Real Life ALC Enrollment Application
An Agile Learning Center can be eez
Email address
425 S. Orleans Ave. Tampa, FL 33606
Child's Name(s), Age(s), D.O.B
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Parent's Name(s)
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Address
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County
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Email
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Phone
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How did you hear about us?
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Grade Range: K-8 or 9-12
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What attracts you most to the Agile Learning Center?
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Records Request/Enrollment Confirmation
When you withdraw your child from their previous school, if they ask for an enrollment confirmation/records request from Real Life ALC, include the name of the previous school and their address or email here:
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Enrollment Date
We have rolling admissions with some scheduled start dates throughout the year. Ideally, when would you like to have your child start school at ALC?
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Student Agreement
These questions are to be answered by the student. (It's fine for the parent to type or enter the information for younger students, but the answers should come from them.) An ALC is an environment where students of every age are free to direct their own learning and activities, yet this freedom comes with responsibilities. I understand that I am expected to: 1) Treat others with respect (whether student, volunteer, staff or parent), 2) Behave appropriate for a shared space such that I don't interfere or disrupt others learning activities, 3) Participate in making, honoring and enforcing rules and structures of the community, and 4) Help solve conflicts when they arise.
Parent Questionnaire & ALC Philosophy Agreement
I understand that the ALC provides a real-world learning environment for students to develop self-direction, self-motivation and self-knowledge and as such never requires students to attend specific classes or produce specific work. The school will support student's requests for learning, but does not direct learning activities according to any curriculum. The School Meeting may make certain activities mandatory for the smooth operation of the school. Currently these are: morning meetings, end of day meetings, clean-up, fire drills, and appearing when a complaint has been filed. Beyond these, the choices are up to each child.
Tell us about your child. Personality? Challenges? Interests?
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Why do you think ALC will be a good fit for your child's learning needs?
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Describe your child's prior schooling. Please include names/dates/schools attended/reason for leaving.
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Any food allergies? Any medical conditions that we should be aware of?
Your answer
Any medication allergies? In case of emergency protocol and contact:
Your answer
Medical Release
As the legal guardian, I give consent to Real Life ALC to provide all emergency medical and dental care prescribed by a licensed physician (M.D.), Osteopath (D.O.), or Dentist (D.D.S.) required to treat any conditions that are necessary to preserve life, limb and wellbeing of dependent.
Please be advised that your child's photograph or video may be taken at various school functions events, and for our yearbook. Do we have your permission to post these pictures on our website, social media sites, and/or printed promotional materials?
TRAMPOLINE WAIVER FORM
I give my child permission to play on the trampoline at Real Life ALC, with the understanding that there will be an adult present while he/she is doing so. I, acknowledge that use of a trampoline can be dangerous and may result in serious injury. My child is aware that failure to follow policies will result in the loss of trampoline use privileges, with reinstatement of privileges at the sole discretion of Real Life ALC. I grant my child my permission to participate in trampoline use. I understand the Trampoline Rules and have explained them to my child. TRAMPOLINE RULES: 1) No more than two children at one time unless playing a supervised game with the facilitator. 2) No somersaults, flips, or other tricks allowed unless one on one with facilitator (no others on trampoline at this time. 3) No double-bouncing or other horse-play allowed. 4) There will be no walking on outside rim of trampoline. 5) Nothing allowed in trampoline such as toys, blocks, sticks, balls, etc. I further release Real Life ALC from all responsibility should any injury arise while my child is using said trampoline.
Pool and Sunscreen Waiver Form
I give my child permission to swim in the pool at Real Life ALC, with the understanding that there will be an adult present while he/she is doing so. I, acknowledge that swimming can be dangerous and may result in serious injury. My child is aware that failure to follow policies will result in the loss of pool use privileges, with reinstatement of privileges at the sole discretion of Real Life ALC. I grant my child my permission to participate in pool use. I understand the Pool Rules and have explained them to my child. During outside activities, there is potential for sunburns. Please bring in a bottle of sunscreen with your child's name on it, swimming suit, and towel to be kept in their cubby. Hats and water are also recommended, however we do have filtered ice water.
Financial Aid
ALC is funded by tuition. The current full time tuition is $6,000 per year. Financial assistance and scholarships may be available in the form of tuition adjustments and through McKay Scholarship Program, Florida Tax Credit Scholarship, or Gardiner Program.
Tuition is due on the 1st of each month. There is 10% deduction If you pay for a full year.
If you intend to enroll full time you agree to submit all required documents including:
(1) This Information Sheet (Done when clicking submit online). (2) Birth Certificate -- a copy. (3) Health Exam (Form DH 3040) -- must be current information (no more than 1 yr old). Please Note: If your religious convictions conflict with requirement (3) you may submit a letter taking an exemption from this requirement. (4) Immunization Record (Form DH 680) -- must be current information (no more than one year old). Please Note: If your religious convictions conflict with requirement (4) you may submit Form DH 681 (Religious Exemption from Immunizations Form). You may obtain this form from your local health department. Rule 64D-3.046 Florida Administrative Code: https://www.flrules.org/gateway/ruleno.asp?id=64D-3.046 KEEP COPIES FOR YOUR RECORDS
A copy of your responses will be emailed to the address you provided.
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