liberty north high school registration newsletter volume 1, issue 1 · 2016-06-22 · 2017 ayrie is...

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Registration Newsletter Liberty North High School 2016-2017 Laptop Distribution Dates Laptops will be distributed to all students on the following dates and mes. Please remember, laptop insurance premiums need to be paid by these dates. Insur- ance premiums must be paid on- line by vising One2Onerisk.com. SENIORS August 2nd, 8 to 11 am AND 12 to 2 pm in the LMC JUNIORS August 3rd, 8 to 11 am AND 12 to 2 pm in the LMC SOPHOMORES August 4th, 8 to 11 am AND 12 to 7 pm in the LMC FRESHMEN August 16th during Freshman Orientaon - 8 am to 12 pm in the LMC Registration Dates Registraon will take place on the following dates for the 2016-2017 School Year. Seniors—August 2nd, 2016 from 8:00 to 11:00 am AND 12:00 to 2:00 pm Juniors—August 3rd, 2016 from 8:00 to 11:00 am AND 12:00 to 2:00 pm Sophomores and Freshmen—August 4th from 8:00 to 11:00 am AND 12:00 to 7:00 pm Mail-in Registraon Deadline is July 29th, 2016 * NEW—pay your fees on-line. Visit hp://www.liberty.k12.mo.us and click on the LPS RevTrak link. From the Eagles’ Nest — Welcome from the Principal Welcome to the 2016-2017 school year. I hope each student and family has a very sas- fying experience at Liberty North High School this year. One very important characterisc of our school that helps with sasfacon and produc- vity is the desire to connue to work with all students and parents/guardians to make sure we communicate well and ensure a posive path of growth and development for each student. This communicaon is vital to helping each child find and develop his or her genius. Please plan to parcipate in parent events such as Open House, Parent Teacher Conferences and the myriad of school acvies we have as best you can. These and the normal email and phone calls go a long way in building the trusng relaonship that forms a strong support system for each student. We ask that you strongly consider joining the Eagle Club as well. This is another great way to be involved in and part of the experience at LNHS. You will greatly enjoy the par- cipaon this organizaon. Welcome to our sixth year at LNHS the home of the Eagles. Marn K. Jacobs, Ed. D., Principal LNHS Mail-in or On-line Pay Available In hopes of making registration easier on parents and students, this year we are of- fering on-line fees payment, as well as, mail-in registration. Paying on-line is as sim- ple as clicking on the LPS Website link to RevTrak. You will still need to complete all forms required and turn or mail them in to the administration office. If you wish to pay by mail, simply attach the required forms along with the Fees Worksheet and mail them with your check to LNHS Registration, 1000 NE 104th St., Liberty, MO 64068. Checks should be made payable to Liberty North High School. Your registra- tion will be processed and you may pick up your receipt with your schedule on the day of registration for your student’s grade level or anytime after that day in the Administration Office. All mail-in registrations must be post marked by July 29th in order to be processed and available by registration. Mail-in registration can only be made on the items listed on the worksheet. Pictures, lunch and Eagle Club fees will need to be handled separately. If you are paying for a parking permit, a copy of your student’s driver’s license and proof of insurance must accompany the form. Students with obligations or fines owed to the school will not be issued a parking permit until the obligation or fine has been cleared. July 2016 Volume 1, Issue 1

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Page 1: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

Registration Newsletter Liberty North High School

2016-2017 Laptop Distribution Dates

Laptops will be distributed to all students on the following dates and times. Please remember, laptop insurance premiums need to be paid by these dates. Insur-ance premiums must be paid on-line by visiting One2Onerisk.com.

SENIORS

August 2nd, 8 to 11 am AND 12 to 2 pm in the LMC

JUNIORS

August 3rd, 8 to 11 am AND 12 to 2 pm in the LMC

SOPHOMORES

August 4th, 8 to 11 am AND 12 to 7 pm in the LMC

FRESHMEN

August 16th during Freshman Orientation - 8 am to 12 pm in the LMC

Registration Dates

Registration will take place on the following dates for the 2016-2017 School Year.

