Clone of Registration and Financial Agreement Form

TACHS 2026 Private Tutoring Form

Completion of this form and registration fee payment are required prior to confirmation of tutoring.
Student Name*

First NameLast Name
Gender*

FemaleMale
Date of Birth*
Student's Grade*
School Student Attends*
Has student been enrolled in a program at Tutoring by Christine previously?

YesNo
To ensure students are fully prepared for the TACHS exam, we recommend two hours of weekly private tutoring—one hour focused on ELA and one hour focused on Math. Please indicate the areas in which you would like tutoring support. Tutoring is for:

TACHS ELA (includes ability)TACH Math
Parent/Guardian Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emails and Phone Numbers

These are collected for contact and session reminders Session reminders come via email and text 24 hours before each session. By clicking "yes" you are indicating that you would like to receive updates by text. Message frequency varies. Message and data rates may apply. You can opt out anytime by replying "Stop." Link to Privacy Policy: https://tutoringbychristine.com/privacy-policy/
Parent/Guardian email*
example@example.com
Student Email (this must be a non-school email - It is highly recommended to create a Gmail if your student does not have one) *
example@example.com
Parent/Guardian Phone Number*

Area CodePhone Number
I give permission for tutoring reminders to be sent to the parent/guardian mobile number*
2nd Parent/Guardian Email
example@example.com
2nd Parent/Guardian Phone Number

Area CodePhone Number
I give permission for tutoring reminders to be sent to the 2nd parent/guardian mobile number
Student/Availability

Completing this form fully and offering as many times as possible that your student is available will expedite scheduling and insure placement.
Tutoring is in person (253 Nelson Avenue, across from the firehouse) unless online arrangements are made.

Our goal is to provide you with sessions on consistent weekly day(s) and time(s) as much as the schedule will allow.

NOTE: Please check practice schedules and other commitments before filling out this form.

Tutoring availability is first-come, first-served.

We don't have confidence in meeting testing and academic goals when students don't maintain a consistent tutoring schedule.

*If you would like tutoring on the half hour instead of the hour, please indicate that in the "notes" section below.
Mondays*

3:004:005:006:007:00Not Available on Mondays
Tuesdays*

3:004:005:006:007:00Not Available on Tuesdays
Wednesdays*

3:004:005:006:007:00Not Available on Wednesdays
Thursdays*

3:004:005:006:007:00Not Available on Thursdays
Fridays*

3:004:005:006:00Not Available on Fridays
Saturdays*

8:009:0010:0011:0012:001:002:00Not Available on Saturdays
Any additional scheduling information we should have? For example, your student's extracurricular commitments, vacation dates, any conflict dates, your preferred day(s)?
At Tutoring by Christine, we occasionally take photos and videos during sessions for use on our social media platforms—do we have your permission to include your child in these images?

YesNo
Financial AgreementFinancial Responsibility and Agreement with Tutoring by Christine LLC (here forward TbC)
My signature indicates I am financially responsible for all charges on the account for my above student's instructional fees with TbC.

This is not a contract to fulfill a minimum number of sessions. We may discontinue tutoring at no charge at any time with more than 24 hours' notice before our next scheduled session.

If TbC availability aligns with the availability we indicate in our registration form, tutoring will be automatically confirmed, and a confirmation email will be sent with access to our online account.

If our circumstances should change and we need to permanently discontinue future instruction, I understand I must call or email the TbC office within more than 24 business hours to not be charged.

I understand and agree that we are permitted the following cancellation policies:

• On-time cancellations for which we are not charged must be cancelled in our TbC account with more than 24 hours' notice and must not exceed one session per month.

• Cancellations under 24 hours or no-shows incur full charges.

Credit cards will be charged at the end of the week after the session has been completed. Any outstanding unpaid sessions will be added to the charge.
Signature for Financial Policy*

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TACHS 2026 Private Tutoring Form

Emails and Phone Numbers

Student/Availability

Financial AgreementFinancial Responsibility and Agreement with Tutoring by Christine LLC (here forward TbC)