PALS Chess Club - Spring Session 2023

Our Lady of Lourdes

North Campus

Chess Club Registration Form

Day and Time: Fridays after school from 3:00 - 4:00 p.m. on full days and from

12:30 - 1:30 p.m. on half days (marked with an asterisk below)

Spring Session Dates: 1/20, 1/27*, 2/10, 2/17*, 2/24, 3/3, 3/17*, 3/31, 4/21, 4/28, 5/12*, 5/19

Grades K-6: Students will be paired based on age and prior experience

Monthly regional PALS scholastic chess tournaments (optional) will be held on Saturdays!

Participant Information

First Name *

Last Name *

Grade *

Register another child? ($20 sibling discount)

Yes

First Name *

Last Name *

Grade *

Register another child? ($40 sibling discount)

Yes

First Name *

Last Name *

Grade *

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 program following chess club.

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

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 Code *

Email Address *

Phone number *

Sign up for the free PALS newsletter for updates about chess club, tournaments, events and special offers!

Registration: *

Spring session: $192

Sibling Registration: *

Fall Session for two children ($20-sibling discount): $364

Sibling Registration: *

Fall Session for three children ($40-sibling discount): $536

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.