SECTION A -- Minor’s Personal Information: Fill out completely. Parent/Guardian must sign.
SECTION B -- Employment Information: Have your employer fill out this section completely. Your employer must sign.
SECTION C -- Physician’s Certification: During the school year, if you have a current physical (within the last 365 days) on file with the school, this section can be completed by a Cherokee Nurse. During the summer, you will need to have your physician complete Section C.
SECTION D -- Proof of Age: If you are a current Cherokee student, you do not need to provide us with a birth certificate or other age-related items.
SECTION E -- School Record: Completed by a Cherokee staff member if you attend Cherokee, otherwise completed by your school.
SECTION F -- Issuing Officer Certification: Completed by a Cherokee staff member. Make sure you sign and date where it states "signature of minor."
After you have filled out your sections, you may email the form to: InfoCherokee@LRHSD.org, or you are welcome to bring the form to the main office in the north building.
Office hours during the school year are 7:00 am to 3:30 pm, Monday thru Friday.