Kumon Garden Oaks - Break or Cancellation Form

Kumon Math and Reading Center of Garden Oaks

1717 W. 34th Street Suite 1250 Houston, TX 77018
Temporary Break or Cancellation Request Form
Name

Student's First NameLast Name
Subject (Math/Reading)
Please choose one of the following:
Pause the Kumon program*: Month
Cancel the Kumon Program as of date

MonthDayYear
Date
*Should you wish to pause the program for more than one month, Kumon headquarters will consider your child(ren) as "new student(s)" and require registration fee be paid.
Reason for Cancelling or Pause
Parent's Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Kumon Math and Reading Center of Garden Oaks