Student Registration

First Name *

Middle Name

Last Name *

Phone *

Email *

Date of Birth *

Grade Level *

Teacher Name

Emergency Contact *

Emergency Contact Phone *

Student

Attendance *

YesNoI acknowledge that if I am unable to attend 2 tutoring sessions after signing up for them, I will not be allowed to sign up for any future tutoring at the Tandem.

COVID-19 *

YesNoI pledge to wear a mask and practice safe social distancing during my tutoring session. I am aware of the risk of Covid-19 exposure related to in-person tutoring at the Tandem, and release the restaurant, its staff, volunteers, and other student participants from liability related to the risk of contracting Covid-19.

Email address used for Google Classroom *

Password used for Google Classroom *

Confirm Password *

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MKE Center Tutoring

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