New Enrollment Form 2026-2027

Enrollment Form 2026-2027

Atelier Kids enrollment form for the 2026-2027 school year. Please complete all sections carefully, including contact details, health information, consents, agreements, and required signatures/dates.
Child Information & Health
Start day

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child First Name, Middle Name, and Last Name

First NameMiddle NameLast Name
Child's Physical Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Child DOB

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Existing medical conditions, medications and/or special attention your child may require
Allergies
Helpful information about the child
Child Lives With
Primary Guardians
Which guardian should be called first?
Contact number
Please enter a valid phone number.Format: (000) 000-0000.
1st Primary Guardian - First name
1st Primary Guardian - Last name
1st Primary Guardian - Relationship
1st Primary Guardian - Email address
example@example.com
1st Primary Guardian - Cell phone
Please enter a valid phone number.Format: (000) 000-0000.
2nd Primary Guardian - First name
2nd Primary Guardian - Last name
2nd Primary Guardian - Relationship
2nd Primary Guardian - Email address
example@example.com
2nd Primary Guardian - Cell phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contacts
Child will be released only to the custodial parent(s) or legal guardian(s) 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(s) or legal guardian(s) cannot be reached.

ID/Passport MUST BE REQUIRED
Emergency Contact 1 Name

First NameMiddle NameLast Name
Emergency Contact 1 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 2 Name

First NameMiddle NameLast Name
Emergency Contact 2 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 3 Name

First NameMiddle NameLast Name
Emergency Contact 3 Phone
Please enter a valid phone number.Format: (000) 000-0000.

Fees & Tuition Agreement
• Registration is $950 per student. New students receive one school t-shirt with the registration. This is a non-refundable payment after 15 days of being confirmed.

• Materials fee $300 twice a year. August and January.

All fees including registration fee, material fee and tuition are non-refundable.

• Payments can be made with Zelle, wire transfer ($15 fee) or credit card (3.75% fees will be applied to credit cards). See the invoice for Zelle number.

• 10% discount will be applied for siblings. (To the older student).

• Tuition is due on the 1st day of the month (payments made after the 5th will be charged at a flat rate of $50). If you plan to go on vacation, please personally deliver your payment prior to your trip or send your check by mail to avoid a late fee. If payment is not received by the 10th , we will apply the last month deposit.

• Late pick up 5-min grace period, then $1/min (Half Day 12:05–12:20pm, Full Day 3:05–3:20pm), $5/min for Extended only starting 5:30pm, $25 flat Afterschool Care after 20 min late

• We request a deposit of one month if choosing the monthly payments plan. This deposit will be applied to the last tuition payment. If leaving before the end of school year we request notice is given 30 days in advance.

• First payment of tuition, last month's deposit and Materials are charged together on the same invoice.

Please see below the following options we offer:

• Early Care: 8:00 – 8:30 am/ $100 per month.

• Early Care $15 per day.

• Afterschool Care: from the end of your child's program through the end of the next program (12:00 – 3:00 p.m. for Half Day, or 3:00 – 5:30 p.m. for Full Day), $250 per month, or $25 per day if used occasionally. If pick-up runs later than the end of the next program, the late pick-up fees above apply for the additional time.

• VPK: Must commit to the attendance requirement for discount (no more than 4 absences in a month). To offer VPK we required a minimum of 4 students enrolled.

• The Florida Department of Children and Families requires a current physical examination (Form 3040) and immunization record (Form 680 or 681) within 30 days of enrollment.

• The Florida Department of Children and Families requires that parents receive a copy of the Child Care Facility Brochure, "Know Your Child Care Facility” (CF/PI 175-24).

• The Florida Department of Children and Families requires that parents receive a copy of the “Distracted Adult” Brochure (CF/PI 175-12).

• The Florida Department of Children and Families requires that parents receive a copy of the “Influenza Virus” Brochure (CF/PI 175-70).

• The Florida Department of Children and Families requires that parents receive a copy of the “Rilya Wilson Act” Brochure (CF/PI 175-70).
Acknowledgment
Parent/Guardian Signature
Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Tuition Options / Program Selection

Program	Time
Half Day	8:30am - 12:00pm
Full Day	8:30am - 3:00pm
Extended	8:30am - 5:30pm

Enrollment 18 months - 2 years program
Enrollment 2-3 years program
Enrollment 4–5 years program
Payment Plan
- The Monthly Plan consists of monthly installments of tuition. A last month's deposit is required to enroll in this payment option. This deposit will be applied to the final month of tuition.
  - Payments are due on the 1st day of each month, beginning with your child's first day of class, through the end of the school year.
- The Bi-Annual Plan consists of two (2) payments. This payment option includes a 2.5% discount.
  - The first payment is due on your child's first day of class, and the second payment is due six months later.
- The Annual Plan consists of one (1) payment. This payment option includes a 5% discount.
  - Payment is due on your child's first day of class.

Photo Release
I understand that my child(ren) whose name(s) are listed below may be photographed at the school during normal daycare hours, field trips, or activities. I understand that these photographs may be used in promoting childcare services, either in print or social media.

With my signature below I grant permission for my child(ren) to be photographed, or their images recorded for print or electronic use in promoting the school services. I understand that it is my responsibility to update this form if I no longer wish to authorize the above uses. I agree that this form will remain in effect during the term of my child’s enrollment. I understand that there will be no payment for me or my child’s participation in this release.
Parent Name
Relationship to Child
Parent/Guardian Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Food Permission
As required by the Department of Children’s and Families (DCF), we must have a food permission form signed by each child’s parent and/or guardian. Atelier Kids is committed to creating healthy habits in kids, we consider it crucial for their development. All the food will be sugar free and the healthiest possible (no artificial flavors, sweeteners, or colors).

Because of our concern for food allergies/conditions, we ask that each child have a signed permission form for in-school celebration such as:

●      Birthday’s

●      Bake Sales

●      Holidays Party

●      Field Trip

●      In-class learning

●      School events (Cultural Week, Carnival, etc.)

I give permission for my child to be served food during in-school celebrations such as the ones mentioned above.

Should your child have any allergies you may list them below. Please note that your child will not be given any food that might cause a reaction and the parent is responsible for providing alternative options so that the child can participate in such celebration.
Child Name
Allergies
Parent/Guardian Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Enrollment Form 2026-2027

Child Information & Health

Primary Guardians

Emergency Contacts

Fees & Tuition Agreement

Tuition Options / Program Selection

Photo Release

Food Permission