CENTENNIAL ACADEMY OF FINE ARTS CHESS CLUB REGISTRATION PAGE REGISTRATION: CENTENNIAL ACADEMY OF FINE ARTS CHESS CLUB Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. 3306 W. Berry Ave. Littleton, CO 80123 Fall Chess Club Details: Mondays after school from 3:15-4:15 pm in the library Fall Dates: 9/30, 10/7, 10/14, 10/28, 11/4, 11/11, 11/18, 12/2, 12/9, 12/16 Open to grades K-5 We welcome all beginner, intermediate and advanced chess players! *Scholarship information: please email info@palschess.com Participant Information Student's Name *FirstLastStudent's Current GradeK12345Student's Birthdate *Chess: *BeginnerIntermediateAdvancedBeginner: Doesn't know how the pieces move. Intermediate: Knows how the pieces move and can play a full game. Advanced: Understands checkmate. 2+ years of playing experience.Chess club? *I've been in a chess club before!I've never been in a chess club before!Does your child have any medical issues or allergies that we should be aware of? *After chess club: *Needs to go to the school's after care programParent Pick upHas permission to walk homeSometimes parent pick up/sometimes school's aftercareWould you like to register another child? *YesNo; I will just register one child.Additional Participant Information Student's NameFirstLastStudent's Current GradeK12345Student's BirthdateChess: BeginnerIntermediateAdvancedBeginner: Doesn't know how the pieces move. Intermediate: Knows how the pieces move and can play a full game. Advanced: Understands checkmate. 2+ years of playing experience.Chess club? I've been in a chess club before!No, I've never been in a chess club before!Does your child have any medical issues or allergies that we should be aware of?Household Contact Information: Contact #1: *FirstLastRelationship to participant(s) *MotherFatherGuardianGrandparentOtherPhone *Email *Contact #2:FirstLastRelationship to participant(s):MotherFatherGuardianGrandparentOtherContact #2 phone:Contact #2 Email:Email Opt-inPlease email me updates about my child's chess club, upcoming tournaments, and more chess-related news!Interested in Volunteering?Yes! I am interested in volunteering at this PALS event and/or others. Please contact me with additional opportunities.PALS is ALWAYS looking out for volunteers. If you're interested in learning more about our volunteer opportunities, please select this box above and we will be in touch.Centennial Academy of Fine Arts Chess Club Registration By signing up for PALS Chess Academy LLC chess clubs, tournaments, or camps, the participant, (or parent/guardian if a minor), in this activity acknowledges the risks associated with the activity and agrees to hold PALS Chess Academy LLC, The McConnell family and any other employees or volunteers regarding chess clubs, tournaments, and camps harmless in the event of any damages or injury that may arise. By providing this electronic signature and participating in, or authorizing participation in, PALS Chess Academy LLC chess clubs, tournaments, or camps in any way whatsoever, you hereby release and hold harmless forever PALS Chess Academy LLC, its instructors, employees, agents, and consultants from any and all liability, for any claim, demand, injury, expense, damage, action or cause of action arising out of or connected with the services or facilities of these entities, including those arising from acts of active or passive negligence. Signature * Clear Signature Emergency Medical Consent In the event of an emergency requiring medical attention for my child/children, 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. Signature * Clear Signature Centennial Academy of Fine Arts Chess Club Payment *We will need a minimum of 8 kiddos registered to run the club Fall 2024 chess club registration: *10-week session: $186Fall 2024 chess club registration siblings: *10-week session for 2 kiddos: $372*Sibling discount code: SIBFALL24 *3rd kiddo? Please email kori@palschess.com* Coupon Code: Apply *Only one coupon allowed per form**In the event of a natural disaster, school cancellation due to weather, building issue, or other emergency, PALS Chess Academy will do their best to reschedule the chess club on a date that is available and approved by the school district and the school. PALS Chess Academy does not guarantee this can occur. Comments or additional information for PALS?Total$0.00Stripe Credit Card * Thank you for being part of our PALS family! Submit FollowFollowFollowFollow Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail Address *MessageSubmit