Flushing Christian School Afterschool (September 2025

Flushing Christian School Chess Afterschool

41-54 Murray Street, Flushing, NY 11355 | (September 12, 2025 - January 30, 2026)

STUDENT 1 INFORMATION
Student's Name*

First NameLast Name
Age*
Grade*
School*
Skill Level*
Allergies or anything else we need to know?
Is the child authorized for self-dismissal?*

YesNo

STUDENT 2 INFORMATION
Student's Name

First NameLast Name
Age
Grade
School
Skill Level
Allergies or anything else we need to know?
Is the child authorized for self-dismissal?

YesNo

STUDENT 3 INFORMATION
Student's Name

First NameLast Name
Age
Grade
School
Skill Level
Allergies or anything else we need to know?
Is the child authorized for self-dismissal?

YesNo

PARENT/GUARDIAN'S INFORMATION
Parent/Guardian's Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Emergency Contacts / Authorized Person to Pick-up

PROGRAM REGISTRATION

Select Program*

Fridays - Full Program (16 sessions) $28/session | 5% sibling discount for the second and subsequent child - automatically applied in the registration.

$448.00 Quantity

Fridays - Single Day Drop-inSingle day drop-in sessions. Please select the quantity from the drop-down, and enter the dates you are signing up for in the "Drop-in Session Dates" text field below.

$30.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

FRIDAYS Drop-in Session Dates (if applicable)

September 19, 2025September 26, 2025October 3, 2025October 10, 2025October 17, 2025October 31, 2025November 7, 2025November 21, 2025December 5, 2025December 12, 2025December 19, 2025January 9, 2026January 16, 2026January 23, 2026January 30, 2026February 6, 2026
Additional Information
Refund Policy and General Media Release*

I understand that all cancellations require at least 24 hours prior to the day of the program in order to receive full credit for the purchased amount to be applied toward any other NYCA programs. Credits never expire and are transferable. Refund requests are considered on a case by case basis. I hereby authorize New York Chess Academy (NYCA) to photograph, take motion pictures, video footage, and/or make electronic sound recordings of the participant I am registering. I authorize the use of any such photographic or electronic reproductions for any purpose, including, but not limited to educational and other public media as may be deemed appropriate by the New York Chess Academy.
Please verify that you are human*
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Flushing Christian School Chess Afterschool