Seniors—August 2nd, 2016 from 8:00 to 11:00 am AND 12:00 to 2:00 pm

Juniors—August 3rd, 2016 from 8:00 to 11:00 am AND 12:00 to 2:00 pm

Sophomores and Freshmen—August 4th from 8:00 to 11:00 am AND 12:00 to 7:00 pm

Mail-in Registration Deadline is July 29th, 2016

* NEW—pay your fees on-line. Visit http://www.liberty.k12.mo.us and click on the LPS

RevTrak link.

From the Eagles’ Nest — Welcome from the Principal

Welcome to the 2016-2017 school year. I hope each student and family has a very satis-

fying experience at Liberty North High School this year.

One very important characteristic of our school that helps with satisfaction and produc-

tivity is the desire to continue to work with all students and parents/guardians to make

sure we communicate well and ensure a positive path of growth and development for

each student. This communication is vital to helping each child find and develop his or

her genius. Please plan to participate in parent events such as Open House, Parent

Teacher Conferences and the myriad of school activities we have as best you can. These

and the normal email and phone calls go a long way in building the trusting relationship

that forms a strong support system for each student.

We ask that you strongly consider joining the Eagle Club as well. This is another great

way to be involved in and part of the experience at LNHS. You will greatly enjoy the par-

ticipation this organization.

Welcome to our sixth year at LNHS the home of the Eagles.

Martin K. Jacobs, Ed. D., Principal LNHS

Mail-in or On-line Pay Available

In hopes of making registration easier on parents and students, this year we are of-fering on-line fees payment, as well as, mail-in registration. Paying on-line is as sim-ple as clicking on the LPS Website link to RevTrak. You will still need to complete all forms required and turn or mail them in to the administration office. If you wish to pay by mail, simply attach the required forms along with the Fees Worksheet and mail them with your check to LNHS Registration, 1000 NE 104th St., Liberty, MO 64068. Checks should be made payable to Liberty North High School. Your registra-tion will be processed and you may pick up your receipt with your schedule on the day of registration for your student’s grade level or anytime after that day in the Administration Office. All mail-in registrations must be post marked by July 29th in order to be processed and available by registration. Mail-in registration can only be made on the items listed on the worksheet. Pictures, lunch and Eagle Club fees will need to be handled separately. If you are paying for a parking permit, a copy of your student’s driver’s license and proof of insurance must accompany the form. Students with obligations or fines owed to the school will not be issued a parking permit until the obligation or fine has been cleared.

July 2016 Volume 1, Issue 1

Page 2: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

Principal Assignments

Elisabeth Fletcher—all Freshmen

Precious Kurth—A-La Grades 10-12

Chris McCabe—Le-Z Grades 10-12

Counselor Assignments

Emily Presser—A-Ek Grades 10-12

Jill Brock—El-La Grades 10-12

Erin McMains—Le-R Grades 10-12

Dana Combs—S-Z Grades 10-12

Janai Howard—all Freshmen

Student schedules will be available for pick up on registration days. Counselors

will also be available in the field house to discuss concerns or to fix any possible

errors. Schedules will only be changed for the following reasons:

There is a gap in your schedule.

The student has not met pre-requisites for a course on their schedule.

A senior is missing a graduation requirement.

The student has already passed a course that is on their schedule

NEED HELP FINDING YOUR CLASSROOM? Tours are available in the area outside the Counseling Center.

The Registration Process

News from the Counseling Center

You may complete the following in any

order to avoid lines.

1. Pick up your schedule, locker as-

signment (if opt-in forms have been

submitted). LPS Transportation

Department requires all students at

the high school level who wish to

ride the bus to complete an opt-in

form.

2. Visit the different displays set up by

various LNHS clubs and organiza-

tions available to students.

3. Have required yearbook and ID

picture taken. Purchase of picture

packets are optional and a separate

check will be needed for purchase.

4. Visit the parking permit table and

check your eligibility to purchase a

permit. Students owing an obliga-

tion or fee to the school will not be

eligible to purchase a permit until

the obligation or fee is cleared.

5. Visit the Health Services Table to

turn in updated health records and

visit with school health staff.

6. Visit the Parent Contact Verification

and Parent Portal table. You may

update parent contact information,

as well as, receive information

needed to create a parent Power

School account to view student

information. Parent must provide

picture ID to receive this infor-

mation.

