PALS Chess Club - Spring Session 2023

The Manning School

Chess Club Registration Form

Day and Time: Fridays after school from 2:30 - 3:30 p.m.

Spring Session: 2/3, 2/10, 2/24, 3/3, 3/10, 3/17, 3/31, 4/7, 4/14, 4/21, 5/5, 5/12

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: *

Spring Session: $192

Sibling Registration *

Spring Session for two children: $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.