Class Registration
Please complete this form to register your student for a Math Mindset class. Spots are limited (4-5 per class) and will be filled on a first-come, first-served basis.You will receive a confirmation email once your student is enrolled.
Student Name
*
First Name
Last Name
Grade
*
Where does your student attend school?
*
Guardian Name
*
First Name
Last Name
Guardian's E-mail
*
example@example.com
Guardian's Phone Number
*
Emergency Contact
*
Another person I can contact in the event of an emergency.
Emergency Contacts Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select the class/es you would like to register for. If a class is full, feel free to still submit the form and note your preferred class—I’ll contact you if a spot opens.
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( X )
Monday 11:30-12:30
$128 per month
Free
$
Free
Monday 12:45-1:45
$128 per month
Free
$
Free
Monday 2:00-3:00
$128 per month
Free
$
Free
Monday 3:15-4:15
$128 per month
Free
$
Free
Tuesday 12:45-1:45
$128 per month
Free
$
Free
Tuesday 2:00-3:00
$128 per month
Free
$
Free
Tuesday 3:15-4:15
$128 per month
Free
$
Free
Wednesday 9:30-10:30
$128 per month
Free
$
Free
Wednesday 10:45-11:45
$128 per month
Free
$
Free
Wednesday 12:00-1:00
$128 per month
Free
$
Free
Thursday 12:45-1:45
$128 per month
Free
$
Free
Thursday 2:00-3:00
$128 per month
Free
$
Free
Thursday 3:15-4:15
$128 per month
Free
$
Free
Friday 9:30-10:30
$128 per month
Free
$
Free
Friday 10:45-11:45
$128 per month
Free
$
Free
Friday 12:00-1:00
$128 per month
Free
$
Free
If the class you wanted is unavailable, let me know which class it is and I'll add you to the waitlist.
Payment Method
*
Please Select
Private Pay
Core Butte Charter Funds
Lake View Charter Funds
South Sutter Charter Funds
I understand that payment or confirmation of payment will have to be received before my student can start taking classes.
*
Yes
Back
Next
Acknowledgment of Policies:
I understand a missed class may be made up when advance notice is given. A no-show without communication does not qualify for a make-up session.
*
Yes
I understand unused make-ups do not carry over. Make-ups must be scheduled as an additional class during a week you are already enrolled and paid for.
*
Yes
I understand if a student will be more than 10 minutes late with no prior communication, the class should be skipped for the day, as late arrivals can be disruptive to the group.
*
Yes
I understand all class updates, payment reminds, and announcements will be sent through email. Text messages are used for cancelations, scheduling make-ups, and late arrival notices.
*
Yes
Reserve My Spot
Should be Empty: