PALS Chess Club -didn't use this for fall 2023

Challenge to Excellence

Chess Club Registration Form

K-2nd grade meets before school on TUESDAYS from 7:00-7:40 am

8/29, 9/5, 9/12, 9/26, 10/3, 10/24, 10/31, 11/7, 11/14, 11/28, 12/5, 12/12

3rd-5th and 6th-8th grade meets after school on FRIDAYS from 3:15-4:15pm

9/1, 9/8, 9/15, 9/29, 10/6, 10/27, 11/3, 11/10, 11/17, 12/1, 12/8, 12/15

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 *

Register a third child?

Yes

First Name *

Last Name *

Grade *

Student's Birthday * 🛈 +

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 after chess club.

Level of Experience *

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

Adult Primary Contact

Relationship to Participants: *

Mother

Father

Guardian

Other Other

First Name *

Last Name *

Email Address *

Zip *

Phone

Alternate Phone

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

Registration: *

K-2nd Fall Session (12 weeks): $216

3rd-5th Fall Session (12 weeks): $216

6-8th Fall Session (12 weeks): $216

Sibling (2) Registration: *

Fall Session for 2 children, both in K-2: $432

Fall Session for 2 children, both in 3rd-5th : $432

Fall Session for 2 children, both in 6th-8th: $432

Fall Session for 2 children, one in each class: $432

Sibling (3) Registration: *

Fall Session 3 siblings: $648

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.