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After School Chess at PS 41 Registration Form
NOTE THAT YOUR CHILD IS FULLY REGISTERED AFTER YOU

1) Complete and submit this form AND

2) Calculate and submit payment to NY CHESS FUND

Make checks payable to NY CHESS FUND with your child(ren)'s name(s) in the memo line. Payments must be dropped off in the PS 41 Main Office (Room 109) in an envelope marked "Jeremy Scheinbach / PS 41 Afterschool Chess." Scholarships are available for those who qualify. If you have any questions, email ps41chess@gmail.com.

FALL SEMESTER 2018
Monday classes: 11 sessions - $220
Wednesday classes: 14 sessions - $280
Thursdays classes: 13 sessions - $260
Parent/Guardian 1 Information
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Email *
Your answer
Mobile *
Your answer
Contact me!
I want to support PS 41 chess program and learn about volunteering and donation opportunities.
Parent/Guardian 2 Name
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Email *
Your answer
Mobile *
Your answer
Contact me!
I want to support PS 41 chess program and learn about volunteering and donation opportunities.
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