Clone of Little Learners of Lakeland Fall 2025

Little Learners is a mommy & me/caregiver and me language enrichment group for children (best for ages 2-5). An adult must be present with the child for the entire session. The Winter series will be held indoors at the Sunshine Circle office at 624 Mid-Florida Dr., Suite 7, Lakeland, FL 33813. The classes are limited to 6 children, so early registration is encouraged!

Visit the Sunshine Circle website to find out more!

Child's Name:*

First NameLast Name

Birth Date:*

MonthDayYear

Parent/Guardian:*

First NameLast Name

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone:*

E-mail:*

example@example.com

Does your child attend preschool?   Yes   No
If so, where? blank
Does your child have siblings at home?   Yes    No
If yes, list names and ages:   blank
Any speech/language concerns?   Yes   No
If yes, describe:   blank

Anything else you'd like to share? (child's interests, allergies, health concerns, etc.)

Media Release
I, parent/guardian name* * for my image and likeness and that of my child, child's name* to be used by Sunshine Circle for promotional purposes and social media.

Payment Method

Step Up fundsCredit Card

Step Up payments: open a new window and navigate to the Step Up EMA site. Search for Sunshine Circle in EMA and request the $25 "Activity" fee for each session. Sessions must be requested before submitting this form.

March 7, 10:00am - My Five Senses

Credit Card Payments

March 7, 10:00am - My Five Senses

$25.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Signature

Date