Q300 Afterschool Program (Upper Division)
31-51 21st St, Queens, NY 11106 | February 2026 - June 2026 (Mondays and Tuesdays)
Child's Information
Student's Name
*
First Name
Middle Name
Last Name
Grade
*
Allergies / anything we need to know?
Please select the sessions you would like to attend
*
Please Select
Mondays only ($594.00)
Tuesdays only ($627.00)
Mondays and Tuesdays ($1,140.00)
Skill Level
*
Please Select
Pawn 1 (Beginner 1) - Absolute Beginners
Pawn 2 (Beginner 2) - Knows the movements and values of pieces
Knight (Beginner 3) - Can do checkmate with Queen+King, and 2 Rooks
Bishop (Intermediate 1) - Can do checkmate with only 1 Rook+King, and knows what "opposition" is
Rook (Intermediate 2) - Players with USCF rating of 800-1299
Queen (Advanced 1) - Players with USCF rating of 1300-1800
King (Advanced 2) - Players with USCF rating of 1800 and above
Not sure
Pick-up Time
*
5:00 PM
5:30 PM
ADD A SECOND CHILD?
Please check the button to add another child in the registration. A 5% sibling discount will automatically be applied.
2nd Child Information
Student's Name
*
First Name
Middle Name
Last Name
Grade
*
Allergies / anything we need to know?
Please select the sessions you would like to attend
*
Please Select
Mondays only ($594.00)
Tuesdays only ($627.00)
Mondays and Tuesdays ($1,140.00)
Skill Level
*
Please Select
Pawn 1 (Beginner 1) - Absolute Beginners
Pawn 2 (Beginner 2) - Knows the movements and values of pieces
Knight (Beginner 3) - Can do checkmate with Queen+King, and 2 Rooks
Bishop (Intermediate 1) - Can do checkmate with only 1 Rook+King, and knows what "opposition" is
Rook (Intermediate 2) - Players with USCF rating of 800-1299
Queen (Advanced 1) - Players with USCF rating of 1300-1800
King (Advanced 2) - Players with USCF rating of 1800 and above
Not sure
Pick-up Time
*
5:00 PM
5:30 PM
ADD A THIRD CHILD?
Please check the button to add another child in the registration. A 5% sibling discount will automatically be applied.
3rd Child Information
Student's Name
*
First Name
Middle Name
Last Name
Birth Date
*
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Year
Grade
*
Allergies / anything we need to know?
Please select the sessions you would like to attend
*
Please Select
Mondays only ($594.00)
Tuesdays only ($627.00)
Mondays and Tuesdays ($1,140.00)
Skill Level
*
Please Select
Pawn 1 (Beginner 1) - Absolute Beginners
Pawn 2 (Beginner 2) - Knows the movements and values of pieces
Knight (Beginner 3) - Can do checkmate with Queen+King, and 2 Rooks
Bishop (Intermediate 1) - Can do checkmate with only 1 Rook+King, and knows what "opposition" is
Rook (Intermediate 2) - Players with USCF rating of 800-1299
Queen (Advanced 1) - Players with USCF rating of 1300-1800
King (Advanced 2) - Players with USCF rating of 1800 and above
Not sure
Pick-up Time
*
5:00 PM
5:30-5:45 PM
Earlier than 5:00 PM
Parent/Guardian's Information and Checkout
Parent/Guardian's Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contacts / Authorized Person to Pick-up
Additional Information
Subtotal
Enter coupon code
Apply remaining NYCA credit
Please enter the NYCA credit code
COUPON CODE DISCOUNT
CREDIT AMOUNT
** SUBTOTAL-COUPON-CREDIT **
Total discount
Coupon code and any applicable credit
Payment Plans
See other payment plan options. If you prefer to pay in full, please keep this field unchecked.
PAYMENT PLANS SECTION
For other payment plans, we will send you an invoice on your preferred payment schedule. (Modes of payment after the first installment: Check, Cash, Venmo, or Zelle)
Two payments (50% due upon sign-up, 50% due by April 30, 2026)
Monthly payments (1st month due upon sign-up, then equal payments every month due on Friday of each month)
Please check the box below if you prefer to auto-charge your card on file
I hereby grant authorization to automatically charge the credit card on file for any recurring payments.
** SUBTOTAL-COUPON-CREDIT / PAYMENT PLAN **
PAYMENT SECTION
** FINAL TOTAL **
** VALUE CONTAINER **
Total
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Last Name
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Security Code
Expiration Month
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Expiration Month
Expiration Year
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Expiration Year
Pick-up Policy, 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. A 15-minute grace period will be provided allowing for extended dismissal until 5:45 PM. I hereby acknowledge and agree that a late pick-up fee of $25 will be charged for the first 15 minutes after the scheduled pick-up time. For every additional minute after the initial 15 minutes, an additional $1 per minute will be charged. This fee is payable directly to the instructor on the day of the late pick-up.
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