7. Stop by the Nutrition Services Ta-

ble—money may be placed on stu-

dent lunch accounts in this area. A

separate check will be needed.

8. Fee Payment Area

9. Stop and visit with a counselor if

you have a scheduling question.

10. Laptop distribution will take place in

the LMC for grades 10-12 on the

specified day. Freshmen laptops

will be distributed at Freshman

Orientation on 8/16. Please be

reminded laptop insurance waiver

needs to be purchased on-line at

One2Onerisk.com prior laptop pick-

up.

Page 3: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

Yearbook Information

Yearbooks may be purchased at

registration. The cost of the 2016-

2017 Ayrie is $55 and for an addi-

tional $5.00 the student may have

their name engraved on the cover.

On August 17th, 2016 the cost of

the yearbook will be increased to

$60.00 and $65.00 for the en-

graved yearbook. The last day to

order a yearbook will be January

6th, 2017. After 1/6/2017 year-

books may be purchased on distri-

bution day 5/12/2017 for $75.00

on a first-come-first-served basis.

Please contact Ronna Sparks-

Woodward at 816.736.5500 for

more information.

Registration Fees Payment Information

This year we are offering a few

different ways to pay fees for regis-

tration.

1. Pay on-line Via Rev Trak

2. Mail-in Registration

3. Fees Payment Area the day of

registration.

If paying fees at registration, sepa-

rate checks will need to be written.

1. Reed Portrait Group for pic-

tures (optional)

2. Eagle Club for membership

(optional)

3. LNHS Nutrition Services

(optional)

4. LNHS for fees

GET INVOLVED WITH LNHS—SCHOOL CLUBS AND ORGANIZATIONS The following is a list of clubs and organizations which are open to Liberty North High

School students. Please make certain you check out their information tables at regis-

tration!

A+/Martin Jacobs American Indian and Pottery Club/Chablis Brendel

Aviation Club/Brett Kisker Art Club/Angie McCune

Book Club/Connie King Biology One Club/ Andrew Bilen

Chess Club/Jamie Jacob Color Guard/Amy Hall

Drama Club/Kim Lenger DECA/Kristen Hittner

Diversity Council/Lisa Nicewaner Educational Internship Program/Melissa Taylor

Environmental Club/Michelle Fairhurst Educators Rising Association/Melissa Taylor

FAC/Doug Davis FCCLA/Jody Fowler

Gay/Straight Alliance/Ted Maxwell French Club/Leigh Ann Zerr

German Honor Society/Stefan Frank Guitar Club/Matt Larson

Improv (BBFP)/Sara Turner Key Club/Katie Mitchell

KNET/Jennifer Higgins LINK/Craig Deaver

Mock Trial/Kim Scholes Model UN/Kurt Gates

National Honor Society/Jill Brock Robotics

Scholar Bowl/Mary Coogan Spanish Club/Spanish Honor Society/Susan Lynn

Speech and Debate/Sean Nicewaner Sports Marketing

Student Ambassadors/Erin Dennis Student Council/Lindsey Plaster

Theatre/David Young Thespians/Rebecca Dempsey

2015-2016 DECA State Champions

Page 4: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

REGISTRATION FEES WORKSHEET

4

LOCKER OPT-IN FORM

LNHS PARENT CONTACT INFORMATION

LIBERTY NORTH HIGH SCHOOL

FEE DESCRIPTION COST

ACT Prep Fee $60.00

Activity Ticket $30.00

Athletic/Family Punch Pass $40.00

Parking Pass $60.00

Pay to Play $50.00

Senior Class Fee $15.00

Yearbook - Engraved $60.00

Yearbook (not engraved) $55.00

Page 5: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

Visit the Athletic website to receive the latest news and information on Eagle Sports direct from the LNHS Athletic Department. http://eagleathletics.liberty.k12.mo.us

Liberty North Fall Sports parent information meeting for athletes in grades 9-12 will be

Sunday, July 31, 2016 @ 1:30 p.m. in the Liberty North Field House. Topics of discus-

sion will be eligibility, MSHSAA citizenship policy and our athletic policy. Athletic train-

ers will speak about prevention of injuries and proper nutrition. In addition, our Eagle

Club will make a brief presentation. Each head coach will be introduced and then will

break out into meetings to cover sport specific information. Coaches will introduce

their staff, cover practice time, game schedules and team expectations.

