SCHRADER LANE CHURCH OF CHRIST TUTORING REGISTRATION FORM - TUTORING, MONDAYS & THURSDAYS, 6PM - 7:30PM
(FALL Semester Tutoring Starts Thursday, September 5th)  
Email *
STUDENTS NAME *
ADDRESS *
SCHOOL'S NAME *
GRADE *
AGE *
PARENT/GUARDIAN NAME *
PARENT/GUARDIAN PHONE # (HOME/CELL) *
Emergency Contact Name and Phone Number *
Others authorized to pick up child
Child's Allergies, etc.  *
SUBJECTS YOUR STUDENT NEEDS HELP WITH. CHOOSE ALL THAT APPLY. *
Required
SPECIFY OTHER SUBJECT AREAS HERE
Please check the days your child will participate in the tutorial program. *
Required
IMPORTANT: PARENT/GUARDIAN COMMITMENT 
Please read and type your (parent/guardian) name below to acknowledge your reading and agreement to this commitment.
I will bring my child to weekly tutorial sessions in a timely manner, contact the tutorial office if my child will not be able to attend a scheduled session, follow the check-in and check-out procedures, pick up my child by 7:30 PM, discuss with my child the importance of a good attitude for tutoring to be successful, discuss with my child homework assignments before bringing my child to tutoring, make sure my child brings textbooks and homework to each tutorial session, make sure my child has other necessary materials, and instruct my child to cooperate and respect the tutorial staff, other students, and church property.
PARENT'S/GUARDIAN'S NAME *
IMPORTANT: STUDENT COMMITMENT 
Please read and type your student's name below to acknowledge their reading and agreement to this commitment.
I will follow the rules and regulations of the Schrader Lane Church of Christ Tutorial Program, which are:
• Bring textbooks, homework assignments, recent tests, and materials needed to each tutorial session
• Respect and obey the tutorial staff and volunteers
• Respect other students and do not disturb them with excessive talking or other disruptive behavior
• Respect the property of the church
• Report to the auditorium at the end of each tutorial session and remain in the auditorium until picked up by authorized person
• Diligently apply myself during each tutorial session, realizing others are sacrificing to help me
STUDENT'S NAME  *
A copy of your responses will be emailed to .
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