Halloween Chess Tournament

Chess4SuccessLA & SPA Chess Club

St. Paul the Apostle School 1536 Selby Ave, Los Angeles, CA90024
Sunday, October 27, 2019, From 1:00 PM to 5:00 PM

Tournament Director: Ivona Jezierska 310.740.0063 or chess4successla@gmail.com

Put on a costume and come play chess! Best costumes receive prizes!

All Levels Welcome! We expect a full house!

Advance registration required. Participants must sign up by Friday, October 25.

Absolutely NO same day registration Individual trophies awarded to two winners of each group.

 Others will receive a medal.

Team trophy awarded for the Highest Scoring School.

COST: $40

then email me with the info requested below

Or Mail $40 with the lower portion of this flyer.

Tear-off must be accompanied by registration fee, no exception.

Please Note – No Same Day Registration!

This is a great opportunity to try out your skills with other students who enjoy chess!

…………………………………… PRINT OUT & RETURN WITH CHECK…………….……….……………………………….……………….

Event: Halloween Chess Tournament at St. Paul the Apostle School Date of Event: Sunday, October 27, 2019

Time: 1:00 PM to 5:00 PM

REGISTRATION CHECKS ARE PAYABLE TO: IVONA JEZIERSKA

Mail check with this portion of the flyer to: Ivona Jezierska, 1213 Preston Way, Venice, CA 90291

CHILD’S FULL NAME: ………………………………………………………………………………..BIRTHDATE…………………

ADDRESS/CITY/ZIP……………………………………………………………………………………….

GRADE: ……………SCHOOL………………………………………………………………………

CIRCLE SECTION: CHAMPIONSHIP . JV . NOVICE

I request that my child, (named above), be permitted to participate in the above chess event. I fully understand that I, or my representative, will take responsibility for supervising my child during this event. I agree to instruct my child to cooperate and conform with the directions and instructions of the tournament director, organizer or any supervision in charge of the tournament hall, school and school grounds. Should it be necessary for my child to have a medical treatment while participating in this event, I herby give the supervisory personnel permission to use their judgment in obtaining medical services for my child and I give permission to the physician selected by such personnel to render medical treatment deemed necessary and appropriate by such physician(s). I, as parent or representative of this child, hereby release, discharge and hold harmless St.Paul the Apostle School and all employees, the Tournament Director, volunteers, and board of directors from any claims arising out of or relating to any injury that may result to my child while participating in this event.

Signature of Parent/Guardian………………………………
Date………………………………
Cell Phone………………………………
E-mail Address………………………………