MSHSAA requires every athlete to have a current physical completed (dated after

February 1, 2016) prior to the athletes first day of practice. First day of fall practices

Monday, August 1, 2016.

Physical forms are available in the Liberty North main office or can be downloaded

from the LNHS Athletic website. Please be certain parent and player has signed all

necessary pages and health insurance information is current and correct.

The MSHSAA information packet regarding athletes and concussions is required to be

reviewed by every athlete and parent/guardian.

The concussion material will be available in the LN athletic office and can also be

downloaded from the LNHS website. A signature of acknowledgement is required

from each athlete and parent/guardian that the concussion materials have been re-

ceived and reviewed.

Bob Kernell, Athletic Director,

[email protected]

816.736.5500

Heather Callura, Athletic Secretary,

[email protected]

816.736.5501

HEAD COACHES

Mens’Soccer—Art Smith

Mens’ Swim and Dive—Mark Warner

Football—Ken Clemens

Softball—Brett Kisker

Women’s Golf—Jeff Braden

Cross Country—David Chatlos

Volleyball— Katie Dowden

Women’s Tennis—Doug Davis

5

Athletic Physicals

LN Athletic Contacts & Fall Head Coaches

2016-2017 Athletic Parent Meeting for Fall Sports

Concussion Information

LNAthletics is now on

twitter

At

http://twitter.com/

LNAthletics

Page 6: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

Athletic Parent Meeting for Grades 9-12—July 31, 2016 @ 1:30 p.m.

Grades 9-12 have the option to purchase a high school activity pass. This pass will admit students into LNHS home

athletic events, excluding tournament and post season competition. The cost of the activity pass for the 2016-

2017 school year will be $30.00 and will be discounted to $15.00 second semester. The activity pass will be added

to the student ID card and distributed in August or before the first home event. Passes may be purchased during

student registration or anytime during the school year in the athletic office.

Grades 6-8 have the option to purchase a middle level activity pass for high school events. The middle level pass-

es will admit students into Liberty North home athletic events excluding tournament and post season competi-

tion. The Eagles middle level pass will be a separate card from the student ID card. Middle level passes will be

available for purchase during the middle level registrations and in the Liberty North Athletic office anytime during

the school year. The cost of the pass will be $30.00 and will be discounted to $15.00 second semester. LPS is not

responsible for lost or stolen Cards.

Liberty North Adult/Family Athletic Punch pass is $40.00 for 10 admissions. The pass may be used at Liberty North

High School home events, with the exception of tournament and post season competition. The high school ath-

letic office and the admission gate for every home event will have punch passes for sale throughout the year.

Missouri State High School Ath-

letics and Activities Association

requires each participant to have a

minimum of 3.0 acceptable credits

of course work for the semester

prior to their participation in ath-

letics, vocal & instrumental music,

debate, forensics, and scholar

bowl. This equals six classes. In

addition students must be en-

rolled in six or more classes for fall

semester.

The fee for the 2016-2017 school

year will be $50.00 for the year,

this does not include a high school

activity pass. There will be a maxi-

mum of $100.00 per family per

year. Any student participating in

a MSHSAA activity will be respon-

sible for paying this fee. For fami-

lies that qualify for “free or re-

duced” lunch the Pay to Play fee

will be waived. Please contact LPS

Nutrition Services 816.736.5375

for more information on the free

or reduced lunch program.

6

Eagles Middle Level Athletic Pass Heritage Middle and South Valley Middle Schools

Academics

LNHS High School Activity Pass

Adult/Family Athletic Punch Pass

Pay to Play

Page 7: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

Liberty Public Schools Secondary Health Record Update For 2016-2017 (through Summer School)

Your child’s learning depends upon good health. To assist in providing health services at school, please complete the following

form and return it to the school nurse. This is required annually.

