Consent and Waiver for Recording Online Tutoring Sessions

(Waiver, Indemnity, Acknowledgement and Release) 

This Consent and Waiver Agreement ("Agreement") is entered into by and between:

 

• Tutor/Organization Name: CRYSTAL STAR MATH & SCIENCE TUTORING INC. (CSTAR)

 

 

 

•Tutor Name: ________________________ 

 

Student Name: _____________________ 

 

• Parent/Guardian Name (if student is under 18):

 

 

________________

 

• Date: _________________ 

 

 

 

1. Purpose of Recording

 

Recordings of online tutoring sessions by CRYSTAL STAR MATH & SCIENCE TUTORING INC. (CSTAR) serve several essential educational, administrative, and legal functions. These include, but are not limited to, the following purposes:

 

a) Academic Review & Reinforcement

 

• Enhances Learning Retention: Students can rewatch sessions to reinforce understanding of key concepts, improving long-term retention and academic performance. 

• Supports Exam Preparation: Recordings provide a valuable resource for review during midterms, finals, and standardized test preparation.

• Encourages Self-Paced Learning: Students can pause, rewind, and revisit complex sections at their own pace to accommodate varied learning styles and needs.

• Clarifies Complex Topics: Enables students to reflect on and better understand difficult subjects discussed during live sessions.

 

b) Quality Assurance & Instructional Improvement

 

• Evaluation of Tutor Performance: Recordings allow CSTAR’s administrative team to assess the effectiveness and professionalism of tutors.

• Instructional Feedback: Tutors can self-review sessions to identify areas of improvement in their teaching approach.

• Curriculum Alignment: Helps ensure that session content aligns with CSTAR’s standardized curriculum and learning outcomes.

• Consistency of Delivery: Promotes uniformity in instructional delivery across tutors and subjects.

 

c) Dispute Resolution & Accountability

 

• Objective Documentation: Recordings act as factual evidence in resolving disputes regarding the accuracy of information taught or student-tutor interactions.

• Academic Integrity Monitoring: Helps investigate concerns about plagiarism, cheating, or other violations of academic conduct.

• Transparency & Protection: Safeguards the interests of both students and tutors by maintaining a clear and unbiased record of each session.

 

d) Compliance & Institutional Policy

 

• Legal Compliance: Ensures adherence to applicable Canadian laws, including: o Freedom of Information and Protection of Privacy Act (FIPPA) o Personal Information Protection and Electronic Documents Act (PIPEDA) o Canadian copyright legislation.

• Data Management Standards: Recordings are managed in accordance with CSTAR’s data security and retention protocols, which include secure storage, limited access, and timely deletion (e.g., after 90 days unless retention is legally required).

• Policy Enforcement: Ensures all participants understand their rights and responsibilities regarding recorded content.

 

e) Accessibility & Accommodations

 

• Inclusive Learning: Recordings provide additional support for students with learning disabilities, cognitive challenges, or language barriers.

• Catch-up Tool: Offers students who missed a session due to illness, emergencies, or approved absences the opportunity to catch up on missed content.

• Resource for Accommodated Needs: Fulfills accommodation requirements under CSTAR’s accessibility policy or third-party recommendations (e.g., from educational psychologists or medical professionals).

• Equitable Access: Helps bridge gaps in understanding by allowing all students equal access to lesson material regardless of their circumstances.

 

2. Scope

 

This section outlines the extent and limitations of CSTAR’s recording practices. It defines the individuals and activities subject to recording, as well as the exclusions, legal framework, and update procedures that govern the policy.

 

2.1 Applicable Parties

 

This policy applies to the following individuals and groups:

 

• Students Enrolled in CSTAR Programs: All students participating in CSTAR’s academic services, including full-time, part-time, and ad hoc learners.

• Parents/Legal Guardians of Minors: Parents or guardians of students under the age of majority are considered stakeholders and are informed of recording practices as part of the enrollment process.

• CSTAR Personnel: All CSTAR-affiliated tutors, instructors, administrators, and support staff who participate in or oversee recorded activities.

 

2.2 Covered Activities

 

The following learning-related activities are subject to CSTAR’s recording protocols:

 

• Live Online Tutoring (Synchronous Sessions): All real-time virtual sessions conducted via CSTAR-approved platforms are recorded for educational and quality assurance purposes.

