Community Chess Club Registration
This club meets on Tuesdays, from 5:30-7pm at Learners Chess, 532 Adams NE.
Starts Tuesday, September 24th.
Coach Victor will work with students to play chess, train to be better at chess, and to have fun playing bughouse and speed chess!
So that we have your child's information on file and for safety, please fill out this form prior to your child's first chess club meeting.
Chess Player's Name
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Most Reachable Phone Number
Any other information we should know about your child?
I agree to ensure my child is picked up by the 7pm end time of each club meeting and that I may be charged $1 per minute if I am more than 5 minutes late to pick up my child.
I agree to be held financially responsible for any equipment or property that my child damages during the course of chess programs with Learners Chess.
I give my permission for my child to be photographed and/or video recorded during chess club activities. I further allow for the reproduction of these media to be used in educational and/or promotional materials produced by Learners. I understand that neither my child’s name nor any other identifying information will appear with the photographs. Further, I understand that neither I nor my child will receive any compensation for the use of these photographs. If for any reason you cannot agree with any part of this this release, please email your objection to email@example.com after completing this form and we will make note of it on your child’s registration manually to ensure they are not photographed.
Optional Donation for the club (we suggest $2 per club meeting). Donations can also be made in person with cash or check.