Serving metro Atlanta
and surrounding areas
404.692.3450
Registration Form
Today's Date:
Gender:
Child's First and Last Name:
Grade for 2012-13:
Age:
Birthdate:
School Name:
Teacher Name:
Allergies:
Parent/Caregiver Name:
Best Phone Number:
Emergency Phone:
Email Address:
Street Address:
City:
State:
Zip:
Child's Hand Dominance:
Current Handwriting Curriculum:
Child's Attention Level:
Wears Glasses/Contacts:
Handwriting Accommodations Received:
Does your child currently get tutored in other subject areas?
If yes, please state.
Handwriting Concerns as Reported by Teacher/Parent:
Child's Interests/Hobbies:
Other Concerns:
What will you be registering for today? If registering for more than one service, please complete this Registration Form for each service.
Terms and Conditions
Payment for summer camps, group classes and summer tutoring is due upon program registration. Refunds for summer camps or group classes will be given provided we receive 5 days notice and minimum participation requirements are met. As a busy mother, I realize that emergencies do occur, and accordingly, I do not have a strict cancellation policy for private tutoring. We will work together to ensure that services are rendered accordingly.
By registering your child for services and providing your email address, you will be included on our mailing list to receive the latest news about group classes, summer camps and other programs. Buckhead Handwriting is not liable for any injuries that may occur during your child's service.
I have read and agree to Buckhead Handwriting's Terms and Conditions.
Letter Recognition
Legibility
Speed
Start Location
Stroke Sequence
Placement on Line
Placement on Line
Orientation/Reversals
Spacing
Size of Letters and Numbers
After submitting this form, you will be taken to a payment page where you can remit payment using a credit card via Paypal. It is not necessary to have a Paypal account to use this service.
