“Chess, like love and music, has the power to make people happy.” – Dr. Siegbert Tarrasch

Include payment of $126 for the full 14-class schedule or $60 for the first six classes.

Make checks payable to the Sioux Empire Chess Foundation or  S.E.C.F.                                                                                                                                   

Student’s Name: ____________________________________     Date of Birth: _______________

School and Grade:  _______________________________________________________________

Parent’s Name/s: __________________________________________________________________

Parent’s Signature: ___________________________

E-mail___________________________________________________________________________

Phone Numbers:___________________________________________________________________

Address: _______________________________City: _________________ State:_____   Zip:________