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 *

Level of Experience *

Register another child?

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 *

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.