• Pre-recorded Instructional Content: Video lessons or modules created by CSTAR tutors and made available to students for asynchronous learning.

• Screen-Sharing & Digital Collaboration: Content shared via screen during sessions, including slide decks, whiteboards, diagrams, or educational software demonstrations.

• Chat Logs & Annotations: Written messages exchanged during sessions (e.g., in chat boxes), tutor/student annotations on digital whiteboards, and collaborative tools.

• Shared Documents & Resources: Any materials exchanged through the CSTAR platform that are integral to the learning session, including homework help, lesson summaries, and links to study resources.

 

2.3 Exclusions

 

The following activities and situations fall outside the scope of CSTAR’s official recording policy:

 

• Third-party Platforms Not Authorized by CSTAR: Sessions conducted via non approved tools or software platforms (e.g., personal Zoom or WhatsApp calls) are excluded from this policy.

• Unauthorized Recordings by Students or Parents: Any audio, video, or screen recording initiated by students or guardians without CSTAR’s explicit prior consent is prohibited and may violate privacy laws or contractual terms.

 

2.4 Compliance with Laws & Policies

 

CSTAR’s recording practices are governed by legal and institutional requirements to ensure responsible data handling:

 

• Canadian Legal Framework: All recordings comply with relevant federal and provincial laws, including: 

o Freedom of Information and Protection of Privacy Act (FIPPA)

o Personal Information Protection and Electronic Documents Act (PIPEDA)

o Canadian copyright legislation regarding instructional content.

 

• CSTAR Internal Policies: Adheres to the organization's data retention and privacy protocols, including secure storage and automatic deletion of recordings after 90 days, unless required for dispute resolution or legal compliance.

 

2.5 Modifications

 

CSTAR reserves the right to revise this recording policy under the following conditions:

 

• Advance Notification: Any substantial updates will be communicated to students, parents/guardians, consulting tutors and staff through official channels (e.g., email or learning platform notifications).

• Implied Consent Through Continued Participation: By continuing to engage in CSTAR’s services after such updates, all parties are considered to have accepted the revised terms unless explicitly stated otherwise.

 

3. Key Definitions

 

This section provides clear definitions of terms used throughout the recording policy to ensure consistency, legal clarity, and stakeholder understanding.

 

a) Copyright

 

• Definition: Copyright is a legal framework that grants creators exclusive rights over their original works, including the right to reproduce, distribute, and control access to those works.

• Application: All CSTAR-created materials—such as session recordings, teaching aids, diagrams, annotated notes, and video content—are protected by copyright laws. Unauthorized reproduction, distribution, or modification of these materials is strictly prohibited and may result in legal consequences.

 

b) Educational Activities

 

• Definition: Educational activities refer to structured learning interactions designed to achieve academic objectives within CSTAR programs. 

• Examples Include:

o Virtual lectures or instructional sessions

o Tutor-student discussions and Q&A

o Collaborative problem-solving exercises

o Real-time or recorded assessments and quizzes

o Personalized feedback and academic guidance

 

c) Intellectual Property (IP)

 

• Definition: Intellectual Property refers to creations of the mind—such as educational content, software, instructional methods, and visual aids—that have commercial or proprietary value.

• Protection: All IP developed or provided by CSTAR (including session recordings, custom learning tools, and proprietary curricula) is protected by applicable copyright and trade secret laws. Unauthorized use, duplication, or distribution of CSTAR’s IP is prohibited.

 

d) Independent Contractor

 

• Definition: For the purposes of this agreement, a tutor is considered an Independent Contractor and not an employee, partner, or agent of CSTAR. As an independent contractor, the tutor is solely responsible for determining the method, timing, and manner of delivering tutoring services. CSTAR does not control or direct the tutor’s work and is not responsible for withholding taxes, providing benefits, or covering expenses incurred by the tutor. The tutor is responsible for complying with all applicable laws and regulations related to their self-employment.

• Tutors engaged through the CSTAR platform are Independent Contractors and not employees of CSTAR.

• CSTAR provides services to these tutors and receives a commission in return.

• Tutors are strictly prohibited from conducting in-person sessions with CSTAR students. Any violation of this policy will result in immediate termination of their access to the platform. 

 

 

e) Personal Information

 

 

• Definition: Personal information includes any data that can be used to identify an individual, either directly or indirectly. 

