WAITING LIST: Deer Park Chess Club
9 Week Session (January 15th to March 11th)
Child Name:
First Name
Last Name
Grade:
Teacher:
Parent Name:
First Name
Last Name
Primary Contact Number:
-
Area Code
Phone Number
Secondary Contact Number:
-
Area Code
Phone Number
Email Address:
example@example.com
After club designation:
HOST
Car Line
Other
Submit
Should be Empty: