St. Paul Methodist School Registration Form
4901 Gulf Breeze Parkway, Gulf Breeze, Fl 32563
DCF# C01SR0071
Student Information:
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Sex:
*
Full Name:
*
First Name
Middle Initial
Last Name
Preferred Name
Child's Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
FOR OFFICE USE ONLY
School Year: 2026/2027 Program:
Number of Days Attending:
Enrollment Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Start Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Family Information: (Address only needed if different from the child)
Mother's Name:
*
Father's Name:
*
Mother's Address:
If different from child's
Father's Address:
If different from child's
Mother's Cell Phone:
*
Format: (000) 000-0000.
Father's Cell Phone:
*
Format: (000) 000-0000.
Mother's Employer:
Father's Employer:
Mother's Work Phone:
Format: (000) 000-0000.
Father's Work Phone:
Format: (000) 000-0000.
Mother's Email:
*
example@example.com
Father's Email:
*
example@example.com
Custody:
Mother
Father
Both
Other
Name and Ages of other children in Home:
Primary Language Spoken at Home:
Church you attend
Emergency 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 the facility in case of illness, accident or emergency, if for some reason the custodial parent or legal guardian cannot be reached:
MUST LIST 1 LOCAL CONTACT
Name
*
Address
*
Phone #
*
Format: (000) 000-0000.
Relationship
*
Name
*
Address
*
Phone #
*
Format: (000) 000-0000.
Relationship
*
Emergency Care Plan instructions (if applicable):
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St. Paul Methodist School Registration Form
4901 Gulf Breeze Parkway, Gulf Breeze, Fl 32563
DCF# C01SR0071
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. I will not hold the center or medical personnel responsible. This was done with the understanding that every attempt will have been made to contact the parents, the child's physician and other people listed on the emergency contact form.
Doctor:
*
Address:
Phone:
*
Format: (000) 000-0000.
Dentist:
Address:
Phone:
Format: (000) 000-0000.
Hospital Preference:
*
Medical Insurance (Name, Policy No, Phone Number):
Please list allergies, special medical or dietary needs or other areas of concern:
*
*In School Picture/ Video Permission Form:
*
YES: I grant permission to St. Paul Methodist School to photograph my child. It is my understanding that these photographs will be solely for the projects in the school and the video typ presentations to be viewd in the school, on the website, and on the closed Facebook page/Brightwheel app. At no time will names be used.
No
* Section 2.8, of the Child Care Facility Handbook, requires that parents are notified in writing of the disciplinary and expulsion policies used by the childcare facility.
Initial:
*
* I give permission for my student to participate in the On Campus field trips (Nature Walks, Chapel, etc.)
Initial:
*
Initial: *Foods that are associated with young children's choking incidents must not be served to children under 4 years of age, such as, but not limited to, whole/round hot dogs, popcorn, chips, pretzel nuggets, whole grapes, nuts, cheese cubes/sticks and any food that is of similar shape and size of the trachea/windpipe. Food for toddlers must be cut into pieces ½ inch or smaller to prevent choking. This applies to all food, even food provided by parents/guardians.
Initial:
*
Initial: *I will read a copy of the brochure "Know Your Childcare Facility", Parent Handbook, "The Flu: A Guide for Parents" found at https://preschool.stpaulmethodist.org/
Initial:
*
Initial: *I will provide a Florida Well Child Physical Examination form and Florida Immunization Record of my child and keep these forms updated. (Forms available from local physicians or Health Department.)
Initial:
*
Your signature below indicates that you have read the above items and that the information on this enrollment form is complete and accurate. I hereby grant permission for the staff of this facility to have access to my child's records.
Signature of Parent/Guardian
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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St. Paul Methodist School Tuition Agreement Form
4901 Gulf Breeze Parkway, Gulf Breeze, Fl 32563
DCF# C01SR0071
Child's name:
*
Age on Sept 1, 2026:
*
School hours: 8:30-12:30
Place an X next to the number of days your child will attend:
2- & 3-Year-olds:
2 days (Tuesday/Thursday) - $400/month
3 days (Monday/Wednesday/Friday) - $450/month
5 days (Monday-Friday) - $525/month
*Students in 3-year-old classes must be FULLY potty trained and wearing underwear! *
VPK (4 Years old by September 1, 2026)
4 days (Monday-Thursday - no cost with voucher)
5 days VPK+ (Friday in addition to M-TH voucher) - $150/month
Read and Initial Below:
2-year-old, 3-year-old and VPK PLUS (Friday) classes will have an annual, non-refundable registration and supply fee of $225 due at time of registration. This will be billed via Brightwheel or can be paid at the school with cash or check. Your child's position is assured only upon receipt of the registration fee. Initial:
*
Extended care is offered from 7:30-8:30 and from 12:30 to 1:30 for $10 each use. Late pickup: If the child is picked up between 1:30-1:45pm, there will be a $20.00 fee added to the $10 aftercare 1 hour fee. If the child is picked up after 1:45pm there will be the $10 aftercare 1 hour fee plus the $20.00 fee from 1:30-1:45pm and then it will be a $5.00 fee per minute starting at 1:46pm. If late pickups occur more than once, the parents can lose privilege of extended care services. Initial:
*
Each month's tuition is due on the first day of the month and is past due on the 6th of the month. A $50.00 late fee will be applied to your account at that time if payment has not been received. If the 5th falls on a weekend, the following Monday will be the cut-off day for payment. Initial:
*
Your signature below indicates that you have read and understand the terms set forth on this tuition form.
Signature
*
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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