Homeschool Class Registration Form
1. Love of Literature: Tuesdays & Wednesdays 9:30 - 12:00 (January - May)
2. Music & Art Appreciation: Wednesdays, 12:00 - 12:45 (January - May)
3. Social Lunch Break, Tuesdays, 12:00 - 12:30 (January - May)
4. Deep Dive, Tuesdays, 12:30 - 2:30 (January - May)
Registering For (check all that apply):
Love of Literature, Tuesdays & Wednesdays 9:30 - 12:00 (January - May)
Social Lunch Break, Tuesdays, 12:00 - 12:30 (January - May)
Deep Dive, Tuesdays 12:30 - 2:30 (January - May)
Music & Art Appreciation, Wednesdays, 12:00 - 12:45 (January - May)
Address (street, city, zip)
Emergency Contact Person and Contact Info
Student's Strengths and Enjoyable Activities
Area(s) of Weakness/Concern/Support May Be Needed
Medical Information (include allergies, diagnosis, or any other areas of concern):
Any information you would like the instructor to know about your student:
After registration is received you will receive a separate email with your payable invoice. Payments may be made by credit card, check, or cash. Payments are due on the 20th of the month for the next month of service. Please select all of your interested classes. * Must have at least 6 students. Discounted rate for 8 or more students.*
Love of Literature: $250/month*
Music & Art Appreciation: $40/month
Social Hour: FREE with Love of Literature and Music & Arts Class; OR $40/month
Deep Dive: $165/month
I understand that I will not be refunded for missed sessions. You may cancel your monthly sessions by notifying EtB in writing (email) by the 20th before the start of the new month.
Yes, I understand
I agree to having my child's photo taken and used in marketing/social media sites. (No names will be used.)
Yes, I'm okay with this.
No, please do not have my child's photo used.
A copy of your responses will be emailed to the address you provided.
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