DDE Advanced Dragon Knight Chess Program (Mondays) Q1 Registration ($149)
September 28 to November 16
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
Full name of school
*
Parent's / Guardian's Information
Parent's Name
*
First Name
Last Name
Emergency Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
E-mail
*
example@example.com
Additional Comments
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Should be Empty: