Medina Chess Club by GvYj9Iw


									                                   Medina Chess Club
                                 2010-2011 Registration Form

Register now! Medina Chess Club will BEGIN WEDNESDAY, SEPTEMBER 15TH!

One-time annual tuition will be $275 for the 1 hr. classes and $350 for the advanced 1.5 hr. class
PLUS a $100 volunteer deposit per family. These fees cover the entire year of chess club - 28
weeks of chess instruction.

Please   complete this form to register your child for chess club. If registering multiple children,
please   complete one form per child and staple together with a single check payable to MEDINA PTA.
Forms    (registration and volunteer sign-up) should be returned to the CHESS CLUB folder in the
school   office.

Registration forms and payment must be received by MONDAY, SEPTEMBER 13TH. Medina Chess
Club will begin WEDNESDAY, SEPTEMBER 15TH immediately following school. Medina Chess Club will
end the first week of May.

***Not sure your child will enjoy chess? Refunds for UNUSED chess tuition and volunteer deposit
must be requested by OCTOBER 1st.

Student Name:______________________________ Grade:_______________
Teacher: __________________________________

Level of Play (circle one):            Beginning Kindergartener
                                       Beginner (other than Kindergartener)
                                       Beg. Intermediate
                                       Adv. Intermediate
                                       All-Girls Team
                                       Advanced Competition (1.5 hrs $350 tuition)

If your child played on the team last year, the coaches will place him/her at the appropriate level.
If you have any questions about placement, please contact Melissa Taylor at 425-283-7476.

Email Address: _____________________________
Daytime phone #s to reach you in case of emergency:___________________

Are you interested in participating in local tournaments?      ___________
* We will be hosting our 5th annual city-wide Medina Chess tournament this winter and we plan to host our 3rd
annual all-girls Queens Quest tournament this Spring.

At this time, do you plan on enrolling your chess club child in the ski bus program at Medina this
winter? __________

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