PS 139 Afterschool Program (January 2024

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Sibling Discount

Subtotal - Sibling Discount

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USDTotal Amount

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

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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PS 69Q Afterschool Program

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