Sabal Palm Elementary School
This is Registration for the current
2024-2025 School Year Only.
Registration DOES NOT carry over each school year.
This registration does not apply to Summer Camp.
Please keep in mind that Sports CLUB is a weekly used program, not a “Drop-In” program.
The last page of this registration form you can select enrollment type for your child and will be billed weekly.
After School (Full Time 4 to 5 days) : $75 per child per week
Before/After School (Full Time 4 to 5 days) : $90 per child per week
Morning ONLY: $25 per child per week
After School (Part Time 2 to 3 days) : $56 per child per week
Before/After School (Part Time 2 to 3 days): $75 per child per week
After School 1 Day a Week : $30 per child per week
CHILD MUST BE AT LEAST 4 YEARS OF AGE!
Check if you have more than one child to enroll in our program
Check here is address is the same of the child.
Leave blank if same as child's.
If you do not have a Driver License, you can use a passport photo or other form of ID card.
Check here if you are employed by Collier County Public Schools
I hereby grant permission for the staff of this facility to contact the following medical personnel to obtain emergency medical care if warranted:
Additional Pick-up authorization.
Signature of Parent/Guardian
· Section 65C-22.006(2), F.A.C., requires a current physical examination (Form 3040) and immunization record (Form 680 or 681) within 30 days of enrollment. (PRE K/VPK ONLY)
· Sections 7.1 and 7.2, of the Child Care Facility Handbook, require a current physical examination (Form 3040) and immunization record (Form 680 or 681) within 30 days of enrollment.
· Section 7.3, of the Child Care Facility Handbook, requires that parents receive a copy of the Child Care Facility Brochure, "Know Your Child Care Facility” (CF/PI 175-24), or
· Section 8.3, of the Family Day Care Home/ Large Family Child Care Home Handbook, requires that parent(s) receive a copy of the family day care home brochure, “Selecting A Family Day Care Home Provider” (CF/PI 175-28).
· 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 child care facility, or
· Section 2.3, of the Family Day Care Home/ Large Family Child Care Home Handbook, requires that parents are notified in writing of the disciplinary and expulsion policies used by the family day care provider. Your signature below indicates that you have received 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.
I give permission to Sports Camp Inc. DBA Sports CLUB (SC) to record the appearance, physical likeness and/or voice on videotape, on film, or digital video disk, and/or take photographs of the appearance of my child, and to release these images to the news media, use for posting on the SC Internet Website, use in internal or external publications, or use in any other manner deemed appropriate by SC to publicize SC, its programs and activities, or to otherwise fulfill the mission of SC.
I acknowledge that SC is the sole owner of all rights in, and to, this visual and/or sound production and/or photograph(s) and the recordings, thereof, and that it has the right to use or reproduce the resulting images and/or sound as often as it finds necessary. The video and/or photographs may be used indefinitely by television, radio, newspapers, magazines, newsletters, brochures, Internet, or in other media once released. SC has the right, among other things, to edit and/or otherwise alter the visual or sound recording, or photographs, as needed. I understand I will receive no compensation for the appearance of the above-named person or for participation in said productions. I agree to hold SC, its employees, its board members, and other parties harmless against claim, liability, loss, or damage caused by, or arising from, my child’s participation in this production.
I hereby acknowledge that participation in Sports Camp / Sports CLUB and related activities is at the sole discretion and judgment of the parent or guardian and involves the possible risk of personal injury. I, on behalf of my child, hereby assume all such risk. I hereby release and agree to hold harmless Sports Camp / Sports CLUB, owners, directors, students and employees from all claims, actions, damages and liabilities for personal injury or damage relating to, or arising out of any Sports Camp activity except where the injury or damage is caused by the gross negligence of Sports Camp / Sports CLUB employees.
COVID-19 AND OTHER INFECTIOUS DISEASES -- WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT
I hereby acknowledge and agree that I understand the hazards of the novel coronavirus (“COVID-19”) and am familiar with the Centers for Disease Control and Prevention (“CDC”) guidelines and other local, state and federal guidelines regarding COVID-19. I acknowledge and understand that that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the CDC guidelines are regularly modified and updated and I accept full responsibility for familiarizing myself with all applicable guidelines. Notwithstanding the risks associated with COVID-19 and other infectious diseases or illnesses that may be prevalent or transmissible from time to time (for instance, influenza, SARS, H1N1, the common cold and the like), which I readily acknowledge, I hereby willingly choose to allow my child to participate in Sports Camp/Sports CLUB and related activities in my sole discretion and judgment as parent or guardian. I acknowledge and fully assume the risk of illness or death related to COVID-19 and other infectious diseases or illnesses arising from my child being on the premises and participating in Sports Camp/Sports CLUB and related activities, and hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE (on behalf of myself and any minor children form whom I have the capacity contract) Sports Camp, LLC, d/b/a Sports C.L.U.B., its owners, officers, directors, agents, employees and assigns (the “RELEASEES”) from any liability related to COVID-19 and other infectious diseases or illnesses which might occur as a result my child being on the premises and participating in Sports Camp/Sports CLUB and related activities. I shall indemnify, defend and hold harmless the RELEASEES from and against any and all claims, demands, suits, judgments, losses or expenses of any nature whatsoever (including, without limitation, attorneys’ fees, costs and disbursements, whether of in-house or outside counsel and whether or not an action is brought, on appeal or otherwise), arising from or out of, or relating to, directly or indirectly, the infection of COVID-19 or any other infectious diseases or illness
It is my express intent that this Waiver and Hold Harmless Agreement shall bind any assigns and representatives, and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the above-named RELEASEES. This Agreement and the provisions contained herein shall be construed, interpreted and controlled according to the laws of the State of Florida. I HEREBY KNOWINGLY AND VOLUNTARILY WAIVE ANY RIGHT TO A JURY TRIAL OF ANY DISPUTE ARISING IN CONNECTION WITH THISAGREEMENT. I ACKNOWLEDGE THAT THIS WAIVER WAS EXPRESSLY NEGOTIATEDAND IS A MATERIAL INDUCEMENT THE PERMISSION GRANTED BY RELEASEES TO BE ON PREMISES AND PARTICIPATE IN THE ACTIVITIES.IN SIGNING THIS AGREEMENT,
I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Wavier of Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Agreement for full, adequate and complete consideration fully intending to be bound by same.
