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After School Chess Classes at Greenbrier

Registering your child is quick & painless. Just fill out this form and afterwards you will be redirected to a paypal page that can process your credit card. Greenbrier Flier Fall 1 2013

Please fill out the form below to continue.

Student Name

School

Grade

Parent Name

Primary Phone Number

Alternative Phone Number

Your Email

Emergency Contact Name

Emergency Contact's Phone Number

Additional Comments

By registering for CheckMatesUSA Classes you agree that you will pick up your child within 10 minutes of class ending. An additional fee may be charged if you child needs to be supervised past this time. If someone other than yourself will be picking your child up or they will be walking home or going to another after school club please indicate in the additional info section. CheckMatesUSA may also take pictures for marketing purposes during the duration of the classes. If you would not like any pictures taken of your child please indicate in the additional comments section of the form above.