Summer 2024 Program Registration Form

Summer 2024 Program Registration Form
Launchpad for School Success

Our program is specifically designed for 4 and 5-year-olds who are entering pre-K and kindergarten, providing age-appropriate activities and experiences tailored to their developmental needs.
Child Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
School entering Fall 2024 *
Grade entering*

Pre-KindergartenKindergarten
Parent/Guardian Information
Parent/Guardian 1

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Parent/ Guardian 2

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Emergency/Medical Information
Emergency Contact Name
Relationship to Child
Phone Number
Please enter a valid phone number.
Physician
Physician Phone Number
Please enter a valid phone number.
List all conditions, physical or behavioral, as well as any allergies, dietary restrictions, or medications:
Authorized Pick-Up

Please list individuals authorized to pick up your child. They will need to show a valid ID.
Name

First NameLast Name
Relationship to Child
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Relationship to Child
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Relationship to Child
Phone Number
Please enter a valid phone number.

Policies and Procedures
Welcome to IPLC Miami’s 2024 Kindergarten Readiness Summer Program! To ensure a safe, fun, and productive environment for all children, please review the following policies and procedures.

Attendance and Drop-off/Pick-up
Program Hours: Monday through Friday, 9:00 AM to 1:00 PM.
Early Drop-off: Available from 8:00 AM at no additional charge.
Drop-off: Please sign your child in at the designated area each morning. Children must arrive by 9:00 AM.
Pick-up: Please sign your child out at the end of each day. Children must be picked up promptly at 1:00 PM. Late pickups may incur additional fees.
Authorized Pick-up: Only individuals listed on the registration form will be allowed to pick up your child. Please notify us in writing of any changes.

Health and Safety
Illness Policy: Please keep your child at home if they exhibit any signs of illness (fever, vomiting, diarrhea, contagious diseases, etc.). Children must be symptom-free for at least 24 hours before returning.
Medication: If your child requires medication during program hours, please provide a completed Medication Authorization Form along with the medication in its original labeled container.
Emergency Procedures: In the event of an emergency, parents/guardians and emergency contacts will be notified immediately. Medical treatment will be sought as necessary.

Behavior and Conduct
Code of Conduct: We promote a positive, respectful, and inclusive environment. Disruptive behavior, bullying, or aggression will not be tolerated.
Disciplinary Actions: Minor incidents will be handled with redirection and positive reinforcement. Repeated or severe behaviors will be discussed with parents/guardians, and may result in temporary or permanent dismissal from the program.

Meals and Snacks
Snacks: Please bring your child's snack daily.
Lunch: Parents are required to provide a packed lunch for their child each day.

Clothing and Personal Belongings
Attire: Children should wear comfortable clothing.
Personal Belongings: Please label all personal items with your child’s name. We are not responsible for lost or stolen items.

Communication
Updates: Regular updates and important information will be shared via email and our private Instagram account. Please ensure we have your current contact information.
Instagram: We will use a private Instagram account to share daily updates, photos, and videos. Consent is required for your child to be included in these posts.

Payment and Refunds
Refunds: We do not offer refunds for missed sessions or cancellations.

By signing below, I acknowledge that I have read and agree to the policies and procedures outlined above for the IPLC Miami Kindergarten Readiness Summer Program.
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Date

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Date

Instagram Consent and Parent Sign-Up
We are excited to keep you updated throughout our Kindergarten Readiness Summer Program! To enhance communication and share special moments, we will be creating a private Instagram account exclusively for the families of children enrolled in the program.
Instagram Consent:

I give my consent for IPLC Miami to include my child in Instagram posts and stories on a private account created specifically for the families of children in the summer program.I understand that this private Instagram account will be used to share updates, photos, and videos of daily activities, ensuring that families stay informed and connected with their child’s experiences.I acknowledge that this account will be private and accessible only to authorized families and staff members of the program.I give my consent for IPLC Miami to include my child in Instagram posts and stories on the public business Instagram account.I understand that these posts will be used to promote the program, share success stories, and highlight activities to the broader community.
Parent Sign Up:
Instagram username/s would like added (Optional):
By signing below, I agree to the Instagram consent as outlined above and wish to stay connected through the private Instagram account.
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Date
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Summer 2024 Program Registration Form

Launchpad for School Success

Child Information

Parent/Guardian Information

Emergency/Medical Information

Authorized Pick-Up

Program Details

Credit Card

Policies and Procedures

Instagram Consent and Parent Sign-Up