PALS Chess Club - Fall Session 2023

Cherry Creek Academy

Chess Club Registration Form

Grades K-2: Monday after school from 3:00 - 4:00 pm

9/11, 9/18, 9/25, 10/2, 10/9, 10/23, 10/30, 11/6, 11/13, 11/27, 12/4, 12/11

Grades 3-6: Monday after school from 3:15 - 4:15 pm

9/11, 9/18, 9/25, 10/2, 10/9, 10/23, 10/30, 11/6, 11/13, 11/27, 12/4, 12/11

Grades 7-8: Monday after school from 3:25 - 4:25 pm

9/11, 9/18, 9/25, 10/2, 10/9, 10/23, 10/30, 11/6, 11/13, 11/27, 12/4, 12/11

*After each weekly lesson, students will be paired according to age and level*

Participant Information

Please select your preferred class *

First Name *

Last Name *

Grade *

Birthday * 🛈 +

Level of Experience *

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

Register a second child?

Yes

Please select your preferred class *

First Name *

Last Name *

Grade *

Birthday * 🛈 +

Level of Experience *

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

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 following chess club.

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

Household / Adult Primary Contact

Relationship to Participants: *

Mother

Father

Guardian

Other Other

First Name *

Last Name *

Email Address *

Zip *

Phone *

Alternate Phone

Please email me updates about my child's chess club, upcoming tournaments, and more chess-related news!

Registration *

Fall Session (Grades K-2): $192

Registration *

Fall Session (Grades 3-6): $192

Registration *

Fall Session (Grades 7-8): $192

Sibling Registration

Fall Session for siblings (Grades K-2): $384

Sibling Registration

Fall Session for siblings (Grades 3-6): $384

Sibling Registration

Fall Session for siblings (Grades 7-8): $384

Sibling Registration

Fall Session for siblings (Grades K-2 and 3-6): $384

Sibling Registration

Fall Session for siblings (Grades K-2 and 3-6): $384

Sibling Registration

Fall Session for siblings (Grades K-2 and 7-8): $384

Sibling Registration

Fall Session for siblings (Grades K-2 and 7-8): $384

Sibling Registration

Fall Session for siblings (Grades 3-6 and 7-8): $384

Sibling Registration

Fall Session for siblings (Grades 3-6 and 7-8): $384

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.