Astoria Lutheran School Afterschool (February 2, 2026

Astoria Lutheran School Chess Afterschool

31-20 21st Ave, Astoria, NY 11105 | (February 2, 2026 - June 15, 2026)

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?

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?

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?

Parent/Guardian's Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contacts / Authorized Person to Pick-up

Select Program

Mondays - Full Program (17 sessions)

$28/session | 5% sibling discount for the second and subsequent child - automatically applied in the registration.

$476.00 Quantity

Mondays - Single Day Drop-in

Single 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

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

MONDAYS Drop-in Session Dates (if applicable)
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.
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Astoria Lutheran School Chess Afterschool

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