Chess In Motion Academy Summer Chess Xplosion Camp

CHESS IN MOTION ACADEMY PRESENT SUMMER CHESS XPLOSION CAMP REGISTRATION FORM
Student Information
Student Name

First NameLast Name
Grade
Birth Date

MonthDayYear
School
Gender

MaleFemale
Parent/Guardian Information
Name

First NameLast Name
Home Number
E-mail
example@example.com
Relationship
Emergency Information
Emergency Contact's Name

First NameLast Name
Cell Number
Phone Number
SUMMER CHESS XPLOSION CAMP*
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REGISTRATION FEE
2,000.00JMD



JULY Full Day COMPLETE PACKAGEMONDAY - FRIDAY July1st -July 25th
68,500.00JMD



JULY FULL DAY Exclude Friday PackageMONDAY - THURSDAY July1st -July 24th
52,500.00JMD



July Half Day 4weeks Monday to Friday 9am-1pm or 12pm-3pm
51,000.00JMD



July Half Day 4weeks Monday to Thursday 9am-12pm or 12pm-3pm
35,000.00JMD



July Weekly Full Day 9am-3pm Monday to Friday
20,000.00JMD



July Weekly Full Day 9am-3pm Monday to Thursday
16,000.00JMD



July Half Day Weekly Monday to Friday 9am-12pm or 12am-3pm
14,000.00JMD



July Half Day Weekly Monday to Thursday 9am-12pm or 12pm-3pm
10,000.00JMD



Weekly Aftercare Aftercare weekly charge $2000
2,000.00JMD



Friday Extravaganza
4,500.00JMD



Total

0.00JMD
Weekly Package Selection. Please select the week(s) for weekly camper

Week 1Week 2Week 3Week 4
Type a question

Friday Fiesta July 4thFriday Fiesta July 11thFriday Fiesta July 18thFriday Fiesta July 25th
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is the student prescribed an inhaler? If yes, please explain any instructions.*
Lunch Arrangements
Please select an option for Lunch*
Class Schedule
Payment Options
Payment options*

Bank TransferPay to Organiser
Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature

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CHESS IN MOTION ACADEMY PRESENT SUMMER CHESS XPLOSION CAMP REGISTRATION FORM

Lunch Arrangements

Class Schedule

Payment Options