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Tutorial Detailed Application

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

Child's Name*
First Last
Your Name*
First Last
Other Parent's Name*
First Last
Primary Phone Number*
Email*
Please select the Tutorial Day you are applying to:*
Child's Date of Birth*
Month Day Year Age as of 9/1/2024
Does your son have any allergies or other medical conditions we should know about?*
Homeschool Curriculum* (Please list the homeschool curricula you currently use, or have used in the past.)*
What language (s) is (are) spoken at home?*
What are some of the activities your son enjoys?*
Please list his involvement in clubs/activities (music, scouts, etc…)*
Please describe some of his talents and affinities.*
About what topics does your son enjoy speaking or writing about?*
What do you consider to be your son's strongest aptitudes and character traits?*
In what learning activities has your son exhibited engagement, passion, and focus?*
Subjects enjoyed most*
Subjects enjoyed least*
Academic strengths*
Academic challenges*
Photo Release Agreement*
- I consent to this photo release agreement.
- I do not consent to this photo release agreement.
I hereby consent to use by the The Riverside Club for Adventure & Imagination of 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.
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Email*
Email
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Tutorial Detailed Application

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Month	Day	Year	Age as of 9/1/2024