Language
  • English (US)
  • Growing Learners

    2020-2021Growing Learners After School Application
  • Instructions

    1. Student's photograph* must be taken and saved to the tablet or electronic device used to complete this application BEFORE entering any information into the form below. 
    2. A photograph* of the signed and dated Influenza Virus DCF Form, complete with Parent/Guardian and Child's Name, must be taken and saved to the tablet or electronic device used to complete this application BEFORE entering any information into the form below. (Note: The upload button for the Influenza Virus DCF Form will appear on the last page of the application.)
    3. Any additional photographs* or documents* that need to be uploaded to this form must be saved to the tablet or electronic deviced used to complete this application BEFORE entering any information into the form below. Additonal photographs include photographs of persons not allowed to pick up student; additional documents include copies of immunization forms, court orders, or letters from doctor(s). 

    *Uploaded photographs must be less than 10 MB.

    ** Required fields are marked with an (*). 

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    Pick a Date
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  • Family Information

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  • Emergency Contacts

    & Authorized Persons Allowed to Pick Up Your Child
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  • Is there any person NOT allowed to pick up your child?

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  • Medical Information

  • In case of emergency, Growing Learners staff will call 911 and contact the parent/legal guardian and/or emergency contacts listed within this application. 

    Please provide Growing Learners with medical personnel contact information to obtain emergency medical care if warranted. 

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  • Privacy Rights & Authorizations

  • PRIVACY RIGHTS

  • PERMISSION TO EVALUATE PROGRAMS AND TRACK STUDENT PROGRESS

  • FLORIDA CHILD CARE STANDARDS AND STATUTES

    • 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" (CF/PI 175-24). 
    • Section 65C-22.006(3)(c)2., F.A.C., requires that parents are notified in writing of the disciplinary practices used by the child care facility. 
  • Program Expecations

  • Please read and check each program expectation, and initial each section. By initialing and signing at the bottom, you agree to comply with each requirement.

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  • Your signature below indicates that you have received the items on the Florida Child Care Standards & Statutes, all of the program expecations, and that the information on this enrollment form is complete and accurate. 

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