LBHS Emergency Contact Information Form
This form needs to be completed for each of your students at the beginning of the school year. Parent/guardian must enter a valid email address to complete the form. Please have your student's emergency contacts and medical information on hand before you start completing the form.
Email address *
Student ID#
Student Last Name *
Student First Name *
Student Middle Name
Gender *
Grade Level
Date of Birth *
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List of names of siblings attending Luther Burbank High School (please include first and last name)
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