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Join Elevate Academy today. Fill out the form below to secure your spot in our personalized tutoring programs.

Child's Information

Tell us about the student

Child's Full Name (First)

Child's Full Name (Last)

Age

Date of Birth

Gender

MaleFemaleOther

Current Grade Level

Select Programs

Choose the programs you are interested in

Math Tutoring

Small GroupsHomework Help

From basic arithmetic to advanced problem-solving. We turn math anxiety into math confidence through interactive, hands-on learning.

Science Tutoring

Practical ExperimentsReal-world Connection

Hands-on experiments and engaging lessons that spark curiosity and wonder about the natural world.

Coding for Kids

New Program

Build games, apps, and future skills. Project-based learning for the next generation of creators.

After-School Support

Homework assistance and study skills. Get the help you need to stay on top of your assignments.

Learning Goals / Specific Needs

Parent / Guardian Information

Your contact details

Parent/Guardian Full Name

Relationship to the Child

Contact Number

Email Address

Emergency Contact

In case we cannot reach you

Emergency Contact Full Name

Relationship to the Child

Emergency Contact Number

Health Information

Medical and safety details

Any known allergies or medical conditions? (Please specify)

Please bring a labeled water bottle for your child. Whole food based, healthy snacks will be provided; inform us of any dietary restrictions.

Current medications (if any)

Are there any physical or emotional learning needs/conditions we should be mindful of?

Family Consent

I hereby provide consent for my child to participate in tutoring sessions at Elevate Academy. I understand that while every precaution is taken to ensure safety, I am responsible for disclosing all relevant health or safety information above.

By submitting this form, you agree to being contacted by Elevate Academy.