Ankeny Chess Dojo Registration – Des Moines Chess Academy

Parent Name *

First

Last

Parent Phone *

Parent Email *

Would you like to add another parent's information?

Student Name *

First

Last

Student Grade

What level will they be attending?

Has this student been in DM Chess Academy events before?

Additional information (Please list any online chess account usernames that you would like to share)

Stripe Credit Card *

Card

Name on Card

Address

Address Line 1

Address Line 2

City

State

Zip Code

Monthly Dojo Membership ($40 per month)

Price: $ 40.00