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FALL 2023 JR. Chess and Game Club Registration Form

Knights

Student Information

First and Last Name*

Answer required for "First and Last Name"

Grade*

Answer required for "Grade"

Address

Answer required for "Address"

Parent Information

Parent / Guardian 1 First and Last Name*

Answer required for "Parent / Guardian 1 First and Last Name"

Parent / Guardian 1 Email*

Answer required for "Parent / Guardian 1 Email"

Parent / Guardian 1 Phone*

Number Required

Parent / Guardian 2 First and Last Name

Answer required for "Parent / Guardian 2 First and Last Name"

Parent / Guardian 2 Email

Answer required for "Parent / Guardian 2 Email"

Parent / Guardian 2 Phone

Number Required

Parents: Your volunteer time and talent is critical to the success of this STEM Opportunity. Are you interested in volunteering in any of the following ways?

Answer required for "Parents: Your volunteer time and talent is critical to the success of this STEM Opportunity. Are you interested in volunteering in any of the following ways?"

Head Coach

Assistant Coach

Team Manager

Decline at this time

Who will be picking up your child (Name and Relationship)?*

Please include contact information if someone other than yourself is picking up your child.

Answer required for "Who will be picking up your child (Name and Relationship)?"

I, Parent/Guardian, grant permission for ( above-named participating child) to participate in the above named activity and I warrant that my child is in good health. In consideration of my child’s participation, I agree to indemnify the school and the Archdiocese of Saint Paul and Minneapolis from any claims or lawsuits brought against the school /Archdiocese of Saint Paul and Minneapolis by myself, my child or others, that arises out of any behavior by my child at the event/activity described above. I also agree to pay reasonable attorney’s fees or expenses incurred by the parish/school and the Archdiocese in defense of such a claim/suit.

Signature*

Signature Required

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"