Tutorial Application

Please complete this form separately for each child applying to Riverside Tutorial. Thank you.

  • MonthDayYearAge as of 9/1/2017 
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    I hereby consent to use by the Riverside Center of Education my child/children’s picture, likeness, photograph or video in all forms and manner for educational, instructional, advertising or promotional purposes without consideration to the undersigned, and I hereby waive any right to inspect or approve the finished version of any written copy that might be used in connection therewith. By checking the box above, I, the Parent, agree and consent to this photo release agreement.
  • This field is for validation purposes and should be left unchanged.
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