Student: _____________________________________________________ Grade: ___________ Sex: M / F (last) (First) (MI)

Medical History: Check all those that apply: Please explain conditions marked in space below chart:

Asthma

Food Allergy

Diabetes

Low Blood Sugar

Seizure/Neurological Disorder

Heart Disorder

Drug Allergy

Other Allergy

Respiratory Impairment

Kidney/Urinary Disorder

Scoliosis

Skin Disorder

Bon/Joint Disorder

Stomach Disorder

Migraines

Blood Disorder

ADHD/ADD

Anxiety Disorder

Bipolar Disorder

Depression

Hearing Impairment/Aids

Glasses/Contacts

Vision Disorder

Other

Note: Physician documentation (including an emergency action plan) will be required for all significant diagnoses such as:

Asthma, Food Allergy, Seizure, Diabetes, and others.

Please explain any conditions checked above:____________________________________________________________________

_________________________________________________________________________________________________________

List any surgeries: __________________________________________________________________________________________

_________________________________________________________________________________________________________

Do you believe your child has a physical or mental impairment that substantially limits a major life activity in the school environ-

ment? _____ Yes _____ No.

If yes, please explain the condition and how it substantially limits your child: ___________________________________________

_________________________________________________________________________________________________________

Please list any medication (s) your child takes at home: ____________________________________________________________

_________________________________________________________________________________________________________

NOTE: IF A STUDENT IS TO RECEIVE MEDICATION AT SCHOOL, A SEPARATE FORM WILL NEED TO BE COMPLETED.

Tylenol Permission: Must check ‘yes’ or ‘no’ and provide signature below for Tylenol.

_____ Yes _____ No I give permission for my child to take Tylenol 3325mg (1-2 tablets) every 4 hours as needed during the

school day. Note: You will be notified if your child has taken 10 does of Tylenol in a school year. We will only give 25 doses of any combination of medications

containing Acetaminophen (such as Tylenol) or non-steroidal anti-inflammatory medication such as Ibuprofen, Aleve, etc. In one given school year. A doctor’s order

will be required for any additional doses above 25. The school only stocks Tylenol. Others need to be provided by the parent/guardian.

While medical information is confidential, I understand the school nurse and other school staff may at times deem it necessary to

share a student’s information, including district health update forms as supplied by the parent with other school personnel, in-

cluding but not limited to teachers, administrators, transportation and cafeteria staff. As a parent I may also share information

as I deem appropriate with my child’s teacher, bus driver, or other specific staff member independent of the school nurse or

other school staff sharing this information.

Parent/Guardian Signature: _________________________________________________ Date: _________________________

(For nursing notation only below this line. Staff to list date and initials when making notations.)

Counselor Referral ___________________________________ Action Plan Given (specify Type): _____________________________________________________

Page 8: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

The Eagle Club Officers for the 2016-2017 School Year are as follows:

President: Rich Schipper

Vice President for Activities: Kim Skinner

Vice President for Athletics: Sam Henderson

Vice President for Membership: Jennifer Muchow

Secretary: Laura Peterson

Treasurer: Susan Burns

Concession/Fund Raising: Theresa Prendergast/Kimbra Downey

Immediate Past President: Linda Wansing

Eagles Are Soaring High!

EAGLE CLUB

EAGLES TAKE FLIGHT!

Welcome all Eagle Families to the 2016-2017 school year. The Liberty North Eagle Club wishes to welcome you either as a

new family or a returning family. The Eagle Club is a combination of a PTSA (Parent, Teach, Student Association) and an

Activity Booster Organization. The Club (referred to as LN Eagle Club) operates under the by-laws of the Missouri PTA.

Any club, team, or organization at Liberty North has the option to participate in the LN Eagle Club. By joining forces as a

PTSA and a Booster Club, we are able to work as one strong unified group to further the principles of each organization.

The Liberty North Eagle Club offers you the perfect way to get involved in the school by being connected. The involve-

ment can range from working in your child’s area of interest, working a concession stand, or leading a volunteer com-

mittee. It also serves as a wonderful way to get to know other parents, teachers, club sponsors, coaches, or administra-

tors. To ensure that we have a successful year, your families support and involvement is critical to our organization. The

Eagle Club will offer multiple opportunities to sign up for membership, either at registration, online, or at fall events. The

Eagle Club meets every 2nd Wednesday of the month at 7pm and you can find the minutes and general information from

each meeting posted on the Eagle Club website.

