PALS Chess Club - Fall Session 2023

The Manning School

Chess Club Registration Form

Day and Time: Tuesday after school from 3:30-4:30 p.m. Location: N110

Fall Session: 9/12, 9/19, 9/26, 10/3, 10/10, 10/17, 10/24, 10/31, 11/7, 11/14, 11/28, 12/5, 12/12

Grades 6-8: No experience required. Students will be paired based on age and experience.

Participant Information

First Name *

Last Name *

Grade

Student's Birthday 🛈 +

Level of Experience

Register a second 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 1

Address 2

City

State

Zip

Email Address *

Phone *

Alternate Phone

Registration: *

Fall Session (13 weeks): $208

Sibling Registration *

Fall Session (13 weeks) for two children: $416

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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.