PALS Chess Club - Spring Session

PRA Classical Homeschool

Chess Club Registration Form

Day and Time: Thursdays after school from 2:00 – 2:45 p.m.

Spring Session Dates: January 12th through May 4th. No class on March 16th.

Grades 4-8: Students will be paired based on age and prior experience

Participant Information

First Name *

Last Name *

Grade *

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 *

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: $240

Sibling Registration: *

Spring Session for two children: $455

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.