Stevens Creek Mathletes Registration

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Class Size: 10-24 students (max)

Mondays
3:40-4:55 PM PST

8 sessions:
January 23, 30
February 6,13, 27
March 6,13, 27

Note: no class on 2/20, 3/20

Total Tuition: $340

Payment Methods:

Zelle: ck@ckmathletes.com

Venmo: @Mathculture
(search for Math, hit green 'businesses' button, select Math Culture LLC)

Check: Payable to "Math Culture LLC"

Mail/deliver check to:
Math Culture LLC
1019 Ray Avenue
Los Altos, CA 94022

Registration is complete when this form is completed and payment is received.
Confirmation will be emailed to you from lia@ckmathletes.com

Email *

First Name of Parent filling out this form *

Last Name of Parent filling out this form
*

Phone Number of Parent filling out this form *

Secondary Phone Number

First Name of Student (one registration form per student) *

Last Name of Student
*

Grade of Student *

Name of Emergency Contact, other than parent on this form (first and last name) *

Phone number of Emergency Contact *

Payment options for tuition include Zelle, check, or Venmo.
*

I understand and will pay with one of these methods

I understand there are no free trial classes. *

I understand and agree to pay before my child's first class

There are no refunds for cancelled registrations or missed classes. *

I understand and agree to the refund policy

We will NOT tolerate ANY type of teasing, name-calling, or destructive behavior during class. It is critical that students feel this is an environment in which they can ask questions, take risks, and feel ‘safe.’ IF your child engages in destructive behavior they will immediately be kicked out of the class. If this happens, you can petition to rejoin the program if you meet with the instructor and Coach K.
*

I understand and agree with the no-bullying policy

Pick Up Policy:

Students MUST be picked up and signed out of the classroom. They will not be released from the classroom unless you have filled out the below sections and noted that they are allowed to leave on their own.

Please choose how your child will be leaving class:

A parent/adult will pick up my student from the classroom when class is over (4:55).

My child has permission to walk/bike home alone.

My child has permission to go directly to an aftercare program on campus.

Other:

Required

Special Considerations (allergies, health issues, or other things we should know)

A copy of your responses will be emailed to the address you provided.

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