Parent Primary Contact *

First Name

Last Name

Parent Secondary Contact *

First Name

Last Name

Child's Name *

First Name

Last Name

Child's Birthday *

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Phone Number *

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Secondary Contact Phone Number

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What are your child's goals for this boot camp?

Improvement of concentration and attention

Improvement of memory skills

Improvement on standardized tests

Accelerated math learning

Other

How did you hear about us?

Friends/Family

Google

Facebook

Instagram

Flyers

Other

Package Options *

A team member will reach out to schedule the sessions

10 Sessions

20 Sessions

40 Sessions

Cancellation & Makeup Policy * *

Cancellation: In order to cancel a class and receive a makeup class, you must inform via email to info@tactilebrain.com 24 hours before the start of class. Once your class reservation is cancelled, the class credit will be returned to your account to be used at a future date; the credits are not refunded.

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Photo/Video Release *

By signing up, you give us permission to use you and your child's name, photograph, video images, and any other likeness in connection with any marketing promotion without any compensation to you.

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