Chess Kids After School Lottery Form 2021
If you are interested in attending the Friday, After-School Chess program, please fill out this survey. If you answer No to any of the following questions, it may disqualify you for eligibility in this program.
Student's First Name
Student's Last Name
If my child is chosen to participate, I give him/her permission to attend via Zoom every Friday starting January 22th- June 15, 2021 from 3:oo -4:00 pm.
In addition, I understand these sessions may be recorded or pictures may be taken for use in our school or on our school website.
Discipline Policy: I understand that if my child does not complete class work assignments, homework assignments or model appropriate behavior, he/she will be removed from the program.
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This form was created inside of NYC Department of Education.