PALS Chess Club - Spring Session 2023

Coyote Creek Elementary

Chess Club Registration Form

Day and Time: Tuesdays after school from 3:30 - 4:30

Spring Session: 1/31, 2/7, 2/14, 2/21, 2/28, 3/7, 3/21, 3/28, 4/4, 4/11, 4/18, 4/25

Grades K-6: No experience required. Students will be paired based on age and level. Coaches will teach separate lessons for the beginner group and the intermediate/advanced group

Participant Information

First Name *

Last Name *

Grade *

Student's Birthday * 🛈 +

Level of Experience *

Register another child?

Yes

First Name *

Last Name *

Grade *

Student's 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 *

City *

State *

Zip *

Email Address *

Phone

Alternate Phone (optional)

Registration Cost: *

Spring Session: $192

Sibling Registration *

Spring session for two students: $384

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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.