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LRA Math & Reading Summer Tutoring
2023 Registration Form for Math & Reading Summer Tutoring Camps
Please fill out a registration form per student
3 items needed for complete registration: this registration form, signed waiver and payment
Camps need a minimum number of students to occur
Morning camp session offered first. Afternoon session added, if needed
Registration will close May 1 or when camps reach maximum
Email nquiroa@livingrockacademy.com with questions
Elementary: completed grades 3-5
Middle School: completed grades 6-8
All students need a water bottle
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Email
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Your email
Student Name:
*
Your answer
Grade (completed May 2023):
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Your answer
Camp Options:
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MS Math & Reading: June 12-16 from 9:00 am-12:00 pm. Cost: $200
Elementary Math & Reading: June 19-23 from 9:00 am-12:00 pm. Cost: $200
More Information about Private Tutoring: Reading
More Information about Private Tutoring: Math
Shirt Size:
*
Youth Small
Youth Medium
Youth Large
Youth Extra Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Parent/Guardian Name:
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Your answer
Parent/Guardian Phone:
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Your answer
Parent/Guardian Email: (A waiver will be emailed for your signed consent to complete registration)
*
Your answer
Payment Options:
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Cash: drop by our front desk marked as Summer Camp with student's name
Check: payable to Living Rock Academy, write 'summer camp and student's name' in the memo
Venmo: @LivingRockAcademy (if asked for confirmation, the last 4 digits are 4894) Please mark as 'Summer Camp' with student's name
Questions about payment? Email
awarrix@livingrockacademy.com
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A copy of your responses will be emailed to the address you provided.
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