Momentum Tutoring - Momentum Tutoring Summer Program Registration Form 2024.

Momentum Tutoring Summer Program Registration Form 2024.

Momentum’s Summer Program Registration Form 2024

Momentum is offering Workshops, Electives, and Projects for K-8th grade students this summer! Visit our website to read more about each program!

Please review our Parent/Guardian Agreement before completing the following sections below:

Parent/Guardian Agreement

The purpose of Momentum Tutoring is to provide affordable, convenient, and effective tutoring and enrichment to students of all ages and abilities:

Momentum will:

1. Offer programs that support and supplement California State Education Standards.

2. Encourage parent and classroom teacher input on student's educational needs.

3. Design a custom curriculum plan based on student's needs.
4. Provide a refund for cancellations made 24 hours in advance.

5. Dismiss a continually disruptive or noncompliant student.
6. Suspend services if invoices are past due.

Parent/Guardian will:

1. Establish a regular schedule for student's tutoring.
2. Support student progress by collaborating with Momentum and school as needed.
3. Provide progress reports and report cards as they become available.
4. Provide 24 hour notice to receive credit for a cancelled session.
5. Pay tuition prior to tutoring on the 1st of each month.
6. Give two weeks courtesy notice if enrollment is to be changed or terminated.
7. Arrive on time for drop off and pick up.

We agree to work together with the student's best interest in mind. We understand because of the unique qualities involved with education, Momentum cannot guarantee any particular results.

Parent/Guardian Information

Parent/Guardian 1 (Primary Contact): First Name

Parent/Guardian 1: Last Name

Parent/Guardian 1: Email

Parent/Guardian 1: Mobile Phone

I Agree to the Terms

How did you hear about Momentum's Summer Programs? (Select all that apply)

What Momentum programs has your student participated in before? (Select all that apply)

New to Momentum? Please provide additional contact information

Parent/Guardian 2 (Secondary Contact): First Name

Parent/Guardian 2: Last Name

Parent/Guardian 2: Mobile Phone

Parent/Guardian 2: Email

Emergency Contact: Name and relation to student

Emergency Contact: Phone Number

Student Information

Student First Name

Student Last Name

Special Needs (IEP, 504 Plan, etc.)

Grade for 2024-2025 school year

School

Photo Release: I grant my permission to Momentum Tutoring to use photographs of my student for legal uses including but not limited to company social media, marketing, and website content.

Summer Workshops

Select which Summer Workshops you would like to enroll in:

Which weeks would you like to enroll your child in Summer Workshops?

Summer Electives

Select which Summer Electives you would like to enroll in:

Which weeks would you like to enroll your child in Summer Electives?

Summer Projects

Select which Summer Projects you would like to enroll in:

Which weeks would you like to enroll your child in Summer Projects?

Summer Tutoring

Interested in private tutoring this summer? List your preferred schedule below including days, times, session length, # of sessions per week, and start date.

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