I.N.C. Student Registration Form

Child's First name

Child's Last name

Child's Birthday

Address

Parent / Guardian Full Name

Phone

Email

Parent / Guardian Full Name

Phone

Email

Please Specify your Childs Educational Status. (Choose all that apply)

Does your child have siblings you intend to register? If so, what are their names and ages?

Does your child receive a Step - Up Scholarship?

Yes

No

Does your child have any Unique Abilities?

Yes

No

If yes to above, please explain.

Does your child have any Allergies

Yes

No

If yes to above, please explain.

What curriculum are you using at home with your child?

At what "grade level" do you feel your child is currently working at in WRITING?

Can your child read?

Yes

No

Can your child write?

Yes

No

Do you have any Educational, Emotional, or Behavioral concerns with your child? If so, please explain.

Has your child attended a drop-off program previously?

Yes

No

Is your child comfortable around animals?

Yes

No

I understand that a signed Release of Liability and Waiver are required to participate in classes at Whispering Oaks Farm. https://form.jotform.com/222697627232057?fbclid=IwZXh0bgNhZW0CMTAAAR312CNE-h0DR4k4eMHy2EvGH_WG80toumTcOd9O0VOGpoOA8eie7WMZHgc_aem_uOrtWymOYBoASJtSZmAO7A

I understand that Whispering Oaks Farm, the property where the I.N.C. Program is located, is a FL Agritourism Facility and therefore subject to FL Stat. 570.88 - 89.

I understand that both the property and the classroom are access controlled for the safety and security of students and animals. I must communuicate with my child(ren)s teachers and/ or I.N.C. administration if I need to pick up my child outside of normal drop off and pick up times.

I understand that Drop-off is from 12:50 - 1:00pm and Pick-up is from 4:00 - 4:10pm. I will be charged $1/ minute if I arrive past 4:10pm.

I understand that tuition ($200) is due on the 3rd Tuesday of each month, prior to the month for which the tuition is being paid.

I understand that there is a One-time Curriculum Fee of $30, which is due at registration and is non-refundable.

Signature

Date

Tuition & Curriculum Fee

I.N.C. Extension Monthly Tuition ($200) & One-Time Curriculum Fee ($30)$230