Soar Detroit - Student Registration

Soar Detroit - Student Registration

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone

Alternate or work phone

Mailing Street

Mailing City

Mailing Zip

How did you learn about Soar Detroit?

Relationship to Student(s)

# of Children to Register

Tutoring Location

Preferred Tutoring Session

Emergency Contact

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone

Emergency Contact Email

I/WE HAVE READ THE WAIVERS (found above this form) FOR PHOTOGRAPY CONSENT, RELEASE OF LIABILITY, AND CONSENT FOR MEDICAL TREATMENT. I UNDERSTAND THEM AND BY CHECKING THE BOX AGREE TO THEM.

Yes, I agree

Child's Information

Child's First Name

Child's Last Name

Birthdate

Gender

Race or Ethnic Origin

African American/BlackAmerian Indian or Alaska NativeAsianHispanic or LatinoNative Hawaiian or Pacific IslanderWhiteRace/ethnic origin not listedPrefer not to say

Current Grade

School

School District

Additional Details

Has your child repeated any grades?

Which Grades?

Does your child have an IEP? (IEP stands for Individualized Education Plan which is given to children by Special Education teachers at school. If you are unaware of a plan, your child probably doesn’t have one select “no/I don’t know)

Please list any health conditions your child may have (i.e. asthma, diabetes, allergies). If your child does not have any health conditions type "NONE"

2nd Child's Information

2nd Child's First Name

2nd Child's Last Name

Birthdate

Gender

Race or Ethnic Origin

African American/BlackAmerian Indian or Alaska NativeAsianHispanic or LatinoNative Hawaiian or Pacific IslanderWhiteRace/ethnic origin not listedPrefer not to say

Current Grade

School

School District

Additional Details

Has your child repeated any grades?

Which Grades?

Does your child have an IEP? (IEP stands for Individualized Education Plan which is given to children by Special Education teachers at school. If you are unaware of a plan, your child probably doesn’t have one select “no/I don’t know)

Please list any health conditions your child may have (i.e. asthma, diabetes, allergies). If your child does not have any health conditions type "NONE"

3rd Child's Information

3rd Child's First Name

3rd Child's Last Name

Birthdate

Gender

MaleFemale

Race or Ethnic Origin

African American/BlackAmerian Indian or Alaska NativeAsianHispanic or LatinoNative Hawaiian or Pacific IslanderWhiteRace/ethnic origin not listedPrefer not to say

Current Grade

School

School District

Additional Details

Has your child repeated any grades?

Which Grades?

Does your child have an IEP? (IEP stands for Individualized Education Plan which is given to children by Special Education teachers at school. If you are unaware of a plan, your child probably doesn’t have one select “no/I don’t know)

Please list any health conditions your child may have (i.e. asthma, diabetes, allergies). If your child does not have any health conditions type "NONE"

4th Child's Information

4th Child's First Name

4th Child's Last Name

Birthdate

Gender

MaleFemaleGender not listedPrefer not to say

Race or Ethnic Origin

African American/BlackAmerian Indian or Alaska NativeAsianHispanic or LatinoNative Hawaiian or Pacific IslanderWhiteRace/ethnic origin not listedPrefer not to say

Grade

School

School District

Additional Details

Has your child repeated any grades?

Which Grades?

Does your child have an IEP? (IEP stands for Individualized Education Plan which is given to children by Special Education teachers at school. If you are unaware of a plan, your child probably doesn’t have one select “no/I don’t know)

Please list any health conditions your child may have (i.e. asthma, diabetes, allergies). If your child does not have any health conditions type "NONE"

Soar Detroit has partnered with Ready4K, an evidence-based family engagement curriculum delivered via text messages. Each week, parents and caregivers receive fun facts and easy tips on how to promote their children’s academic development. You may unsubscribe at any time. Do you consent to receive this content?

Yes, thank you!No, not at this time.

Please click "Submit" below to complete your child's registration request. Someone will contact you to arrange for a reading assessment. Please note that enrollment is at Soar Detroit's discretion and will take into consideration factors such as your child's reading proficiency and space available.

Contact Information