Early Spring 2021 Deposit

Homeschool Connections Program

Enter your information below to register.

 

Your payment information for the Non-Refundable Deposit ($200.00) will be processed below.

*** Remaining Tuition Fee: $4,790 – Due by January 2nd, 2021 ***

Classes for Early Spring Begin on January 11th, 2021.

Student Information

Student Name
Gender
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 Information

Credit Card
CVV
Expiration Date
Postal Code

$200 Non-Refundable Deposit

In the event that we are unable to operate due to Federal/State/Local/CDC guidelines we will continue to provide our program remotely. No price adjustments or refunds will be granted.

  • I hereby provide this deposit with the intention of enroll the child named above and agree to ALL terms and conditions outlining the requirements of the Homeschool Connections Program by Leap Tutoring Academy.
  • Leap Tutoring Academy reserves the right to dismiss any student whose behavior is disruptive to the program. In such cases, there will be no refund.
  • I grant to Leap Tutoring Academy and to its employees the right to photograph my child and to use these photographs or video recordings for print or electronic publishing.
  • A fully completed emergency form MUST be on file in the prior to the student’s first day. It will be provided to you upon registration.
  • No refunds for the program deposit will be granted.

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.