PALS Chess Club - Fall Session 2023 DIDN'T USE

Cherry Creek Academy

3rd-6th grade

Chess Club Registration

When: Mondays after school from 3:15-4:15 p.m.

Fall Dates: 9/11, 9/18, 9/25, 10/2, 10/9, 10/23, 10/30, 11/6, 11/13, 11/27, 12/4, 12/11

Who: 3rd grade through 6th grade

*After each weekly lesson students will be paired according to age and level*

Participant Information

First Name *

Last Name *

Grade *

Birthday 🛈 +

Level of Experience

Does your child have any medical issues or allergies that we should be aware of? *

Register a second child?

Yes

First Name *

Last Name *

Grade *

Birthday * 🛈 +

Level of Experience *

Register a third child?

Yes

First Name *

Last Name *

Grade *

Birthday * 🛈 +

Level of Experience *

Does your child need to return to the school's aftercare program following chess club? *

Yes, please take my child to the school's aftercare following chess club.

No, my child will be picked up by a designated adult following chess club.

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

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

Registration *

Spring Session: $192

Spring Session (prorated): $128

Sibling Registration *

Spring session for two children: $384

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.