PALS Chess Club - Spring Session

Challenge School

Chess Club Registration Form

Day and Time: Wednesdays after school from 2:00 - 3:00 p.m in rooms 170, 176, and 177.

Spring Session (17 weeks):

1/11, 1/18, 1/25, 2/1, 2/8, 2/15, 2/22, 3/1, 3/8, 3/15, 3/29, 4/5, 4/12, 4/19, 4/26, 5/3, 5/10

Grades K-4: Beginners are welcome to join! Students will be paired based on age and experience. Coaches will teach separate lessons for the beginner, intermediate, and advanced groups.

Participant Information

First Name *

Last Name *

Grade *

Student's Birthday 🛈 +

Level of Experience *

Register a second child?

Yes

First Name

Last Name

Grade

Student's Birthday 🛈 +

Level of Experience

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.

Does your child take the bus home after chess club? (if so, one of the coaches or parent volunteers will walk your child to the bus a few minutes before 3:00) *

Yes

No

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 (17 weeks): $245

Spring Session, starting 1/18 (prorated for 16 weeks): $230

Sibling Registration

Spring session for two children (17 weeks): $490

Spring session for two children (starting on 1/18, prorated for 16 weeks): $461

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.