Items highlighted in yellow are required.
Authorization for Emergency Medical Care
(Please print and bring to office after it has been signed)
This can be FAXED directly from your child’s Pediatrician.
FAX (316) 684-2847
(ONE form is required for EACH individual child enrolled)
The Application Form can be found HERE.
Holy Cross Lutheran Church and School admits individuals without regard to race, color, gender, disability, age, ancestry, national origin, or veteran status. Holy Cross does not discriminate on the basis of any of the aforementioned categories with regard to the administration of any policy or program.
Holy Cross Lutheran Church
600 N Greenwich Rd, Wichita, KS 67206 | 316-684-4431 | Fax: 316-684-2847Site By: LMG