Sunday, May 6 th , 2018 Berryessa Kumon Center 10:00AM – 11:00AM 1030 Piedmont Road, Suite G Registration Deadline: Monday, April 30 th , 2018 Registration Fee: $15.00 Forms of Payment: Cash or Check (Please prepare exact change.) Student First Name _______________________ Last Name ____________________ Grade (tick): K & Under 1 2 3 4 5 6 7 8 9 & Above Parent Signature * & Date: ____________________________ ____ /____ /_______ 1 Check-in will start 30 minutes before the Test Time. 2 Please bring your own pencils and erasers. 3 Students will complete based on their current grade level. (September 2017 grade) 4 Registration fee includes test entrance and TWO presents. 5 Submit the Participation Form below and the registration fee before April 30 th . 6 Math Contest results will be announced within 2 weeks after the test date. * By signing above you grand the participation Kumon centers the right to use, incorporate, or publish and materials including but not limited to tests, results, names, photographs or video footage taken of you or your child(ren) as a result of participation in this event. The amount of award and number of winners will depend on how many participants are in each level. FOR OFFICE USE ONLY. DO NOT WRITE. PAID