•Examples Include:

o Student and tutor names

o Recorded audio and video (e.g., voices, facial images)

o Chat messages and screen-shared documents containing identifiers

 

• Regulatory Compliance: The handling of personal information is subject to the Freedom of Information and Protection of Privacy Act (FIPPA) and related privacy regulations. CSTAR is committed to safeguarding personal data through secure recording, storage, and access protocols.

 

f) Authorized Use

 

• Definition: Authorized use refers to the access, viewing, and application of session recordings and educational content strictly within the bounds of this policy.

• Permitted Users: 

o Students enrolled in the recorded session

o CSTAR tutors and administrative staff for academic or training purposes

o Third parties (e.g., parents, legal guardians, academic auditors) only with explicit, written consent from CSTAR and relevant stakeholders 

• Restrictions: Recordings may not be shared publicly, posted online, or disseminated beyond the approved circle of users without prior CSTAR authorization.

 

4. Nature of the Recordings

 

This section outlines the components, storage protocols, ownership, and permissible uses of recordings created during CSTAR’s educational activities. It also specifies prohibited actions to protect the integrity, privacy, and intellectual property rights of all involved.

 

4.1 Content May Include

 

CSTAR’s educational session recordings may capture a wide variety of instructional and interactive elements, including but not limited to:

 

• Video & Audio:

o Live or recorded footage of tutoring sessions involving both tutor and student. o Verbal explanations, academic discussions, and oral feedback.

• Screen Sharing:

o Visual presentations such as slides, diagrams, virtual whiteboards, and software demonstrations.

o Real-time annotations and written examples displayed during instruction.

• Chat & Documents:

o Text-based communications exchanged during sessions.

o Uploaded or collaboratively edited documents (e.g., assignments, notes).

o Time-stamped transcripts of discussions for review and documentation.

 

4.2 Storage & Access

 

CSTAR prioritizes the secure handling of all session recordings through stringent data storage and access controls:

 

• Storage Protocols:

o Recordings are securely stored on encrypted, password-protected cloud-based platforms compliant with Canadian privacy standards.

o Backup mechanisms are in place to prevent data loss or unauthorized access.

• Access Restrictions:

o Access is limited to:

▪ The enrolled student and/or their legal guardian

▪ Assigned CSTAR tutors and authorized administrative personnel

o External access (e.g., for academic review or audits) is granted only with prior written approval from CSTAR and in compliance with applicable laws.

• Retention Policy:

o Recordings are retained for a standard period of 90 days.

o Extended retention may occur for:

▪ Ongoing academic or disciplinary reviews

▪ Legal compliance or investigative purposes

▪ Documenting training and quality assurance activities

 

4.3 Intellectual Property & Privacy

 

• Ownership: 

o All session recordings are the exclusive intellectual property of CSTAR, unless otherwise stipulated in a formal agreement.

o Students and parents/guardians may access recordings but may not alter or redistribute them without explicit written permission.

• Privacy Compliance:

o CSTAR adheres to the Freedom of Information and Protection of Privacy Act (FIPPA) and the Personal Information Protection and Electronic Documents Act (PIPEDA).

o All personal and academic data within recordings is treated with confidentiality and processed in accordance with these laws.

 

4.4 Prohibited Uses

 

To protect all participants and uphold academic integrity, the following uses of recordings are strictly prohibited:

 

 

• Unauthorized Sharing:

o Recordings may not be posted, distributed, or shared on any social media, public websites, or third-party platforms.

• Commercial Exploitation:

o Use of any CSTAR recordings or educational content for advertising, monetization, or other commercial purposes is forbidden.

• Distortion or Misuse:

o Editing, misrepresenting, or otherwise manipulating recordings in a way that alters context or misuses participants’ contributions is not permitted.

 

 

Violations of these terms may lead to disciplinary action, termination of access, or legal consequences as applicable.

 

5. Consent to Record

 

This section outlines the informed consent agreement required from students and/or their parents or legal guardians regarding the recording of CSTAR's online tutoring sessions. Consent is a condition of participation in CSTAR’s programs involving recorded content.

