Q300 Afterschool Upper Division (Sep 2024

Q300 Afterschool Program (Upper Division)

31-51 21st St, Queens, NY 11106 | September 9, 2024 - January 28, 2025 (Mondays and Tuesdays)

Student's Name*

First NameMiddle NameLast Name
Grade*
Allergies / anything we need to know?
Please select the sessions you would like to attend*
Skill Level*
5:00 PM5:30 PMEarlier than 5:00 PM
Please check the button to add another child in the registration. A 5% sibling discount will automatically be applied.

Student's Name*

First NameMiddle NameLast Name
Grade*
Allergies / anything we need to know?
Please select the sessions you would like to attend*
Skill Level*
5:00 PM5:30 PMEarlier than 5:00 PM
Please check the button to add another child in the registration. A 5% sibling discount will automatically be applied.

Parent/Guardian's Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contacts / Authorized Person to Pick-up
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
See other payment plan options. If you prefer to pay in full, please keep this field unchecked.

Total

USD

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. A 15-minute grace period will be provided allowing for extended dismissal until 5:45 PM. I hereby acknowledge and agree that 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.
Please verify that you are human*
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Q300 Afterschool Program (Upper Division)