First-class form
Please fill this in and sign it at your child's first class (we have paper copies too). Four Corners Tutoring, operated by Verena LLC · 1404 Brady Springs Road · (859) 285-8906
Your child
Child's first name
Grade
Allergies or medical needs
Parent or guardian
Name
Phone
Email
Emergency contact (name & phone)
Adults allowed to pick up
Treats and photos
- Yes, my child may get candy or food prizes (stickers are always fine).
- No food prizes, please.
We don't take photos or videos of students and never post them online.
Please check each box
- I'm the child's parent or legal guardian.
- I understand the tutors are 12-year-old students, and an adult (Shashank Singh or another tutor's parent) is home and supervising every class.
- I agree to drop off and pick up my child at the door, on time, or send an adult listed above.
- If I make my child a student login, I agree to the privacy notice (fourcorners website › Privacy): we keep only a first name, grade, username, and learning progress, never your child's email, address, or photos. I can see, download, or delete it any time from my parent account.
- I've read the policies: cash at each class; free to cancel up to 24 hours before; late cancellations and no-shows pay for the missed class at the next class (not for illness or emergencies); 30 days' notice before price changes.
Signature
Date
We keep this form while your child takes classes with us and for one year after, then shred it. Ask us any time to see or update it.