 

5.1 Grant of Permission

 

By signing this agreement, the Student and/or Parent/Guardian explicitly:

 

• Grants CSTAR Permission to record all aspects of online instructional sessions, including but not limited to:

 

o Video and Audio Feeds: Capturing both student and tutor visual and verbal interactions.

o Screen Sharing and Annotations: Including any on-screen instructional materials, virtual whiteboard usage, and live annotations.

o Chat Logs and Shared Materials: Such as typed messages, file exchanges, collaboratively edited documents, and assessment tools.

 

5.2 Authorization of Storage and Use

 

The Student and/or Parent/Guardian authorizes CSTAR to securely store and utilize these recordings for the following defined purposes:

 

• Educational Review: To support student learning, exam preparation, and review of complex topics.

• Quality Assurance: For evaluating tutor performance and improving instructional delivery.

• Dispute Resolution: To address questions regarding academic integrity, behavior, or service quality.

• Accessibility Accommodations: To support students with disabilities or those who missed sessions due to valid reasons.

 

5.3 Access Restrictions

 

Access to recorded sessions is strictly controlled and limited to:

 

• The Student and/or Parent/Guardian of the enrolled student.

• Authorized CSTAR Staff, including tutors, academic coordinators, and quality assurance personnel.

• Third Parties, only if:

o Explicit written consent has been obtained from the Student/Parent.

o Legally required under a court order, subpoena, or relevant privacy legislation.

 

5.4 Acknowledgments

 

By signing, the Student and/or Parent/Guardian also acknowledges the following:

 

• Right to Revoke Consent: Consent may be withdrawn at any time through a written request to CSTAR; however, revocation will not apply retroactively to recordings made prior to the request.

• Separate Consent for Marketing: No recordings will be used for marketing, promotional, or public relations purposes without obtaining separate, written consent.

• Confidentiality Safeguards: CSTAR commits to applying reasonable security measures, including password protection, encryption, and access control to protect the privacy of all participants.

• No Entitlement to Royalties or Compensation: The Student and/or Parent/Guardian waives any right to royalties, fees, or other compensation for the use of these recordings within the scope defined in this policy.

• Consequences of Policy Violation: Any misuse of recordings, unauthorized distribution, or breach of this agreement may lead to disciplinary action, termination of services, or legal action as applicable under institutional policy and Canadian law.

 

6. Use and Disclosure

 

This section outlines the permitted purposes, access limitations, legal requirements, and restrictions regarding the use and disclosure of recorded tutoring sessions conducted by CSTAR.

 

6.1 Permitted Use

 

 

Session recordings may be used strictly for internal and educational purposes, including:

 

• Educational Enhancement: Supporting students in reviewing material for deeper understanding, exam preparation, and reinforcement of learning outcomes.

• Quality Monitoring: Enabling CSTAR staff to assess instructional effectiveness, identify areas for improvement, and provide professional development for tutors.

• Dispute Resolution: Serving as objective documentation in cases involving academic integrity, behavioral concerns, or service complaints.

 

6.2 Restricted Access

 

Access to recordings is tightly controlled to ensure confidentiality:

 

• Limited to Authorized Individuals: Only CSTAR staff with a need-to-know role (e.g., academic coordinators, technical support, quality assurance) and the enrolled student and/or their parent or legal guardian.

• No Unapproved Access: Recordings may not be accessed, viewed, or used by unauthorized personnel or external entities without prior written authorization.

 

6.3 Prohibition of Public Distribution

 

To safeguard privacy and intellectual property:

 

• Marketing Use Prohibited Without Consent: Recordings may not be shared on public platforms, websites, social media, or used in promotional materials unless explicit, separate written consent is provided by the student and/or parent or legal guardian.

• No Redistribution or Derivative Use: Students, parents, or third parties may not copy, modify, upload, or share CSTAR recordings without written authorization. Any unauthorized use may lead to disciplinary or legal action.

 

6.4 Legal Compliance

 

All uses and disclosures of session recordings must comply with applicable laws and regulations, including:

 

• FIPPA (Freedom of Information and Protection of Privacy Act) – governs the collection, use, and disclosure of personal information in educational settings.

• PIPEDA (Personal Information Protection and Electronic Documents Act) – ensures privacy and data protection in electronic communications and recordings.

• Canadian Copyright Law – protects the intellectual property contained within session recordings, including instructional content and materials.

 

6.5 Data Retention

 

CSTAR follows a defined retention schedule for recordings:

 

 

• Retention Period: Session recordings are stored securely for 90 days from the date of recording.

