New Client Intake Form Parent/Guardian Name * First Name Last Name Parent/Guardian Email * Parent/Guardian Phone * (###) ### #### Student's Name * First Name Last Name Student's Grade (School Year 2024-2025) * Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Student's Current School * Area of Focus or Concern How did you hear about us? * Word of mouth Google Facebook Building Sign LATENESS, CANCELLATIONS, and NO SHOWS. * FEES & PAYMENT The Client agrees to the posted Session rate. Payment shall be made in advance or immediately following the session. LATENESS, CANCELLATIONS, and NO SHOWS Our lateness and cancellation policy is designed to be fair to both the Student and SP Tutor and other students who may be scheduled on the same day. If the Student cannot attend a session for any reason, please contact us at least 24 hours before the session. You will be charged a flat fee of $50 if you fail to show or cancel within 24 hours of the scheduled session. No adjustments of fees or schedule shall be made for time lost due to late arrival or early departure by the Student. You authorize SP Tutor to charge your credit card by booking an appointment. HEALTH AND SAFETY SP Tutor is committed to providing a safe and healthy environment for all our students and staff. We adhere to the highest standards of cleanliness and hygiene in our facilities. Should there be any health concerns or symptoms of illness, we kindly ask for immediate communication to ensure the well-being of all involved. This policy is in place to safeguard the health and safety of our community, respecting the need for precaution and mutual responsibility. PRIVACY POLICY We respect the privacy of our clients and are committed to protecting your personal information. Your details and session records will be handled with confidentiality and will not be shared with third parties without your consent, except as required by law. LIABILITY RELEASE By engaging with SP Tutor's services, clients agree to release, indemnify, and hold harmless SP Tutor, its members, directors, officers, employees, contractors, volunteers, agents, and representatives from any and all claims, damages, or liabilities arising from or related to the student's participation in the sessions. This release extends to all aspects of the sessions, including but not limited to personal injury or damage to property. AGREEMENT TO TERMS By scheduling a session with SP Tutor, you acknowledge that you have read, understood, and agreed to these terms and conditions. You acknowledge that these terms form a binding agreement between you and SP Tutor. Signature * Thank you!