PALS Chess Club - Spring Session

Sandburg Elementary

Chess Club Registration Form

Day and Time: Tuesdays after school from 2:45 - 3:45 p.m. in the GT room

Spring Session: 1-14, 1-28, 2-4, 2-11, 2-25, 3-10, 4-7, 4-14, 4-21*, 4-28*

* Make-up classes, pending the school's approval

Participant Information

First Name *

Last Name *

Grade *

Student's Birthday * 🛈 +

Level of Experience *

Register another child? ($20 sibling discount!)

Yes

First Name *

Last Name *

Grade *

Student's Birthday * 🛈 +

Level of Experience *

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

Please email me updates about my child's chess club, upcoming tournaments, and more chess-related news!

Registration: *

Spring Session: $130

Registration: *

Spring Session: $110 (a $20 discount)

Sibling Registration *

Spring Session for two students: $240, a $20 sibling discount!

Sibling Registration *

Spring Session for two students: $202, a $20 sibling discount and additional $38 discount for Santigo and Mateo!

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.