• Extended Retention: In cases involving academic disputes, investigations, or legal requirements, recordings may be retained longer as necessary and permitted by law.

 

6.6 Legal Exceptions

 

Recordings may only be disclosed without consent under the following conditions:

 

• Legal Requirement: If compelled by a valid subpoena, court order, or applicable legislation.

• Regulatory Investigation: If requested by an authorized regulatory body during an investigation of compliance or misconduct.

• Health or Safety Concerns: Where disclosure is necessary to prevent serious harm and permitted under privacy legislation.

 

7. Policy

 

This section outlines CSTAR’s guiding principles for the recording of educational activities, ownership of instructional content, and conditions governing the creation, access, and use of recorded materials, including the terms and conditions and privacy policy posted on our website.

 

7.1 Recording Educational Activities

 

CSTAR supports the use of recordings as a tool to promote inclusive, flexible, and high-quality education:

 

• Inclusive Learning Support: Recordings of live online or hybrid tutoring sessions enhance accessibility for students who need to review material, require accommodations, or cannot attend in real-time.

• Availability Period: Recordings will be accessible to enrolled students for up to 90 calendar days from the date of the session, after which they will be deleted unless an extension is approved under academic, legal, or policy-based grounds. • Initiation of Recording:

o By CSTAR Staff: Tutors or instructors may initiate session recordings for instructional, assessment, or review purposes.

o By Students: Students seeking to record a session must request and obtain explicit permission in advance. Such recordings are subject to the same access, privacy, and use restrictions as CSTAR-initiated recordings.

• Non-Academic Requests: Any requests to record sessions for purposes outside of academic or accommodation-related reasons (e.g., personal use, third-party consultation) must undergo review and approval by CSTAR administration. Unauthorized recordings are strictly prohibited.

 

7.2 Intellectual Property

 

CSTAR affirms the ownership and protection of educational content and participant contributions:

 

• Ownership of Materials: All instructional content—including slides, explanations, examples, and recordings—are the intellectual property of CSTAR, unless otherwise specified in a formal agreement or license.

• Participant Contributions: Comments, questions, and dialogue from students during recorded sessions are considered part of the recording and are protected as personal information under FIPPA. This information shall not be used or disclosed in a way that violates the privacy rights of participants.

 

7.3 Recording Criteria

 

All recordings must adhere to established institutional standards and this policy:

 

• Policy Compliance: Recordings must comply with CSTAR’s Recording Policy, privacy laws (e.g., FIPPA and PIPEDA), and all applicable institutional guidelines.

• Prohibition on Secondary Use: Recordings may not be reused, edited, or repurposed for other instructional contexts, public use, or promotional activity without explicit written consent from CSTAR and, where applicable, the participants.

• No Unauthorized Distribution: Uploading or sharing recordings on public platforms, social media, peer-to-peer sites, or external services is strictly forbidden and constitutes a breach of this policy.

• Retention and Deletion:

o Ownership of recordings remains solely with CSTAR.

o Recordings should be deleted by students or staff after their intended use period, unless explicit retention authorization has been granted.

o All storage must be done on CSTAR-approved platforms with secure access controls.

 

8. Waiver and Release

 

To ensure mutual understanding and consent, this section outlines the legal release of liability related to the recording, storage, and authorized use of session content. By participating in CSTAR’s programs, the Student and/or Parent/Guardian explicitly agree to the following terms:

 

8.1 Acknowledgment of Policy and Purpose

 

• The Student and/or Parent/Guardian acknowledge that they have read, understood, and accepted the terms of CSTAR’s Recording Policy.

• They recognize that recordings serve the purposes of academic enrichment, accessibility, instructional improvement, compliance, and dispute resolution as detailed in this policy.

 

8.2 Waiver of Claims

 

• The Student and/or Parent/Guardian voluntarily waive any present or future claims against CSTAR, its staff, tutors, and affiliates relating to: 

o The act of recording sessions;

o The secure storage and authorized access of recordings;

o The use of recordings for approved educational or administrative purposes.

• This includes any claims for monetary compensation, damages, or benefits resulting from the recording, display, or limited distribution of session content as defined by the policy.