On behalf of each of the Eagle Club officers and myself, I want to once again welcome you to the Liberty North High School family and the LN Eagle Club. Together, we can achieve great success for our students, staff, and facility. I would also like to thank you in advance for your time commitment and your resources to help facilitate a great learning experience for our students and staff. Please feel to contact me at [email protected]. Rich Schipper

Eagle Club President

2016-2017

Page 9: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the
Page 10: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the
Page 11: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

Liberty North High School Parking Pass Policies & Procedures

ELIGIBILITY:

Student must be seniors, juniors and sophomores for the current school year

Students must have a valid driver’s license

Students must have insurance on the vehicle

Students must have cleared all financial obligations

Students may be denied the privilege to park based upon attendance issues, discipline issues, and/or

parking/driving incidents

REQUIREMENTS:

All students who are granted the privilege to park must have their parking permit displayed properly in their vehi-

cle. All students will be issued a student parking permit and must park in the student lots only. Students are not

allowed to park along curbs, on fire lanes, or in the faculty/visitor parking lots. All parking locations are clearly

marked.

VIOLATIONS:

A ticket, parking boot, or tow (as deemed appropriate by the school administration) may occur for any violation.

Tickets cost a minimum of $10.00, boot cost a minimum of $50.00, and towing fees are based upon tow company

rates and will be accompanied by a $10.00 ticket. Persistent offenders will face disciplinary consequences, and/or

lose the privilege of parking during the current school year and/or the ability to park during the receding school

year.

LOSS OF PRIVILEGE:

Student behaviors including, but not limited to, the following list may result in loss of parking privileges for the

remainder of the current school year and/or the ability park during the following school year.

NON-REFUND POLICY:

If a student loses the privilege to park on campus during the year, he/she is not eligible for a refund of parking

fees.

Any student parking permit questions, contact Bob Kernell at 816.736.5504

Being tardy more than 10 times per semester throughout

the school day

Leaving the school grounds and/or taking others

with you in your vehicle during the school day

Exceeding the attendance caps of 10+ days per semester

for any class, including study hall

Financial obligations which have not been paid in a

reasonable period of time, 60 days

Having two or more parking violations Vehicular noise which disturbs school

Dangerous driving in the lot

Page 12: Liberty North High School Registration Newsletter Volume 1, Issue 1 · 2016-06-22 · 2017 Ayrie is $55 and for an addi-tional $5.00 the student may have their name engraved on the

School Year

2016-2017

Permit #

Liberty North High School

Parking Permit Application

Student’s Name: ___________________________________________________________________ Last Name First Name Middle Initial

Student’s Home Phone: ______________________ Student’s Cell Phone: _____________________

Grade: 10 11 12 Diver’s License Number: ________________________________________

Vehicle Make/Model: ________________________ Vehicle Year: ___________________________

License Plate Number: ________________________Vehicle Color: __________________________

Insurance Company: _________________________ Policy Number: _________________________

Parent/Guardian(s) Name: ___________________________________________________________

Vehicle Registered Owner: __________________________________________________________

Turn in all registration materials to Julie Kinder in the LNHS Administration Office

_____ Completed copy of this form, signed by parent and student

_____ Photocopy of driver’s license

_____ Photocopy of vehicle insurance card

_____ Payment of $60—cash, check, money order or pay on Rev Trak

CONSENT TO SEARCH: By executing this Parking Permit Application I/we hereby consent to the

search, by school officials or law enforcement, of any vehicle I/we park on school premises. I/we

will open the vehicle upon demand by the school officials or law enforcement. Refusal to allow a

search of my vehicle while parked on school premises will result in the revocation of any parking

permit issued pursuant to this application.

AGREEMENT: My child and I have read and discussed the information regarding parking rules on

this form. We realize that it is a privilege to park at Liberty North High School and this privilege

can be revoked without the refund of the parking fee.

___________________________________________ ___________________________________

Parent Signature Date Student Signature Date