Phone: +1 (345) 943-7323

Email: info@caymanlearning.com

Address: 7 Pasadora Place, Smith Rd, Grand Cayman

After School Tutoring Form

Cayman Learning Centre & School

After School Tutoring

Registration Form

    After School Programmes

    STUDENT INFORMATION

    Student Legal Name*:
    Student Preferred Name*:
    Date of Birth*:
    Gender*:MaleFemale
    Registration for Year (Yr1- Yr12)*:
    Proposed Start Date*:
    Current Grade/Year (Indicate if British or American system)*:
    Name of current school:
    Had your child ever repeated a year/ grade?:YesNo
    If yes, which year/ grade was repeated?:
    Where:
    Has your child ever received Special Education or Learning Support?:YesNo
    If so, please provide details of extra help given and provide specialist reports:
    Is your child's first language English?:YesNo

    PARENTS INFORMATION

    Indicate Primary Caregiver: Mother / Father / Guardian / Other:
    Mother's Name*:
    Street Address*:
    District*:
    PO Box*:
    Postal Code*:
    Phone Work*:
    Cell*:
    Email:
    Place of Employer:
    Profession:

    FATHER INFORMATION

    Father Name*:
    Street Address*:
    District*:
    PO Box*:
    Postal Code*:
    Phone Work*:
    Cell*:
    Email:
    Place of Employer:
    Profession:

    STUDENT RELEASE INFORMATION

    Name*:
    Phone:
    Relation:
    Name:
    Phone:
    Relation:
    Please indicate if there is a court order restricting access to this child:YesNo
    If so, indicate individuals name:

    Parent Declaration

    I hereby declare that I have read and understood the information contained on this form, including the attached policies and procedures form, and agree with all of Cayman Learning Centre’s Policy and Procedures. I understand that my child will be required to participate fully in programmes and adhere to centre/school rules and policies. I agree that all parents/ guardians/ caregivers involved will do their upmost to cooperate fully with the centre/school in its rules and policies.

    The information I have provided is correct.

    Signed (Parent/ Guardian):
    Dated:
    I consent that pictures and/or videos taken of my child may be used for CLC promotional purposes only.
    I consent to receiving newsletters.
    I accept Terms and Conditions for Afterschool Tutoring*: Yes, I Accept.

    Terms & Conditions.