PALS Chess Club - Fall Session 2023

Ralston Elementary

Chess Club Registration Form

Day and Time: Wednesday afternoons 2:40-3:40

Fall Session: 9/6, 9/13, 9/20, 9/27, 10/4, 10/11, 10/18, 10/25, 11/1, 11/8, 11/15, 11/29, 12/6, 12/13

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 *

Birthday * 🛈 +

Level of Experience *

Register another child?

Yes

First Name *

Last Name *

Grade *

Birthday * 🛈 +

Level of Experience *

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 *

Fall (14 week session): $224

Sibling Registration *

Fall session for two students: $448

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

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.