Chess4SuccessLA & SPA Chess Club

Sunday, April 26, 2020 From 1:00 PM to 5:00 PM

St. Paul the Apostle School 1536 Selby Ave, Los Angeles, CA90024

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

We expect a full house!

Advance registration required. Participants must sign up by Friday, April 24.
Absolutely NO same day registration
Individual trophies awarded to two winners of each group.
Other players will receive a medal.
Team trophy awarded for the Highest Scoring School.
Novice K-6 NOT rated (groups based on grade), Championship-rated K-8

Registration fee is $40.00.

ONLINE CONFIRMATION

Step 1:

Consent Form & Tournament Payment

Email*
Name*
First Last
Best Phone Number (Emergency Contact)*
My Child's Name*
Date
MM slash DD slash YYYY
Check the appropriate level
What Grade is your child in?*
Consent*
I agree to consent my child to attend
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 School which hosts the tournament 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.
Pictures from this event may be used in promotional materials. If there are a small number of players in a section, we reserve the right to combine sections.
Have a great Tournament experience!
Spring Chess Tournament
Price: $40.00
Use the quantity field to pay for multiple children.
Total
$0.00
Email
This field is for validation purposes and should be left unchanged.

MAILING INFORMATION

Please print this page out and use this form if you are not paying online.

Please include a $40 check if not paid above, with the lower portion of this flyer.

Tear-off must be accompanied by the 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

SPRING Chess Tournament at St. Paul the Apostle School 1536 Selby Ave, Los Angeles, CA 90024 Sunday, April 26, 2020 From 1:00 PM to 5:00 PM

REGISTRATION CHECKS ARE PAYABLE TO: IVONA JEZIERSKA

Mail check with this portion of the flyer to: Chess4SuccessLA 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 hereby 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