treatment, please fill out this form.  *Must be printed and signed*

3. Virginia Pediatric Asthma Action Plan - If your child needs to use an inhaler during school hours, please fill out this form.  *Must be printed and signed*

4. Seizure Action Plan - Please complete this form if your child has a history of seizures.  *Must be printed and signed*
 

5. Diabetes Care Plan - If your child has diabetes, please fill out this form.  *Must be printed and signed*
 

6. Hot Lunch Service by Wholesome Lunch Services – WLS delivers lunches from local vendors directly to schools. Each lunch is sealed and labeled with your child’s name, grade, teacher + dietary restrictions. You can order and pay directly through the WLS website.

7. Walker Form - Please fill out this form if your child will be walking or biking home from school at any point during the school year.

For Application forms see the Admissions Page