The Playful Family, Inc. Homeschool Enrollment Form

Family Information

Parent(s)/ Guardian(s) First Name

Parent(s)/ Guardian(s) Last Name

Address

Phone

Student Information

Child's First Name

Child's Last Name

Child's Date of Birth

Month

Day

Year

Age

Allergies/ Medical Conditions

Special Needs/ Accommodations

Emergency Contact/ Authorized Pick Up

Emergency Contact (other than parent):

Name

Relationship

Phone

Authorized Pick Up Persons (ID Required):

Name

Program Selection

Which Pod are you selecting?

M/W/F- $600/ month

T/Th- $400/ month

Tuition Payment Method

Payment Method

PayPal

Cash/ Check/ Credit Card

Florida Step Up for Students Scholarship

Registration and Enrollment Fee

A non-refundable $150 enrollment fee is required to secure your child's spot in the homeschool pod. Once the fee is received, your enrollment request will be reviewed and confirmed. (Additional paperwork requirements and important start-of-year details will be forwarded to you via email prior to the beginning of the school year.)

Product

Homeschool Enrollment Fee$150

Signature

Signature field is empty.