Registration Form - Summer Step-Up
Child's Name ________________________________________ M/F Grade entering______
Parent/Guardian' s Name ________________________________
Address ____________________________________________
__________________________________________________
Phone_____________________ Bus____________________ Cell __________________
Allergies ___________________________________________
(We will be working with various household substances and food items during the science and cooking classes, please be specific).
Please indicate which session(s) you are interested in:
_____ Session I June 16 - 19 Mon. - Thurs. 9-12
_____ Session II June 23 - 26 Mon. - Thurs. 9-12
_____ Session III July 7 - 10 Mon. - Thurs. 9-12
_____ Session IV July 14 -17 Mon. - Thurs. 9-12
Indicate which classes you are interested in:
_____ Book Club (1st-3rd) ____Read On! (4th-6th)
_____ Math 4 Me (1st-3rd) ____Math 4 Me(4th-6th)
_____ Science/No-Cook Cooking (1-6)
* Please note: Classes are each 1 hour, Reading, Math, and Science/No-Cook Cooking classes are held consecutively
Fees
Class fees are $100 per session for 3 classes, $80 for 2 classes, $40 for 1 class.
Make check payable to: Smart Move Tutoring
Mailing Address:
Chandler United Methodist Church
Attn. Smart Move Tutoring
450 E. Chandler Heights Rd.
Chandler, AZ 85249
Signature_______________________
Date _______________
# of classes registered for ____________
Total Amount _________