WILDER ELEMENTARY CHESS CLUB REGISTRATION PAGE REGISTRATION: WILDER ELEMENTARY CHESS CLUB Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. 4300 W Ponds Cir, Littleton, CO 80123 Wilder Spring '25 Chess Club Details: Tuesday afternoons from 2:45-3:45 pm Dates: 1/21, 1/28, 2/4, 2/11, 2/18, 2/25, 3/11, 3/18 (no club on 3/4) Open to grades K-5 *Please note-limited to first 25 registrations* 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 has played 5 or more complete chess games with an adultMy child can accurately explain the movement of castlingMy child can explain all 5 rules of when they can't castleMy child can correctly explain checkmateMy child can correctly explain stalemateMy child has a basic understanding of chess notationMy child has played in 3 or more tournamentsMy child solves chess puzzles at least once a week onlineMy child can explain en passant (the fifth row rule)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? *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 has played 5 or more complete chess games with an adultMy child can accurately explain the movement of castlingMy child can explain all 5 rules of when they can't castleMy child can correctly explain checkmateMy child can correctly explain stalemateMy child has a basic understanding of chess notationMy child has played in 3 or more tournamentsMy child solves chess puzzles at least once a week onlineMy child can explain en passant (the fifth row rule)Sibling 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.Wilder 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 Wilder Chess Club Payment *Please note-limited to first 25 registrations* Spring 2025 chess club registration: *8- week session: $165Spring 2025 chess club registration siblings: *2 kiddos for the 8 weeks: $330*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
