PALS Chess Club - Winter Session 2023

Steele Elementary

Chess Club Registration Form

When and Where: Tuesdays after school from 2:50 - 3:50 p.m.

Winter Session: 2/14, 2/21, 2/28, 3/7, 3/14, 3/21

Open to grades K-5: After each weekly lesson, students will be paired according to age and level.

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 *

Register a third child?

Yes

First Name *

Last Name *

Grade *

Student's Birthday * 🛈 +

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 after chess club.

Level of Experience *

Does your child have any medical issues or allergies that we should be aware of? *

Adult Primary Contact

Relationship to Participants: *

Mother

Father

Guardian

Other Other

First Name *

Last Name *

Email Address *

Phone *

Alternate Phone

Sign up for the free PALS newsletter for updates about chess club, tournaments, events and special offers!

Registration: *

Winter Session: $108

Registration Options: *

Winter Session for two children: $216

Registration Options: *

Winter Session for three children: $324

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.