I FURTHER AGREE AND CONSENT TO THE FOLLOWING:
1. Sports Camp/Sports CLUB is authorized to take my child’s temperature as a process to screen for disease or illness.
2. If my child shows symptoms of disease or illness based on Sports Camp’s/Sports CLUB’s sole discretion, I may be notified and will then make arrangements to have my child picked up from Sports Camp/Sports CLUB within twenty (20) minutes thereof.
3. Other than that is necessary for child drop-off and pick-up, I may be denied access to the Sports Camp/Sports CLUB building and other facilities areas from time to time, in Sports Camp/Sports CLUB’s sole discretion, for purposes of prevention of disease transmission and illness.
There is the one form of payment accepted by Sports CLUB which requires an authorization form prior to attendance. Your payment will be automatically withdrawn the week prior to your child attending per your enrollment selection at the end of this enrollment form.
Credit Card on File:
· If a credit card payment is dishonored by the banking institution for any reason, Sports CLUB will not reprocess. There will be a $35 charge for declined payments. The parent or legal guardian will be required to provide compensation in full (money order or cashier’s check only) prior to the child attending further.
Only check this box if you are currently working with an ELC case worker.
This form is for you to supply Sports Camp, Inc. (“Sports CLUB”) with credit card information to keep on file for the payment of all services and processing fees per transaction. A new form must be completed for each card kept on file every school year. Payment will be taken out the Friday prior to each upcoming week. Please review Enrollment Policies for further information. Sports CLUB accepts Visa, MasterCard, and Discover. There are No Refunds.
Take your time when entering this information. If it is incorrect, your registration will not be processed.
No dashes or spaces between digits
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If more than one child, please add to list.
I hereby authorize Sports Camp, Inc. dba Sports CLUB to charge the credit card listed above for the payment of all services and fees. This credit card will be kept on file and will remain in effect until the expiration of the credit card account or end of the school year. Applicants may revoke this method of payment on file by submitting a written request at least 1 (one) week prior to scheduled charge. A new form must be submitted if any information such as credit card expiration or authorized users is amended. Applicants agrees to pay the cost for any returned or challenged payments.
Sports CLUB follows this policy concerning custody: To avoid confusion, the parent or legal guardian who enrolls the child into the Sports CLUB program is responsible to provide the weekly fees based on the child’s enrollment. Sports CLUB will not participate in custody disagreements between parents. As the parent or legal guardian of the child listed below, I agree the information provided on this form is accurate. Moreover, my signature confirms that I will comply with all the program policies.
Parent Acknowledgement Form:
By checking off each box, I understand that is an indication of my initials. By placing my signature on this form, I indicated that I am the parent or legal guardian of the child listed above. I understand the Parent Acknowledgement Form will be kept in my child’s file as an official document.
It is highly suggested to print/save this page for future reference.
Absences: NO REFUNDS. Credit for prepayment in advance will not be credited for absenteeism UNLESS the prepaid credit is for health reasons ONLY. If a student is absent for two or more days for health reasons, validated by a doctor’s note, then prepayment for a full week shall be converted to payment for a partial week and the remaining funds shall be rolled over into the next week as a credit. This is per the CCPS RFQ rules.
Late Payment: A late payment of $10 per family will be billed to the student’s account on Monday for payments that are not made by 6:00 PM on Friday of the previous week.
Late Pick Up: Sports CLUB closes promptly at 6:30 PM. For every 15 minutes or portion thereof that a parent or legal guardian is late picking up his/her child, a late fee of $15 per family for every 15 minutes will be charged. Lateness in excess of 30 minutes past closing (6:30 PM) will result in notification of Law Enforcement.
Credit Card Fees (SCC): I understand that a processing fee of $2.00 will be charged if my total if between $0.00-$9.00. A processing fee of $3.00 will be charged if my total is between $10.00-$99.00. A processing fee of $5.00 will be charged if my total is $100 or over. I understand the processing fee will be in addition to each transaction with the use of the credit card on file. If a credit card payment is dishonored by the banking institution for any reason, Sports CLUB will not reprocess. There will be a $35 charge for declined payments. The parent or legal guardian will be required to provide compensation in full (money order or cashier’s check only) prior to the child attending further.
Subsidized Child Care: Parent(s) or legal guardian(s) receiving subsidized child care through the Early Learning Coalition (ELC) must adhere to the guidelines as outlined in the ELC Parents Rights and Responsibilities for Service Form. Parent(s) or legal guardian(s) with children subsidized through ELC services is responsible for parent fees that are in excess of the subsidized certificate and/or any tuition that may be incurred. As a reminder any and all changes must be reported and documented within 10 days to the ELC Office. Failure to report changes may be cause for recoupment of partial or all distributed school readiness funds and possible termination.
Enrollment: I understand that this is an after-school registration for the current 2024-2025 school year only. I understand that this registration does not include summer camp. I understand that I must register for summer camp separately. I understand that each school year I must resubmit.
Please be advised, this is how you will be charged weekly. You will be charged separately if your child attends additional days. Change in program participation requires a written notification by Monday of the week prior.
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