PALS Chess Club - Fall Session 2023

Eldorado Elementary

Chess Club Registration Form

Day and Time: Tuesdays before school from 7:30 - 8:30 a.m.

Fall Session: 9/19, 9/26, 10/3, 10/10, 10/24, 10/31, 11/7, 11/14, 11/28, 12/5, 12/12

Open to grades K-6: After each weekly lesson, students will be paired according to age and level.

Participant Information

First Name *

Last Name *

Student's Birthday * 🛈 +

Grade *

Level of Experience *

Register a second child?

Yes

First Name

Last Name

Student's Birthday 🛈 +

Grade

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 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 *

Email Address *

Zip *

Phone *

Alternate Phone

Registration *

Fall Session (11 weeks): $176

Sibling Registration *

Fall Session (11 weeks) for two children: $352

Sign up for the 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.