CFS Summer Camp Registration Elementary School 
Free summer programming at Kellogg Middle School for any elementary age student in Portland Public Schools. Open to grades k-5. 

Breakfast and lunch provided! Come to learn chess, other strategy games, and have fun with students across Portland.

Please bring a water bottle and snack. Transportation is not provided. 

In partnership with Latino Network SUN, please note that Latino Network will need their own paperwork filled out in addition to this online registration.

 Schedule:

9:30 - 10 Check in and breakfast

10 - 12:30 Chess lesson and chess games

12:30 - 1 lunch

1 - 2:30 Other strategy games and outdoor play

2:30 - 3 Dismissal and pickup


Any demographic information collected in this form is kept confidential and used only for grant reporting purposes.

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Student first and last name *
Student Gender *
Pronouns *
Race *
Ethnicity *
Parent or Guardian Name *
Parent or guardian email *
Parent or Guardian phone number  *
Grade level your child completed this year *
School and ID number (must be a Portland Public School student) *
Emergency Contact Name and Number
Which session would you like to attend?  *
Any special needs? (allergies, medications, access requirements etc.) *
Chess level 
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I hereby grant Chess for Success permission to use my child's likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.

I understand and agree that all photos will become the property of Chess for Success and will not be returned.

I hereby irrevocably authorize Chess for Success to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.

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I HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE AND I AFFIRM I AM THE LEGAL GUARDIAN FOR THE REGISTERED STUDENT AND GRANT CHESS FOR SUCCESS PERMISSION TO TAKE AND USE PHOTOS OF MY STUDENT
Please be on the lookout for an email confirming your registration from info@chessforsuccess.org or patty@chessforsuccess.org. If you have not received an email, your registration is not confirmed. These are done manually with only 25 spots available each week. Please give us 24-48 hours to respond after you complete the form.
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