Community Catalyst Club Registration
Please fill out the following form to register for Creator's Club.
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Email *
Parent Name *
Student(s) Name *
Upcoming Grade *
Special Needs/Allergies/IEP/504
Parent Phone Number (Emergency Contact) *
I consent to my child being photographed during workshop activities. *
My child may participate in off-campus activities, such as walking to the park. *The students will be accompanied by an adult and staff members of Momentum Tutoring* *
My child is interested in the following *
Required
Which weeks would you like to enroll your child? *
Required
Will you need to bring your child later than 9:00?
Clear selection
If you answered "yes" to the previous question please share what time
Will you need to pick up your child earlier than 12:00?
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If you answered "yes" to the previous question, please share what time
Are you new to Momentum Tutoring?
If you are new to Momentum please take a moment, after submitting this form, to fill out the registration form on the Momentum Tutoring website. This will allow us to send invoices for summer.
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