PS 69Q Afterschool Program
77-02 37th Avenue Jackson Heights, NY, 11372 | November 21, 2024 - January 30, 2025
Student Information (1)
Student's Name
*
First Name
Middle Name
Last Name
Age
*
Grade
*
School
*
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
Allergies or anything else we need to know?
Is the child authorized for self-dismissal?
*
Yes
No
Student 1 Registration
*
Full Program (9 sessions) - $252
Thursday - November 21, 2024 - $30
Thursday - December 5, 2024 - $30
Thursday - December 12, 2024 - $30
Thursday - December 19, 2024 - $30
Thursday - January 2, 2025 - $30
Thursday - January 9, 2025 - $30
Thursday - January 16, 2025 - $30
Thursday - January 23, 2025 - $30
Thursday - January 30, 2025 - $30
ADD A SECOND CHILD - Get 5% sibling discount on the 2nd (and subsequent child)
Please check the button to add another child in the registration. A 5% sibling discount will automatically be applied.
Student Information (2)
Student's Name
*
First Name
Middle Name
Last Name
Age
*
Grade
*
School
*
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
Allergies or anything else we need to know?
Is the child authorized for self-dismissal?
*
Yes
No
Student 2 Registration
Full Program (9 sessions) - $252
Thursday - November 21, 2024 - $30
Thursday - December 5, 2024 - $30
Thursday - December 12, 2024 - $30
Thursday - December 19, 2024 - $30
Thursday - January 2, 2025 - $30
Thursday - January 9, 2025 - $30
Thursday - January 16, 2025 - $30
Thursday - January 23, 2025 - $30
Thursday - January 30, 2025 - $30
ADD A THIRD CHILD
Please check the button to add another child in the registration. A 5% sibling discount will automatically be applied.
Student Information (3)
Student's Name
*
First Name
Middle Name
Last Name
Age
*
Grade
*
School
*
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
Allergies or anything else we need to know?
Is the child authorized for self-dismissal?
*
Yes
No
Student 3 Registration
Full Program (9 sessions) - $252
Thursday - November 21, 2024 - $30
Thursday - December 5, 2024 - $30
Thursday - December 12, 2024 - $30
Thursday - December 19, 2024 - $30
Thursday - January 2, 2025 - $30
Thursday - January 9, 2025 - $30
Thursday - January 16, 2025 - $30
Thursday - January 23, 2025 - $30
Thursday - January 30, 2025 - $30
Parent/Guardian's Information
Parent/Guardian's Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Emergency Contacts / Authorized Person to Pick-up
Payment Information
Subtotal
Sibling Discount
Subtotal - Sibling Discount
TOTAL
*
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Security Code
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Additional Information
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.
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