Multiplication Bootcamp

Registration Form

Become a Multiplication Whiz!
CHILD INFORMATION:
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade*
Name of School*
Location of School (City, State)*
On a scale of 1-10, how confident is your child in multiplication? (You may need to ask.)
Child's Interests (Favorite Superhero, TikTok, Cartoon, TV Show, etc.)*
I consent to the use of photographs/ video taken during the course of the Bootcamp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources).*

Yes, I consent.No, I do not consent
PARENT/GUARDIAN INFORMATION (1):
Parent/Guardian Name*

First NameLast Name
Signature*

Clear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
PARENT/GUARDIAN INFORMATION (2):
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
E-mail
example@example.com
EMERGENCY CONTACT

In case of an emergency and parent/ guardian cannot be reached, who should we contact?
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
CHOOSE A SESSION & MOTIVATIONAL MERCH

Currently, Bootcamp will run from April 17th- April 19th (12p-1:30p) and May 11th and May 25th (11a-12:30p) at Lamond- Riggs Library. Group sessions are normally $30 per student. However, this is a free service to you and your family. In order to continue to offer this service to the community, we ask that each family purchases at least one item from our website: www.teachmetutors.mshopify.com or make a Cash App donation: $TeachMeTutors93. Secure your spot today! ONLY 10 spots per session available.
Are you interested in one-on-one tutoring with a highly-effective teacher? If yes, we will follow up with you.*

Yes, absolutely!Not at this timeMaybe during next school year
How did you hear about us?*

FacebookInstagramReferralTikTokOther
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Registration Form

CHILD INFORMATION:

PARENT/GUARDIAN INFORMATION (1):

PARENT/GUARDIAN INFORMATION (2):

EMERGENCY CONTACT

CHOOSE A SESSION & MOTIVATIONAL MERCH