Student Information

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Student Release - Name & Photo

Student Medical Information

If not applicable, list 'NONE'​

Parent/Guardian Information

Parent 1 Information

Parent 2 Information

Emergency Contact Information (other than parents)

La Pietra provides families access to a password protected Student-Parent Online Directory. Please indicate below what information you would like to be included in the directory for the 2019-20 School Year. We request at least one form of contact to be published.


Your electronic signature below gives your child permission to make off-campus field trips, permits school staff to seek medical treatment should it be necessary and a parent unavailable, and it absolves the school and its agents of liability in the event of accident, illness, or other unforeseen events.

My electronic signature of my full name below denotes agreement to all the terms listed above in addition to acknowledging my family and daughter have read and accepted La Pietra’s 2019-20 Parent-Student Handbook including academic honesty and expectations, and will adhere to those policies. I understand that the Handbook is a general overview of the School’s policies and guidelines and that these policies and guidelines, as well as any other policies and guidelines which may be adopted by the School, are subject to modification, discontinuation or change without notice.

Enter Full Name​
Enter Full Name​