VPK Program | VPK Providers in St Johns County

Your search for a quality Center is now over. You no longer have to worry leaving your children with someone else. Join our SCHOOL FAMILY and ENROLL your children now!

Enrollment Form
Before & After School Permission Form
Automatic Payment Form

Family Information

Last Name *

First Name *

Relationship to Child *

Social Security Number

Street Address *

City *

State *

Zip Code *

Home Phone

Work Phone

Ext

Cell Phone

Email *

Last Name *

First Name *

Relationship to Child *

Social Security Number

Street Address *

City *

State *

Zip Code *

Home Phone

Work Phone

Ext

Cell Phone

Email *

Child Information

Last Name *

First Name *

Sex *

Date of Birth *

Date of Enrollment *

Child Lives With

Custody *

Physician Phone

Dentist Phone

Hospital Preference

Known Allergies

Emergency / Release Contacts

Name

Contact Number

Address

Name

Contact Number

Address

Name

Contact Number

Address

Name

Contact Number

Address

Authorization

Section 65C-22.006(2), F.A.C., requires a current physical examination (Form 3040) and immunization record (Form 680 or 681) within 30 days of enrollment.

Section 402.3125(5), F.S., requires that parents receive a copy of the Child Care Facility Brochure, "KNOW YOUR CHILD CARE FACILITY"

Section 65C-22.006(4)(c)2., F.A.C., requires that parents are notified in writing of the disciplinary practices used by the child care facility.

Influenza Virus Brochure (DCF licensing requirement)

Children will be released only to custodial parent or legal guardian and the persons listed above. By signing below, you verify that you have received the above items and that all information on this enrollment form is complete and accurate.

Parent /Legal Guardian's Name *

Date

Registration / Supply Fee

A registration/supply fee of $100.00 is due upon enrollment. This is an annual, non-refundable fee. This fee is utilized for your child's equipment and supplies for the year. (Excluding Part-time VPK)

(initials) *

Weekly Tuition Fees

Tuition is due EVERY FRIDAY for the COMING WEEK. If payment is not made by start of Monday (7:00am) of the current week, a $10.00 late fee will be added for that day and each day thereafter until tuition is paid in full. We reserve the right to deny admission until your account is current.

(initials) *

Late Pick-Up

The hours of operation at Hidden Little Treasures Learning Center are:

Monday-Friday, 7:00am-6:00pm by the COMPUTER CLOCK!

Late pick-up fees will be charged as follows for children not picked up on time:

$5.00 for the first minute and $1.00 each additional minute/per child picked up after 6:00pm

(initials) *

Vacation / Absence / School Closures

If your child is absent partial weeks for any reason, tuition remains the same. You will receive 1 week credit per school year (August 25-July 31st ) FREE. Your child must be enrolled at Hidden Little Treasures for 3 months in order to be eligible to receive a one week vacation credit. You will need to pay the full cost of any additional weeks your child is absent to keep his/her space. Tuition is due in full for the week whether your child attends or not or for the days that the school is closed. This includes weather related/emergency closures. Make up days will not be allowed.

(initials) *

Withdrawals

If for any reason you withdraw your child(ren) from Hidden Little Treasures Learning Center, a two weeks WRITTEN NOTICE is required and tuition is due and payable for those two weeks whether or not your child attends. Tuition will be charged until such notice is given.

(initials) *

Parent Handbook Acknowledgement

I have clearly read Hidden Little Treasures Learning Center’s Parent Handbook that is located online on the Center’s website and have asked for clarification for anything that I did not understand or have a question about.

(initials) *

Parent Name *

Date *

EMERGENCY RELEASE FORM

, give permission for Hidden Little Treasures Learning Center to provide First Aid/CPR For My Child

Emergency Information

Address

Phone Number

In the case of an emergency I give permission to take my child to (Hospital name)

If my child needs to be transported by an ambulance service please use

I understand all procedures and have given consent on all areas listed.

Parent Name

Date

PHOTOGRAPH / VIDEO CONSENT

,give Hidden Little Treasures Learning Center consent to photograph or videotape my child

I understand that these pictures and videos will not be used in any other means than to show the growth, development and the enjoyment that my child has at Hidden Little Treasures Learning Center. These pictures and videos will not be given to anyone but be used solely for Hidden Little Treasures Learning Center and its website

, give Hidden Little Treasures Learning Center consent for my child

to watch videos that relate to an activity or subject talked about in class.

Parent Name

Date

Child's Biography

Child's Disposition

How does your child react when you leave him/her?

What is your child's normal disposition?

Does your child have any bad habits?

Yes

if Yes , what are they?

Are there any restrictions to play or activities?

Yes

if Yes , what are they?

Any speech, hearing or vision problems?

Yes

if Yes , which one(s)?

Is your child prone to any illness (such as headaches, tummy aches, etc)?

Yes

if Yes , what are they?

How is your child most easily settled?

Sleeping

What is your child's mood when they are put to bed?

What is your child's mood when they wake up?

Does your child take a nap?

Yes

if Yes , when?

Personality Traits

Has your child had experience playing with other children?

How does your child act when he/she is:

Afraid?

Happy?

Angry?

Tired?

Toilet Training

Is your child toilet trained or in the process?

Yes

If Yes, what are the steps you are using to toilet train your child?

Does your child have any fears related to potty training?

Yes

Does your child have any accidents?

Yes

What word does your child use for:

Bowel movements?

Urination?

Soiled Diaper?

Kindly complete the form below and submit once done

From

Transportation: Hidden Little Treasures Learning Center

From

Transportation: Hidden Little Treasures Learning Center

Notes

I give permission for my child *

To be*

dropped off to and / or

released from

The care of

I fully understand that my child will be transported

to and / or

from

for before and /or after school care

Parent/Guardian Signature *

Transportation

Automatic Payment Form