DPS Registration

Please complete the following form to register for a school chess team. Credit card payments are processed by PayPal.

Participant's Information
Name*
First Last
Full Name of School*
Grade Level*
Home Room or Teacher*
Is child a registered DPS Before or After School Student?*
- Yes
- No
Registration Fee (per semester)*
Price: $110.00
Registration Fee (per semester)*
Price: $90.00
Parent's/Guardian's Information
Name*
First Last
Emergency Phone*
Email*
Additional Comments
Permission 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

Participant's Information