DDE Main Chess Program (Wednesdays) Q3 Registration
February 5 to April 9
Student's Information
Student Name
*
First Name
Last Name
Grade Level
*
Please Select
1
2
3
4
5
Home Room or Teacher
*
Parent will pick up child:
*
From the chess club directly
My child should go to after-school
Parent's / Guardian's Information
Parent's Name
*
First Name
Last Name
Emergency Phone Number
*
Please enter a valid phone number.
E-mail
*
example@example.com
Additional Comments
Submit Registration
Should be Empty: