In-Person Tutoring Student Intake Form
Our in-person language classes provide engaging, high-quality bilingual education in a supportive, face-to-face learning environment. Our experienced instructors provide interactive Spanish, Mandarin and ESL language instruction tailored to help each student build confidence and reach their language-learning goals. Students benefit from personalized instruction, hands-on activities, and meaningful interaction while learning and connecting in a fun and welcoming environment.
Parent's Name
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First Name
Last Name
Parent's Phone Number
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Format: (000) 000-0000.
Parent's Email
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example@example.com
Student Info
Please describe the area where your child needs most support with language learning.
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Preferred Class Times/Days (Please select 2-3 options)
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Preferred Tutoring Location (additional Bilingual Kids tutoring locations will be available in November, 2026)
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The Hive (Kids Korner Explorer) - 6555 Balboa Ave. Ste 204, San Diego, CA 92111
La Jolla Recreation Center - 615 Prospect St., La Jolla, CA 92037
At a convenient location near you (such as a library)
In the comfort of your own home (please provide home zip code)
Home Zip Code
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Suggested Tutoring Location
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Special instructions? (IEP's, Allergies, etc.) Please be as specific as possible.
How did you hear about us?
Parent/Guardian Consent: I hereby release Bilingual Kids from any and all liability arising out of my child's participation in this program. I assume all risks associated with this activity. In case of illness, I authorize a representative of Bilingual Kids to obtain immediate care deemed necessary by licensed medical personnel. I have read and fully understand these terms and I sign it voluntarily.
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I Agree
Photo/Video Release: I hereby allow Bilingual Kids to use my child's picture, face, or likeness in advertising for the sole purpose of promoting the Bilingual Kids program. I understand that this would be on print, online, and/or video images of in-program activities.
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Yes
No
Bilingual Kids Tutoring Terms And Conditions
Please scroll to the bottom of the text boxes below to enable the agreement checkboxes.
Confirmation
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature
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Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
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