Clone of (NEW) (TUESDAYS) PS/IS 178 (THE HOLLISWOOD SCHOOL)

PS/IS 178 - The Holliswood School (TUESDAYS, September 22, 2026 - January 19, 2027)

189-10 Radnor Rd, Hollis, NY 11423

Student's Name

First NameMiddle NameLast Name
Age
Grade
Chess Skill Level
* Please fill out the form and indicate each participant's level. Participants will be grouped based on these levels, and coaches will conduct assessments to ensure appropriate placement. When participants are ready for the next level, they will be automatically promoted.
Pick-Up Information:
Name:
Phone Number:
Name:
Phone Number:
Allergies or anything else we need to know?

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 Empire Chess Training programs. Credits never expire and are transferable. Refund requests are considered on a case by case basis. I hereby authorize Empire Chess Training 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 Empire Chess Training.
My Products
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Full Program (15 Sessions)
September 22, 2026 - January 19, 2027

$375.00 Quantity



September 22
$28.00 Quantity



September 28
$28.00 Quantity



October 6
$28.00 Quantity



October 13
$28.00 Quantity



October 20
$28.00 Quantity



October 27
$28.00 Quantity



November 10
$28.00 Quantity



November 17
$28.00 Quantity



November 24
$28.00 Quantity



December 1
$28.00 Quantity



December 8
$28.00 Quantity



December 15
$28.00 Quantity



January 5
$28.00 Quantity



January 12
$28.00 Quantity



January 19
$28.00 Quantity



Subtotal

$0.00

Tax

$0.00

Total

$0.00

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

PS/IS 178 - The Holliswood School (TUESDAYS, September 22, 2026 - January 19, 2027)