Reading Bootcamp (January 2023)

Reading Bootcamp (2023)
Are you approved for the Ohio ACE program?*

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Student Information
Student's Name*

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Grade (22/23 yr)*

3rd Grade4th Grade
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PublicPrivateCharter
Sibling Information

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Grade

3rd Grade4th Grade
School Name
School Type

PublicPrivateCharter
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COVID-19

I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.I further acknowledge that Fail Me Not Tutoring LLC has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.I further acknowledge that Fail Me Not Tutoring can not guarantee that I/my child will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, staff, and other clients and their families. I voluntarily seek services provided by Fail Me Not Tutoring LLC and acknowledge that I am increasing my/ my child’s risk of exposure to the Coronavirus/COVID-19. I acknowledge that I/my child must comply with all set procedures to reduce the spread while attending my appointment.
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Informed Consent and Acknowledgement
I hereby give my approval for my child’s participation in any and all activities prepared by Fail Me Not Tutoring, LLC during the selected semester.
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Media Disclosure
Fail Me Not Tutoring, LLC may periodically photograph students participating and working during tutoring sessions. These photos may be used in a variety of ways; public relations and marketing purposes: images printed on brochures, posters, and newsletters or on our Facebook and Instagram pages. Full names will not be included in photographs or social media sites. We appreciate your support and look forward to showcasing the work our scholars are doing during their tutoring sessions.
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Price
Registration Fee: $75/pp

Monthly Fee: $130/mo
Confirmation
BY ACKNOLWDING AND SIGNING BELOW, I AM AKNOWLEDGING AND AGREEING TO THE POLICY AND PROCEDURES LISTED ON OUR REGISTRATION PAGE OF OUR WEBSITE, AS WILL AS THE REGISTRATION FORM.
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Reading Bootcamp (2023)

Student Information

Sibling Information

Parent/Guardian Information

Emergency Information

COVID-19

Informed Consent and Acknowledgement

Media Disclosure

Price

Confirmation