Daughter of Zion Junior Academy
Please fill in your details in the form below and complete payment via the PayPal link to be automatically registered for your school's chess program.

Payment Information:

- All parents must register their students online using this form before the start of the first club.

- Payment needs to be made during registration or the registration form will be considered invalid.

- Full payment is required before the start of the first club

- Parents of Title 1 students and students who receive free and reduced lunch may email
palmbeachchessinfo@gmail.com to inquire about other payment options.
Student Full Name *
Your answer
Current Grade *
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Parent/Guardian Full Name *
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Parent/Guardian Email Address
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Primary Emergency Contact Number *
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Secondary Emergency Contact Number *
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If Applicable: Please list any health or social information we need to know about your child. Examples include diagnosed allergies or health conditions.
Your answer
Does your child have a USCF (United States Chess Federation) rating and if so, what is it? *
Your answer
Which Session are you registering your child for? *
Terms of Service *
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