Chess Club

Registration for Chess club:

* Indicates required field

Child Name *

First

Last

Child Grade *

Child teacher *

Parent/guardian Name *

First

Last

Emergency Contact (Name and Phone Number) *

Emergency Contact 2 (Name and Phone Number) *

Email *

Phone Number *

All reasonable precautions are taken to assure your child's safety and prevent injuries from occurring. If an incident should occur, you grant permission for the instructor, school or HSA to obtain emergency medical care if it appears necessary.

Agreement to the term *

"I have read and agree to the terms outlined above."

Comment *

After you click on the Submit button you will be redirected onto the Shining Knights company website where you will be able to pay the club fees.
If you require financial assistance, please email Anne Heffron at heffroa@lmsd.org as soon as possible .

Submit