Saturday Chess Program

SATURDAY CHESS PROGRAM REGISTRATION
Student Information
Student Name

First NameLast Name
Birth Date

MonthDayYear
School
Gender

MaleFemale
Grade
Student Email
example@example.com
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
Packages Being offered, please the package along with the activities.
prevnext( X )
REGISTRATION FEE
2,000.00JMD



Package 5 - 5 Activities(Including swimming)
60,000.00JMD



Package 4 - 4 Activities ( not including swimming)
50,000.00JMD



Package 3 - 3 Activities (Not including swimming)
42,000.00JMD



Package 2 - 2 Activities Not including swimming
30,000.00JMD



Package 1 - 1 Activity( Chess, Karate, Music, Robotics)
16,000.00JMD



SWIMMING ONLY - 1 Activity(SWIMMING)
20,000.00JMD



Reading Program Reading age ( 4-6) Requirements (Notebook, pencil)
18,000.00JMD



Chess (9:00am - 11:00am)INDIVIDUAL PRICE $16,000
FreeJMD



KARATE (10am - 11am)INDIVIDUAL PRICE $16000
FreeJMD



Music ( 11:00am - 12:00pm)INDIVIDUAL PRICE $16000
FreeJMD



CHESS (11:00am - 1:00pm)INDIVIDUAL PRICE $16000
FreeJMD



SWIMMING (1:00pm - 2:00pm)INDIVIDUAL PRICE $20000
FreeJMD



ROBOTICS & CODING (9:00am - 10:00am)INDIVIDUAL PRICE $16000
FreeJMD



CHESS (1:00pm - 3:00pm)INDIVIDUAL PRICE $16000
FreeJMD



Total

0.00JMD
Alt. Phone Number
Is the student prescribed an inhaler? If yes, please explain any instructions.
Lunch Arrangements
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.
Please select an option for Lunch
BANK TRANSFER CAN BE MADE TO:
Type: Personal/savings
First Name: Melisha
Last Name: Smith
Branch Name: Scotia Bank
Branch: Half Way Tree
Branch Transit: 60145
Account Number 100906975
Account Currency: JMD
Payment Options
Payment options

Bank TransferPay to Organizer
All Covid protocol must be follow.
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.
Should be Empty:

SATURDAY CHESS PROGRAM REGISTRATION

Lunch Arrangements

Payment Options