Middle/High School Tutoring (8 Sessions)

Name:*

First Name Required Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

First Name of Parent/Gaurdian:* First Name of Parent/Gaurdian is Required

Last Name of Parent/Gaurdian:* Last Name of Parent/Gaurdian is Required

First Name of 2nd Parent or Gaurdian: First Name of 2nd Parent or Gaurdian is not valid

Last Name of 2nd Parent or Gaurdian: Last Name of 2nd Parent or Gaurdian is not valid

Phone Number:* Phone Number is Required

1st Student/Athlete First Name:* 1st Student/Athlete First Name is Required

1st Student/Athlete Last Name:* 1st Student/Athlete Last Name is Required

1st Student/Athlete Birthday:* 1st Student/Athlete Birthday is Required

I understand that monthly tuition is based on a four-week average month. There will be some months when a student may receive five lessons for a weekly scheduled class, and some months when, due to holiday closures, a student may receive less than 4 lessons in a month. YARD will follow all Yelm School District closures and any weather closures. Regardless of the amount of weekly scheduled lessons, tuition is based on a four-week month. There are NO REFUNDS FOR MISSED CLASSES(Including single classes), MISSED Rental Space AND/OR TUTORING SESSIONS.:* I understand that monthly tuition is based on a four-week average month. There will be some months when a student may receive five lessons for a weekly scheduled class, and some months when, due to holiday closures, a student may receive less than 4 lessons in a month. YARD will follow all Yelm School District closures and any weather closures. Regardless of the amount of weekly scheduled lessons, tuition is based on a four-week month. There are NO REFUNDS FOR MISSED CLASSES(Including single classes), MISSED Rental Space AND/OR TUTORING SESSIONS. is Required

Yes, I Understand

I understand that if my student is enrolled in a monthly class and for some reason tuition is not paid by the 10th of the month, there will be an automatic $10.00 late fee added to my account. :* I understand that if my student is enrolled in a monthly class and for some reason tuition is not paid by the 10th of the month, there will be an automatic $10.00 late fee added to my account. is Required

Yes, I understand

I agree to pay a returned check fee of $25 for any NSF check returned by the bank.:* I agree to pay a returned check fee of $25 for any NSF check returned by the bank. is Required

Yes, I agree

I understand that as a participant in and/or a spectator at Youth Athletics Recreation Development (YARD), I may be included in videotapes or photographs taken during any event and during training. I agree to be photographed and/or videotaped and that my name, face, likeness, voice, and appearance may be used in advertising and promoting YARD.:* I understand that as a participant in and/or a spectator at Youth Athletics Recreation Development (YARD), I may be included in videotapes or photographs taken during any event and during training. I agree to be photographed and/or videotaped and that my name, face, likeness, voice, and appearance may be used in advertising and promoting YARD. is Required

Yes, I understand No, I would like to opt out of photographs and videos

I acknowledge and agree that training and exercise are strenuous physical activities that involve risk of property damage, bodily and personal injury, illness, paralysis, and death, and assume full risk and responsibility for the same. In consideration of permitting Student to participate in training and any activity ancillary thereto, I hereby VOLUNTARILY AND ABSOLUTELY RELEASE, DISCHARGE, WAVE AND RELINQUISH any and all claims, causes of action, losses, costs, expenses, damages and/or torts, whether in law or equity (collectively "Claims"), which I and/or Athlete/Student may have against Youth Athletics Recreation Development and/or its officers, directors, agents, servants or employees (collectively, "YARD") in any way arising out of or relating to such training or exercise provided by or in conjunction with YARD or in activities incidental thereto wherever or however the same may occur, and for whatever period said activities or instructions may continue. I further agree to fully indemnify and hold YARD harmless for any Claims. The foregoing RELEASE AND WAIVER is intended to be as broad and inclusive as is permitted by the laws of the State of Washington; if any portion of this document is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. (Parent or Legal Guardian must sign for all persons under 18 years of age.):* I acknowledge and agree that training and exercise are strenuous physical activities that involve risk of property damage, bodily and personal injury, illness, paralysis, and death, and assume full risk and responsibility for the same. In consideration of permitting Student to participate in training and any activity ancillary thereto, I hereby VOLUNTARILY AND ABSOLUTELY RELEASE, DISCHARGE, WAVE AND RELINQUISH any and all claims, causes of action, losses, costs, expenses, damages and/or torts, whether in law or equity (collectively "Claims"), which I and/or Athlete/Student may have against Youth Athletics Recreation Development and/or its officers, directors, agents, servants or employees (collectively, "YARD") in any way arising out of or relating to such training or exercise provided by or in conjunction with YARD or in activities incidental thereto wherever or however the same may occur, and for whatever period said activities or instructions may continue. I further agree to fully indemnify and hold YARD harmless for any Claims. The foregoing RELEASE AND WAIVER is intended to be as broad and inclusive as is permitted by the laws of the State of Washington; if any portion of this document is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. (Parent or Legal Guardian must sign for all persons under 18 years of age.) is Required

Yes, I acknowledge

A parent, guardian or designated adult must be present during all PRIVATE tutoring sessions unless prior arrangements have been made and with specific approval.:* A parent, guardian or designated adult must be present during all PRIVATE tutoring sessions unless prior arrangements have been made and with specific approval. is Required

Yes, I agree to have a parent, guardian, or designated adult present

Responsible Party/Parent/Guardian Signature Accepting Above Waiver (electronically sign by typing full name and date signed):* Responsible Party/Parent/Guardian Signature Accepting Above Waiver (electronically sign by typing full name and date signed) is Required

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$545 for 6 Months

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	Middle/High School Tutoring (8 Sessions) – Payment $545 for 6 Months	$545.00
	Total	$545.00

YARD Yelm Washington Youth Academics Athletics Receational Development

Middle/High School Tutoring (8 Sessions) – Payment

$545 for 6 Months

$545.00

Total

$545.00