Please complete the following form to register for a school chess team. Credit card payments are processed by PayPal. Participant's InformationName* First Last Full Name of School*Grade Level*-- Select --K123456789101112Home Room or Teacher*Is child a registered DPS Before or After School Student?*YesNoRegistration Fee (per semester)* Price: $110.00 Registration Fee (per semester)* Price: $90.00 Parent's/Guardian's InformationName* First Last Emergency Phone*Email* Additional CommentsPermission and Liability Waiver*By submitting this form, I recognize that activities connected with this program may involve accidental physical injury. I agree to assume the risk of my child's participation in this program, and I hereby release Triangle Chess and the Durham Public Schools Board of Education, its members, officers, employees, and agents, from and against any claim for any losses, damages or injuries arising out of, during, or in connection with the student's participation in the program and related activities or the rendering of emergency medical procedures or treatment, if any. I have read and agree with the above Permission and Liability Waiver This iframe contains the logic required to handle Ajax powered Gravity Forms.