PS 290Q Afterschool Program
September 2024 - January 2025
Child's Information
Student's Name
*
First Name
Middle Name
Last Name
Grade
*
Allergies / anything we need to know?
Skill Level
*
Please Select
Pawn 1 (Beginner 1) - Absolute Beginners
Pawn 2 (Beginner 2) - Knows the movements and values of pieces
Knight (Beginner 3) - Can do checkmate with Queen+King, and 2 Rooks
Bishop (Intermediate 1) - Can do checkmate with only 1 Rook+King, and knows what "opposition" is
Rook (Intermediate 2) - Players with USCF rating of 800-1299
Queen (Advanced 1) - Players with USCF rating of 1300-1800
King (Advanced 2) - Players with USCF rating of 1800 and above
Not sure
Please select the sessions you would like to attend
*
Please Select
Mondays (15 sessions) - $480.00
Thursdays (15 sessions) - $480.00
Mondays and Thursdays - $960.00
ADD A SECOND CHILD?
Please check the button to add another child in the registration. A 5% sibling discount will automatically be applied.
2nd Child Information
Student's Name
*
First Name
Middle Name
Last Name
Grade
*
Allergies / anything we need to know?
Skill Level
*
Please Select
Pawn 1 (Beginner 1) - Absolute Beginners
Pawn 2 (Beginner 2) - Knows the movements and values of pieces
Knight (Beginner 3) - Can do checkmate with Queen+King, and 2 Rooks
Bishop (Intermediate 1) - Can do checkmate with only 1 Rook+King, and knows what "opposition" is
Rook (Intermediate 2) - Players with USCF rating of 800-1299
Queen (Advanced 1) - Players with USCF rating of 1300-1800
King (Advanced 2) - Players with USCF rating of 1800 and above
Not sure
Please select the sessions you would like to attend
*
Please Select
Mondays (15 sessions) - $456
Thursdays (15 sessions) - $456
Mondays and Thursdays - $912
ADD A THIRD CHILD?
Please check the button to add another child in the registration. A 5% sibling discount will automatically be applied.
3rd Child Information
Student's Name
*
First Name
Middle Name
Last Name
Grade
*
Allergies / anything we need to know?
Skill Level
*
Please Select
Pawn 1 (Beginner 1) - Absolute Beginners
Pawn 2 (Beginner 2) - Knows the movements and values of pieces
Knight (Beginner 3) - Can do checkmate with Queen+King, and 2 Rooks
Bishop (Intermediate 1) - Can do checkmate with only 1 Rook+King, and knows what "opposition" is
Rook (Intermediate 2) - Players with USCF rating of 800-1299
Queen (Advanced 1) - Players with USCF rating of 1300-1800
King (Advanced 2) - Players with USCF rating of 1800 and above
Not sure
Please select the sessions you would like to attend
*
Please Select
Mondays (15 sessions) - $456
Thursdays (15 sessions) - $456
Mondays and Thursdays - $912
Parent/Guardian's Information and Checkout
Parent/Guardian's Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contacts / Authorized Person to Pick-up
Any dismissal instruction or other additional Information?
Subtotal
Enter coupon code
Apply remaining NYCA credit
Please enter the NYCA credit code
COUPON CODE DISCOUNT
CREDIT AMOUNT
** SUBTOTAL-COUPON-CREDIT **
Total discount
Coupon code and any applicable credit
Payment Plans
See other payment plan options. If you prefer to pay in full, please keep this field unchecked.
PAYMENT PLANS SECTION
For other payment plans, we will send you an invoice on your preferred payment schedule. (Modes of payment after the first installment: Check, Cash, Venmo, or Zelle)
Two payments (50% due upon sign-up, 50% due by November 30, 2024)
Monthly payments (1st month due upon sign-up, then equal payments every month due on Friday of each month)
Please select your preferred mode of payment:
Check
Cash
Venmo
Zelle
** SUBTOTAL-COUPON-CREDIT / PAYMENT PLAN **
PAYMENT SECTION
** FINAL TOTAL **
** VALUE CONTAINER **
Total
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USD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Pick-up Policy, Refund Policy and General Media Release
*
I understand that all cancellations require at least 24 hours prior to the day of the program in order to receive full credit for the purchased amount to be applied toward any other NYCA programs. Credits never expire and are transferable. Refund requests are considered on a case by case basis. I hereby authorize New York Chess Academy (NYCA) to photograph, take motion pictures, video footage, and/or make electronic sound recordings of the participant I am registering. I authorize the use of any such photographic or electronic reproductions for any purpose, including, but not limited to educational and other public media as may be deemed appropriate by the New York Chess Academy. I hereby acknowledge that a 15-minute grace period will be provided for late pick-up, allowing for extended dismissal until 5:15 PM. A late pick-up fee of $25 will be charged for the first 15 minutes after the scheduled pick-up time. For every additional minute after the initial 15 minutes, an additional $1 per minute will be charged. This fee is payable directly to the instructor on the day of the late pick-up.
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*
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