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To register your child for TEAM Northwest Tutoring this year, please complete the form below.
REQUIRED
:
Please also click
here
to sign the electronic checklist for TEAM Northwest.
If you have questions, please click
here
.
2016-2017 TEAM Northwest Tutoring Registration Form
Student Name, School, Grade Level, Homeroom Teacher
*
Parent/Guardian(s) Name, Phone Number, Email Address
*
Dismissal Procedures
*
My child will be picked up on Mondays and Thursdays at 4:15.
My child will attend Crossroads on Mondays and Thursdays. S/he has registered with Crossroads for activities on these days.
My child is registered to attend Crossroads on Mondays, and will be picked up on Thursdays at 4:15.
My child is registered to attend Crossroads on Thursdays, and will be picked up on Mondays at 4:15.
My child will walk home on Mondays and Thursdays at 4:15.
My child is registered to attend Crossroads on Mondays, and will walk home on Thursdays at 4:15.
My child is registered to attend Crossroads on Thursdays, and will walk home on Mondays at 4:15.
Please let us know how to dismiss your child from tutoring sessions at 4:15. Please note that if a student is picked up late 3 or more times, s/he may be dismissed from the program.
Emergency Contact Information
*
Please list the names and contact information for AT LEAST one adult not already listed. In the event of an emergency or an illness, these contacts would also have permission to pick up your child.
Is there anything else you'd like us to know about this student? Please include allergies.
*
Submit
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