Summer Workshop Registration
Please fill out the following form for Momentum's summer programs.
Email address *
Parent Name *
Your answer
Student(s) Name *
Your answer
Upcoming Grade *
Your answer
Special Needs/Allergies/IEP/504
Your answer
Parent Phone Number (Emergency Contact) *
Your answer
I consent to my child being photographed during workshop activities. *
Which workshop(s) will your child attend? *
Required
Which weeks would you like to enroll your child? (minimum of two required) *
Required
A Pre-assessment is required for all workshops. Please choose the date on which you are available for the free assessment. *we will contact you to arrange the time for that day* *
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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