Summer Bootcamp Registration Form

Name of Current School
Grade Entering for 2025-2026 School Year
Sessions Per Week
Summer Bootcamp Sessions Availability
Desired areas of focus. Ex: Phonics, Fluency, Writing, Reading Fluency, Reading Comprehension Strategies, Math, etc.
Please list any allergies you child may have.
Please tell me your about your child's favorite color, animal, hobbies, places to go/visit for fun.
Additional Comments or Questions:

Tutoring Session Requested:
Preferred Payment Cycle:
After registration is complete, there are additional documents that must be reviewed and signed in person.
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This fee is comprised of the registration fee, deposit and supplies/materials fee. Please note that this fee must be paid prior to tutoring services starting. Parents determine the start date.

$25.00 Quantity
Item subtotal:$0.00

Total

$0.00
I hereby certify that the information provided in this application is accurate and correct to the best of my knowledge. Draw your signature into the box below.
Should be Empty:

The Scribble Room Registration Form