 

8.3 Release of Liability

 

• The Student and/or Parent/Guardian release and hold harmless CSTAR and its representatives from any liability, loss, or injury arising directly or indirectly from:

o The creation and use of recordings in compliance with institutional and legal guidelines;

o Any inadvertent disclosures made in accordance with lawful data requests;

o Technical issues or third-party platform vulnerabilities beyond CSTAR’s reasonable control.

• This release applies to all recording formats, including but not limited to video, audio, screen-sharing data, chat logs, and instructional materials.

 

8.4 Binding Nature

 

• This waiver and release are binding on the Student and/or Parent/Guardian, as well as their respective heirs, legal representatives, and assigns.

• It remains in effect for the duration of enrollment in CSTAR programs unless formally revoked in writing, and such revocation shall not apply retroactively.

 

 9. Duration and Revocation

 

To ensure transparency and maintain the integrity of CSTAR’s academic environment, all tutoring sessions are recorded for quality assurance, instructional improvement, and compliance purposes. Consent to recording is a mandatory condition of enrollment in CSTAR programs. 

 

9.1 Duration of Consent

 

•Consent granted under this policy is considered active and ongoing for the entire duration of the student’s enrollment in CSTAR programs.

• This includes all sessions conducted under CSTAR’s supervision or in connection with its academic offerings, whether live, pre-recorded.

 

9.2 Revocation Procedure

 

 

• The student and/or Parent/Guardian may submit a written notice of consent revocation to CSTAR’s designated administrative contact (via email or physical letter).

• The revocation will be effective upon receipt and acknowledgment by CSTAR. 

 

 

9.3 Limitations of Revocation

 

 

• Revocation is not retroactive and does not apply to any recordings made prior to the date of receipt of the revocation notice.

• Any recordings made before revocation may continue to be used in accordance with CSTAR’s permitted uses, including academic review, instructional enhancement, dispute resolution, or legal compliance, until securely deleted per the data retention policy. 

 

 

9.4 Effect of Revocation

 

 

• As recording is a mandatory component of CSTAR’s programs, revoking consent will result in immediate termination of the student’s membership and access to classes.

• No alternative arrangements will be provided, and re-enrollment will not be permitted unless consent to recording is re-established.

• This policy ensures that CSTAR can maintain consistent instructional standards and comply with applicable operational and legal obligations.

 

 

10. Acknowledgement

 

 

This section affirms the Student's and/or Parent/Guardian's understanding of CSTAR’s recording practices and outlines specific expectations related to the use of recorded content.

Acknowledgement of these terms is required for participation in CSTAR’s online programs and assessment activities.

 

10.1 Video Recording of Class Sessions

 

• Recording Authorization: CSTAR may record live online class sessions, including video, audio, screen-sharing, chat interactions, and shared documents. • Retention Period: All such recordings will be stored securely on CSTAR-approved, password-protected cloud platforms and retained for up to 90 days from the date of the session, unless an extension is required for academic or legal purposes.

• Access Restrictions:

o Recordings are strictly available to registered participants, including the student, parent/guardian (if applicable), and authorized CSTAR personnel.

o Recordings are intended for educational use only and may not be used beyond the original scope without written authorization.

• Prohibited Actions:

o Students and/or parents/guardians may not record, edit, distribute, or share class recordings on any platform (e.g., social media, messaging apps, file-sharing services) without CSTAR’s prior written consent.

o Unauthorized recording or dissemination is considered a breach of CSTAR’s policy and may result in disciplinary measures, termination of enrollment, or legal action as appropriate under privacy and intellectual property laws.

 

10.2 Video Recording During Assessments

• Purpose: Recordings may be used during quizzes, tests, and other forms of assessment to uphold academic integrity and prevent misconduct

• Scope of Monitoring:

o This may include webcam video, microphone audio, screen recording, and log file tracking, depending on the assessment format.

o All participants will be notified in advance when an assessment is subject to recording.

• Data Security & Access:

o Recordings from assessments will be stored separately from general class recordings and protected with additional access restrictions.

o Access will be limited exclusively to authorized CSTAR staff and used only for academic review, dispute resolution, or legal compliance.

o Assessment recordings will be deleted after the review period unless required for ongoing investigation or compliance reasons.

 

Signatures

 

 

Student (if over 18): _________________          Date: ____________

 

Parent/Guardian (if under 18): ____________    Date: ____________

 

Organization Representative: _______________Date: ____________

 

Tutor: __________________    Date: ____________