HAPPYLAND PRESCHOOL REGISTRATION 2018 - 2019

REGISTERING FOR: Tues/Thurs 3’s ______Mon/Wed/Fri VPK 4’s ______

CHILD’S FULL NAME ______

NAME YOU WOULD LIKE CHILD CALLED______(this will also be the name we teach them to read and write)

MALE______FEMALE______

CHILD'S BIRTHDATE AND YEAR______

PARENTS’ NAME ______

HOME ADDRESS ______

HOME PHONE NUMBER ______EMAIL ______

CHILD LIVES WITH______

CUSTODY:MOTHER_____ FATHER_____ BOTH_____ OTHER______

FATHER'S OCCUPATION ______

FATHER'S WORK PHONE NUMBER ______CELL ______

MOTHER'S OCCUPATION______

MOTHER'S WORK PHONE NUMBER ______CELL______

NAMES AND AGES OF SIBLINGS______

SPECIAL FEARS OF CHILD______

SPECIAL INTERESTS OF CHILD______

FORM OF DISCIPLINE USED AT HOME ______

RELIGIOUS PREFERENCE______

TERM USED FOR "TOILETING" AT HOME______

IF MILITARY, EXPECTED ROTATION DATE______

Medical Information: I hereby grant permission for the staff of this facility to contact the following medical personnel to obtain emergency medical care if warranted:

Doctor______Address______Phone______

Hospital Preference ______

Please list allergies, special medical needs or other areas of concern: ______

______

I HAVE READ THE "KNOW YOUR CHILD'S DAY CARE CENTER" BROCHURE AND UNDERSTAND THAT HAPPYLAND PRESCHOOL IS A LICENSED PRESCHOOL (LICENSE NUMBER C01OK0006) AND MEETS ALL REQUIREMENTS SET BY THE STATE OF FLORIDA.

DISCIPLINE AT HAPPYLAND PRESCHOOL HAS BEEN THOROUGHLY EXPLAINED AND I UNDERSTAND THAT NO FORM OF PHYSICAL PUNISHMENT IS EVER USED ON THE CHILDREN. A BRIEF PERIOD OF "TIME OUT" AND/OR A VERBAL REPRIMAND MEETS WITH MY APPROVAL FOR ANY UNDESIREABLE BEHAVIOR ON THE PART OF MY CHILD.

I UNDERSTAND THAT I AM TO PROVIDE A DAILY SNACK , DRINK AND LUNCH FOR MY CHILD UNLESS OTHERWISE INSTRUCTED.

I UNDERSTAND THAT I MUST PROVIDE A SCHOOL PHYSICAL FORM AND A FLORIDA IMMUNIZATION CARD FOR MY CHILD PRIOR TO MY CHILD’S FIRST DAY OF SCHOOL.

Contacts: Child will be released only to the custodial parent or legal guardian and the persons listed below. The following people will also be contacted and are authorized to remove the child from Happyland in case of illness, accident or emergency, if for some reason the custodial parent or legal guardian cannot be reached:

______

Name Phone#Relation to Child

______

Name Phone#Relation to Child

______

Name Phone#Relation to Child

______PARENT'S SIGNATURE DATE

Happyland Preschool

1018 White Point Road

Niceville, FL 32578

Dear Parents,

Attached is a registration form for the 2018 - 2019 school year. Please complete the front and back and return it as soon as possible. In-house registration will be until February 14. Families with children currently enrolled canbegin turning in forms. Open registration will begin on February 20. Completed forms will be accepted on a first come first serve basis beginning Feb 20 at 8:00 am.

In order to enroll in the 3 year old class, your child must be 3 years of age by September 1, 2018. The 3 year old class is held Tuesdays and Thursdays, 9:00-2:00. Registration fee is $150.00 and must accompany the registration form. Tuition is $180.00 per month.

In order to enroll in the 4 year old class, your child must be 4 years of age by September 1, 2018. This is a VPK class and the state will not allow any exception to the age. The 4 year old class is held Mondays, Wednesdays, and Fridays, from 9:00 – 3:00. The tuition for this class is paid for by the state. The parents must obtain a “Certificate of Eligibility” from Child Care Services to complete enrollment (Child Care Services will require a copy of your child’s birth certificate and proof of Florida residency). Instructions for obtaining this certificate are on the reverse side of this page. Without a certificate, tuition is $275/month.

Please feel free to contact me if you have any questions.

Cindy Zimmermann

Office: 897-3400

Email: