Registration Form

Click on Link to download form.

Chess Club Registration Form


Student Name:  _________________________________________________________________

                                    (First)                          (Middle)                      (Last)

Grade ____________             Teacher ___________________________________


Chess Experience:  ________________________________________________________________

(i.e.:  none, know how the pieces move, play a lot, etc..)


My child should be in:  Beginners group (2:35 to 3:15) _____ Advanced group (2:35 to 3:45) ______

(Note:  If you are unsure which group to choose, instructor will suggest a level after assessment.  Most K-2 students should be in the Beginners Group.)


Parent/Caregiver Name: ___________________________________________________________



Parent Email Address:_____________________________________________________________


Parent Primary Phone #: __________________________________________________________


Parent Cell Phone # (if different from above): ________________________________________


After club meetings, my child will be: ______in afterschool program; _____ car-rider; ____ a walker.

All children will receive a t-shirt.

Please circle students t-Shirt size:

Youth Small   Youth Med   Youth Large   Adult Small   Adult Med   Adult Large

Please return this page in an envelope with your check made payable to the: Glen Arden Chess Club.

You can turn it in directly to the office or to your child’s teacher in their folder.  

Please mark on the envelope:  Glen Arden Chess Club.

For Chess Club Use:

Amount paid __________________  Date________________

Check # ______________________ or Cash $_____________

Other notes: