Sum It Up
Student Registration Form

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Please complete one form per child. Please visit the policies and procedures page before registering your child.


Contact Information
Child's First Name:
Child's Last Name:
Parent's First Name:
Parent's Last Name:
Street Address:
 
City:
State:
Zip Code:
Phone Number: (example: 3015551212)
Emergency Phone Number: (example: 3015551212)
Email Address:
School He/She Attends:
In 2012-2013, my child is entering grade:
Special Instructions/Specific Learning Needs:
Does your child have any special medical concerns?

Yes No

If yes, please explain:

T-Shirt Size:  

Each Family who registers for more than $300 of classes will earn back a $20 refund. $400 of classes earns $30 back, and $500 earns $40 back etc. What's this?

Sum It Up | 16501 Black Rock Road
Darnestown, Maryland, 20874
Phone: 301-343-3958
www.SumItUpTutoring.com
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