reg graphic left pile of games

Summer Camp at Harker Middle School Registration Page
Sign Up for Chess Class, Modern Board Game Class, Or Both!

Harker Middle School Campus, 3800 Blackford Avenue, San Jose, CA 95117
July 8-12 and July 15-19
9 AM to 12 Noon for Chess, 12:30 PM to 6:00 PM for Modern Board Games

Once you have completed this form, please remember to press the "Submit" button on the bottom of the form (otherwise, we will not receive your info!).  You should receive an email within three business days verifying your registration.  If you do not receive an email verification, please contact Success Chess School at Info@SuccessChess.Com.

STUDENT'S NAME:
PARENT'S NAME: 
STREET ADDRESS:
CITY: ZIP:
TELEPHONE:
E-MAIL ADDRESS: 		GRADE:
 

SELECT PROGRAM:
Sign up for Chess, Modern Board Games, or both!  With new lessons and activities each week, students can attend either week or both weeks.*  There there are discounts for signing up for both weeks or both classes, and for registering siblings.  Please note there is no class on weekends, and that students who attend for the full day should bring a lunch to eat during our 12 Noon to 12:30 lunch break.

*For the chess camp, our beginner class covers basic concepts in week 1, so beginners can sign up for both weeks or week 1 only, but not week 2 only.  Intermediate and Advanced level chess players are welcome to take either week or both.

If registering a 2nd or 3rd child for the summer camp, please select the appropriate discount.



SELECT YOUR CHILD'S CHESS LEVEL (CHESS CAMP ONLY*):
*If your child is not taking the chess class, you can ignore this selection or leave it marked as 'BEGINNER.'

Beginner--has never played chess before, or knows the names of the pieces and that is about all
Intermediate--has played chess before, knows how the chess pieces move and how to castle
Advanced--has been playing chess for a number of years and/or has played in US Chess Federation tournaments

SELECT PAYMENT OPTION (CREDIT CARD OR CHECK):

If paying by credit card, please fill out information below, and note that the billing address on the credit card should be the same as the address you entered at the top of this registration form.  If paying by check, please mail your payment to: SUCCESS CHESS SCHOOL, 39039 PASEO PADRE PKWY, #201, FREMONT, CA 94538.  On your check, please include your child's name plus your phone number in case we have any questions.  Your child's registration will not be complete until we receive your payment.

             
Select a Credit Card type: *
Credit Card Number (Please enter number with no
spaces or dashes, e.g. 3423765423484921):*

CVV Number (For Visa & Mastercard, the last 3 digits in the signature area on the back of the card; for American Express, the 4 digits above the credit card number on the front of the card) : *

Exp. Month: *       Exp. Year: *
                   
Cardholder name (please input name exactly as it appears on card): *