Palmer HS

Day and Time: Wednesdays after school from 3-4 PM.

Cost and duration: $12/class, (e.g. $96 per 8 week session) - Financial Aid Available

Location: Classroom TBD

Terms: A full refund will be given to any request ONE WEEK PRIOR to the beginning of a session. This gives us ample time to staff accordingly. Thanks for understanding!

Please fill out the form below to register.

Participant Information:

First name

Last name

Grade

D.O.B

GUARDIAN INFORMATION

First name

Last Name

Phone #

Address

Address line 2

City

State

Zip Code

Registration Cost

School Program

Payment Item

Fall Session (8 weeks) –Sept 6th, 13th, 20th, 27th, Oct 4th, 11th, 18th, 25th – $96

Fall/Winter Session (8 weeks) – Nov 1st 8th 15th, 29th, Dec 6th, 13th, 20th Jan 10th – $96

Winter/Spring Session (8 weeks) Jan 17th ,24th, 31st, Feb 7th 14th, 21st Feb 28th, March 6th, 13th – $96

Spring Session (8 weeks) March 20th, April 3rd, 10th, 17th, 24th, May 1st, 8th, 15th – $96

Total Cost:

Terms

Emergency Medical Consent

In the event of an emergency requiring medical attention for my child, I understand that Summit School of 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.

Electronic Signature

By providing this signature and participating in, or authorizing participation in, this Summit School of Chess after school chess enrichment in any way whatsoever, you hereby release and hold harmless forever Summit School of Chess, 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. All participants, guardians, and observers must comply with Palmer HS’ code of conduct.