Enrollment Agreement

KIDS LANGUAGE ACADEMY LLC – ORLANDO FL

 

A. ENROLLMENT AGREEMENT

Welcome to Kids Language Academy!

This is a great choice for your child! We’re honored to become a part of your child’s early learning experiences – and we’re excited to get to know you, your family members, and all the important people in your child’s life.
The first important thing we want you to know, is we are committed to making you time with us 100% positive. We want be part of your family and for that reason we see our students as our own child.
For that and many other reasons PLEASE call us at any time, we are not just a Child Care you are now part of our family, and family answer questions at any time.

One more time, welcome to Kids Language Academy!


1a. TELL US ABOUT YOUR CHILD

FIRST NAME
MIDDLE
LAST
NICKNAME
DATE OF BIRTH
GENDER
 Male Female
LANGUAGE SPOKEN AT HOME
Child(ren) lives with (check one):  Mother Father Both Guardian
Child's home address
Home Phone
Please list family members your child lives with, including the name and ages of sibilings.
Desire start date:
Days he or she will attend
 M T W TH F Parents night out

2a. TELL US ABOUT YOU

Our top priority is the safety of children in our academy. Our staff will release your child ONLY if the parents and guardians listed – or to the other emergency contacts you authorize below.
If in case you need to authorize a new pick up person by phone, you may do so – but we will need to ask you to answer the two security questions you provide here to verify your identity. For your child’s safety, any time a person we do not recognize comes to pick up your child, we will ask for a government – issued photo ID.

Parent/Guardian Relationship to child Cell phone
Home address Email address Home phone
Employer and address State Work phone
Parent/Guardian Relationship to child Cell phone
Home address Email address Home phone
Employer and address State Work phone

3a. EMERGENCY CONTACTS INFORMATION AUTHORIZED TO PICK UP YOUR CHILD (18 OR OLDER)

Security Questions Question 1 Answer
Question 2 Answer
Item Authorized Contact #1 Authorized Contact #2 Authorized Contact #3
Name
Relationship
Address
Phone
Alternative Phone
The people named here are authorized to pick up my child. I will notify the center on days when an authorized "Emergency Contact" will pick up my child.
Kids Language Academy - Discount, if applicable :
Free enrollment
Other:
Office / Notes
(Always write the date at the end and name of the person who wrote it)
Date - Revision - Effective - Page Parent/Guardian signature: Center Director signature: