Respect the Game Youth Chess Program Registration Form

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Free 6-week youth chess program for ages 12–18. Meets every Tuesday & Thursday, 4:30 PM – 5:30 PM starting July 2, 2026. Location: 135 S. Pearl St, Albany, NY.

Participant Full Name

Participant Age

Parent/Guardian Full Name

Parent/Guardian Phone Number

Parent/Guardian Email

Chess Experience Level

Beginner / never played before

I know how the pieces move

I have played casually

I have played in tournaments

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Parent/Guardian Consent

I give permission for my child to participate in the Respect the Game Youth Chess Program at The Alice Moore Black Arts & Cultural Center.

Photo Release & Participant Behavior Agreement

I give permission for my child to be photographed or recorded during the program for promotional, reporting, and community purposes.

I understand participants are expected to be respectful, listen to instructors, care for program materials, and practice good sportsmanship.

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