PALS SCHOLARSHIP-CHESS CLUB REGISTRATION PAGE REGISTRATION: PALS SCHOLARSHIP- CHESS CLUB Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. Chess Club Scholarship Application Form Thank you for your interest in our Scholarship program! Please be aware that our scholarships are limited and awarded based on both financial need and the order in which applications are received. For every 10 paid chess club registrations, we are able to award 1 full scholarship. Once we know that we have a scholarship available, we’ll be in touch as soon as possible. It can be a slow process with notification as late as the day before the first club or even after the club starts depending on numbers. We appreciate your patience in advance. Date *Student's School: *Participant Information Student's Name *FirstLastStudent's Current Grade *K12345678Student's Birthdate *Does your child have any medical issues, accommodations or allergies that we should be aware of? *Chess player level: Beginner (still learning how the pieces move) Intermediate (knows how all of the pieces move, pawn promotion, understands concept of checkmate) Intermediate/Advanced (knows all of the above, can play a complete game from start to finish (checkmate), understands stalemate, understands basic chess tactics ie. pins/forks/discovered attacks etc.) Advanced (all of the above, plays daily or weekly online, has competed in tournaments My child's chess level is: *BeginnerIntermediateIntermediate/AdvancedAdvancedChess club? *I'm returning!I've never been in a chess club before!After chess club: *Go to the school's after care programParent Pick upBusHas permission to walk homeOther/see comments belowAfter club other comments:Description of need for the scholarship: *Household Primary Contacts *Emergency contact & Authorization to pick up student from chess club or camp Contact #1: *FirstLastRelationship to participant:MotherFatherGuardianGrandparentOtherContact #1: Phone *Email *Contact #2:FirstLastContact #2 Relationship to participant: MotherFatherGuardianGrandparentOtherContact #2: PhoneContact #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.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. Registration Agreement 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. Emergency Medical Consent Signature: * Clear Signature Chess Club Cancellation, Refund & Behavior Policies 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. Once chess classes have started, no refunds will be given, except for verified medical reasons. No partial refunds or make-ups for missed classes (i.e. routine illness, vacation, or other personal schedule conflict). Full refunds will be issued if a refund request is submitted in writing one week prior to the club session start date. PALS Chess Academy expects chess club participants to adhere to the following behavior expectations: Showing respect to the coaches, other chess students, chess space, & chess equipment Exhibiting good sportsmanship No bullying-verbal and/or physical bullying will not be tolerated Unsafe and inappropriate behaviors will not be tolerated and can be grounds for dismissal. Child will be unenrolled from chess club with no refund for the chess club session Cancellation, Refund, Behavioral Agreement Signature: Clear Signature Scholarship Session Information Name of School Chess Club: *Club Session signing up for: *Fall SessionWinter SessionSpring Session1st Quarter2nd Quarter4th Quarter3rd QuarterComments or additional information for PALS? 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