Confirmation

IHSA STATE CHESS TOURNAMENT

Please complete the form below to confirm your child's attendance:

All information provided will be emailed directly to my district email account and will remain confidential.

* Indicates required field

Player's Name *

First

Last

Guardian's Name *

First

Last

Contact Number (In case of questions or emergencies.) *

Additional Information: *

Activity Permission Form *

I am the above listed student's legal guardian and my child has my permission to attend the IHSA State Chess Tournament. It is my understanding that this trip will be supervised by a responsible adult from the high school. I waive all claims against Belleville Township High School District 201 due to accidental injury of the students named above resulting in said activities because of a personal family policy providing adequate medical coverage, or because the student is covered by school insurance available through Illinois School District Agency.

Submit