Prairie Chess

Student Signup Form

Student Name(First and Last)* Note: This is how it will be displayed and shown. *

Has this student been in Prairie Chess Club before? If yes, use the same student name and parent email(s) as a previous year.

Student Email (Optional)

Student Has Scholastic Chess Membership

School *

Grade *

1st Parent/Guardian Name *

1st Parent/Guardian Email *

1st Parent/Guardian Phone *

2nd Parent/Guardian Name (Optional)

2nd Parent/Guardian Email (Optional)

2nd Parent/Guardian Phone (Optional)

Additional Information