2022-2023 Tuesday Chess Club Payment Page

Kid's Club "Tues. Chess Club with Nick"

Child's Name(Required)

First Last

Child's Classroom Teacher/Class #(Required)

Parent/Guardian A Name(Required)

First Last

Parent/Guardian A Email(Required)

Enter Email Confirm Email

Parent/Guardian A Phone(Required)

Parent/Guardian B Name

First Last

Please only fill out if the second parent/guardian needs to be informed about Kid's Club

Parent/Guardian B Email

Enter Email Confirm Email

Parent/Guardian B Phone

Kid's Club Chess Club(Required)

Price:

Total

Payment Method*

American Express

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

School Number: 15K321

180 7th Avenue
Brooklyn, NY 11215

Principal

Elizabeth Phillips

Assistant Principals

Sara Despres
Elizabeth McCormack