Enroll for Tutoring - GOODT Studio

01 · Student Registration

Student Full Name *Preferred Name Date of Birth *Grade * School * Teacher(s) / Main Classroom ContactSubjects Needing Support Primary Tutoring Goals Student Strengths, Interests & Goals

02 · Parent / Guardian Information

Primary Parent/Guardian Full Name *Relationship to Student * Phone *Email * Home Address * Additional Parent/GuardianRelationship Additional PhoneAdditional Email Preferred Communication *

03 · Emergency Contacts

Please provide at least two people who can be contacted if a parent/guardian cannot be reached.

Contact #1 Name *Relationship *Phone *Alternate Phone Contact #2 Name *Relationship *Phone *Alternate Phone Contact #3 NameRelationshipPhoneAlternate Phone

04 · Authorized Pickup

Only people listed below may pick up the student unless the parent/guardian provides updated authorization.

Authorized Person #1RelationshipPhoneAuthorized Person #2RelationshipPhoneAuthorized Person #3RelationshipPhonePickup Restrictions / Special Instructions

05 · Weekly $75 Payment Policy

$75 WEEKLY TUITION · DUE BY MONDAY

Tuition is $75 per week and is paid in advance to reserve the student's spot.

Missed-day credit: An eligible missed paid day creates a credit of $18.75 ($75 ÷ 4 scheduled days).

How to use the credit: The credit is deducted from the next week's $75 balance. Credits are not paid out as cash.

Example: One missed paid day = $18.75 credit → next week's balance = $56.25.
Two missed paid days = $37.50 credit → next week's balance = $37.50.

I understand and agree to the $75 weekly tuition, Monday payment deadline, and missed-day credit policy. *

06 · Parent / Guardian Agreement

I confirm that the information in this enrollment form is accurate to the best of my knowledge. *I understand that tutoring tuition is $75 per week and is due by Monday. *I understand that eligible missed-day credits are deducted from the following week's tuition balance. *I understand that tutoring provides academic support but does not guarantee a specific grade, test score, or academic outcome. *I agree to promptly update contact information, pickup authorization, or relevant student information when it changes. *I agree to review the Student Expectations with my child and support a safe, respectful learning environment. *

Parent/Guardian Full Name *Date *

07 · Photo / Video Consent

Select one option.

YES — I give permission for my child to be photographed/video recorded and for the image, voice, or likeness to be used for Academy-related promotional, educational, community, website, social-media, printed, or event materials.LIMITED — I permit photos/video for internal program documentation and parent updates, but not public promotional use.NO — I do not give permission for my child's photo/video to be used publicly.

08 · Emergency Authorization

Known Allergies / ReactionsMedications / Important Emergency InformationOther Emergency NotesPreferred Emergency Medical Facility / ProviderFacility / Provider PhoneI authorize Academy staff to call 911/emergency services when they reasonably believe immediate assistance is necessary, while attempting to contact me as soon as reasonably possible. *Parent/Guardian Full Name *Date *

09 · Student Expectations

Be respectful — treat students, tutors, staff, visitors, and property with respect.Be ready — arrive prepared with schoolwork, materials, and a book.Participate — ask questions, follow directions, and make a genuine effort.Protect the learning environment — no bullying, fighting, threats, or intentional damage.Use technology responsibly and only as permitted.Complete assignments honestly and ask for help instead of copying.Communicate when something is difficult or affecting learning.Follow pickup procedures and remain in the designated area until released.

I understand these expectations and agree to do my best to contribute to a safe, focused, and respectful learning environment. *

10 · Tutor Intake & Academic Baseline

For parent/guardian and tutor use. Complete what you know; the tutor may update this after the initial assessment.

Reading Level / EvidenceWriting Level / EvidenceMath Level / EvidenceHomework / Organization NeedsWhat Helps This Student Learn Best?Barriers / Concerns to Monitor30-Day Academic Goal(s)

11 · Tutor Progress Notes

For Academy/tutor use. Add session notes, progress, assignments, strengths, and next steps.

Initial Tutor NotesWeekly Progress / Parent Communication NotesNext Academic Focus / Recommendations

12 · Enrollment Checklist & Details

Enrollment Date *Program Start Date *Payment Status *Additional Enrollment Notes

BOOKS & Basketball Academy

TUTORING ENROLLMENT