Leap Tutoring Learning Pods Registration

Select your Group below.

Student Information

Student Name

Gender

Male

Female

Birth Date

Home Address

Zip

Home Phone

Email Address

Parent 1 / Guardian

Work Phone

Cell Phone

Parent 2 / Guardian

Work Phone

Cell Phone

Emergency contact: (Name)

Relationship

Phone

Credit Card

CVV

Expiration Date

Postal Code

ELA SESSION 1 - SEPT - OCT / SPECIAL - 1 Session Free - 10 Session Learning Pod ($540.00)

MATH SESSION 1 - SEPT - OCT / SPECIAL - 1 Session Free - 10 Session Learning Pod ($540.00)

BOTH ELA + MATH SESSION 1 - SEPT - OCT / SPECIAL - 4 Sessions Free - 20 Session Learning Pod ($960.00)

ELA SESSION 2 - OCT - NOV / SPECIAL - 1 Session Free - 10 Session Learning Pod ($540.00)

MATH SESSION 2 - OCT - NOV / SPECIAL - 1 Session Free - 10 Session Learning Pod ($540.00)

BOTH ELA + MATH SESSION 2 - OCT - NOV / SPECIAL - 4 Sessions Free - 20 Session Learning Pod ($960.00)

I have read the above statement, and the terms and conditions listed, and agree to all terms indicated.

By typing my name I agree to the above with my digital signature.

Please note by registering you agree that the program design may be modified to a remote only platform as a result of any COVID related incidents.