MOUNTAIN VIEW ELEMENTARY CHESS CLUB REGISTRATION PAGE REGISTRATION: MOUNTAIN VIEW ELEMENTARY CHESS CLUB Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. Mountain View Elementary 10095 Lexington Dr. Colorado Springs, CO 80920 CHESS CLUB DETAILS: Monday after school from 3:40-4:40pm Spring Dates: 2/3, 2/10, 2/24, 3/3, 3/10, 3/17, 3/31, 4/7, 4/14, 4/21, 4/28, 5/5, (no club-2/17, 3/24) Open to grades K-5 We welcome all beginner, intermediate and advanced chess players! Participant Information Student's Name *FirstLastStudent's Current Grade *K12345Student's Birthdate *Chess Knowledge: (check all that apply) *My child is brand new to chess/exploring interestMy child has never been in a chess club beforeMy child has been in a chess club for 1 or more yearsMy child can correctly explain checkmateMy child has a basic understanding of chess notationMy child has played in 3 or more tournamentsAfter chess club: *Schools after care programParent Pick upPermission to walk/ride bike homeOther-see comments belowDoes your child have any medical issues, accommodations, or allergies that we should be aware of? *Would you like to register another child? *YesNo; I will just register one child.Additional Participant Information Student's NameFirstLastStudent's Current GradeK12345Student's BirthdateSibling Chess Knowledge: (check all that apply)My child is brand new to chess, exploring interestMy child has never been in a chess club beforeMy child has been in a chess club for 1 or more yearsMy child can correctly explain checkmateMy child has a basic understanding of chess notationMy child has played in 3 or more tournamentsSibling After chess club: Schools after care programParent Pick upPermission to walk/ride bike homeOther-see comments belowDoes your child have any medical issues, accommodations or allergies that we should be aware of?Household/Adult Primary Contact Emergency Contact & Authorization to Pick up Contact #1: *FirstLastRelationship to participant(s)MotherFatherGuardianGrandparentOtherPhone *Email *Contact #2: FirstLastContact #2 Relationship 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.Mountain View 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 Mountain View Chess Club Payment Spring 2025 chess club registration: *12-week session: $223Spring 2025 chess club registration siblings: *2 kiddos for the 12 weeks: $446*Sibling discount code: KBTD4HYG *Please use ONLY for sibling registrationCoupon Code: Apply *Only one coupon allowed per form*Comments or additional information for PALS?*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. Total$0.00Stripe Credit Card *Thank you for being part of the 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
