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PALS Chess Club - Fall Session 2023
Homestead Elementary
Chess Club Registration Form
Day and Time:
Wednesdays from 1:45 - 2:45 p.m.
Fall Session Dates:
9/6, 9/13, 9/20, 9/27, 10/4, 10/11, 10/25, 11/1, 11/8, 11/15, 11/29, 12/6, 12/13
Open to grades K-5:
After each weekly lesson, students will be paired according to age and level.
Participant Information
First Name
*
Last Name
*
Student's Birthday
*
+
Grade
*
Kindergarten
1st
2nd
3rd
4th
5th
Level of Experience
*
Beginner (less than one year of playing experience)
Intermediate (more than one year of playing experience)
Returning Student
Register another child?
Yes
First Name
*
Last Name
*
Grade
*
Kindergarten
1st
2nd
3rd
4th
5th
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
*
Phone number
*
Email Address
*
Zip Code
*
Sign up for the free PALS newsletter for updates about chess club, tournaments, events and special offers!
Registration:
*
Fall (13 week) Session: $208
Sibling Registration:
*
Fall (13 week) Session for two children: $416
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.