PALS Chess Club - Spring Session 2023

Cherry Creek Academy

Chess Club Registration Form

Grades K-6

Club Schedule: Fridays after school from 3:15 – 4:15 p.m.

Spring Session: 2/3, 2/10, 2/24, 3/3, 3/17, 3/31, 4/7, 4/14, 4/21, 4/28, 5/5, 5/12* (make-up class)

Participant Information

First Name *

Last Name *

Grade *

Birthday 🛈 +

Level of Experience

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

Register a second child?

Yes

First Name *

Last Name *

Grade *

Birthday * 🛈 +

Level of Experience *

Register a third child?

Yes

First Name *

Last Name *

Grade *

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 following chess club.

No, my child will be picked up by a designated adult following chess club.

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 (prorated, starting on 2/24): $160

Sibling Registration *

Spring session for two children (prorated to start on 2/24): $320

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.