PALS Chess Club - Fall Session

Polaris at Ebert Elementary
Chess Club Registration Form

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

Falll Session:  Weekly from 9/11 – 12/11 whenever school is in session


Participant Information

Register a second child?

Household / Adult Primary Contact

Relationship to Participants: *
Registration Options: *
Registration Options: *
Photo Consent

I give permission for photos of my child, captured during regular chess camp activities, to be used solely in news stories, the PALS website, our e-newsletter, and/or other promotional materials. I understand that my child’s name will not be published on the Internet.  I may revoke my consent at any time by sending an e-mail to

Emergency Medical Consent: *