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PALS Chess Club - Spring Session 2023
Timber Trail Elementary
Chess Club Registration Form
Day and Time:
Friday mornings before school from 7:30 - 8:30 a.m.
Spring Session:
1/27, 2/3, 2/10, 2/24, 3/3, 3/10, 3/24, 3/31, 4/7, 4/14, 4/28, 5/5
Grades K-5:
Beginners are welcome to join! Students will be paired based on age and experience.
Participant Information
First Name
*
Last Name
*
Student's Birthday
*
🛈
+
Grade
*
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Level of Experience
*
Beginner (less than one year of playing experience)
Intermediate (more than one year of playing experience)
Returning student
Register a second child?
Yes
First Name
Last Name
Student's Birthday
🛈
+
Grade
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Does your child need to return to the school's aftercare program following chess club?
*
Yes, please take my child to the school's aftercare program following chess club.
No, my child will be picked up by a designated adult following chess club.
Level of Experience
Beginner (less than one year of playing experience)
Intermediate (more than one year of playing experience)
Returning student
Does your child have any medical issues or allergies that we should be aware of?
*
Household / Adult Primary Contact
Relationship to Participants:
*
Mother
Father
Guardian
Other
Other
First Name
*
Last Name
*
Address 1
*
Address 2
City
*
State
*
Zip
*
Email Address
*
Phone
Alternate Phone
Registration
*
Spring Session: $192
Sibling Registration
*
Spring session for two children: $384
Sign up for the free PALS newsletter for updates about chess club, tournaments, events and special offers!
Emergency Medical Consent:
*
In the event of an emergency requiring medical attention for my child, I understand that PALS Chess instructors will make every effort to contact me. However, if I cannot be reached, I give permission for a licensed physician or medical treatment center to administer emergency medical care if needed.