IG Chess - Oct 2026

We're glad you've chosen to register for

DOROT's Intergenerational Chess Program

at the Leffell School in Hartsdale.

Sessions are on Wednesdays from 4:30pm to 6pm.

By registering, you are committing to all 7 sessions.

The program dates are

October 21, 28

November 4, 11, 18 (no session on November 25th)

December 2, 9

This program is for

Adults 60+ and

High School Teens

Registration required.

Please complete this form.
Are you an adult 60+ or a high school teen?
Name

First NameLast Name
Gender Identity
Preferred Email
example: infowestchester@dorotusa.org
Email for Reminders:
IF OA registers by PHONE but does provide an email for SF account.
Preferred Email type:
Preferred Phone #
Format: (000) 000-0000.
Preferred Phone type:
Secondary Phone #
Format: (000) 000-0000.
Secondary phone type:
I have participated in a DOROT event before.
Zip Code
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Year
Birth Month
Birth Day
Emergency Contact:

First NameLast Name
Emergency Contact Phone:

Area CodePhone Number
Emergency Contact Relationship:
Name of High School:
High School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Grade:
Parent/Guardian name:

First NameLast Name
Parent/Guardian email:
example@example.com
Parent/Guardian phone:

Area CodePhone Number
How did you hear about this High School program?

Other
How did you hear about this Intergenerational program?

Other
What is your chess playing experience?
I understand that as a DOROT volunteer it is my responsibility to:
Attend all sessions of the program.
Arrive on time; stay for the full session.
Make an effort to get to know all the other participants.
Agree to focus on relationships, learning and fun, not competition.
Use the game of chess as a way to enjoy intergenerational connections.
Behave in a respectful way with everyone.
Have you, since attaining the age of 18, been convicted of a criminal offense? (Conviction will not disqualify you from volunteering unless there is a direct relationship to the volunteer task or your volunteer activity would pose an unreasonable risk to property or safety.)
Terms of Participation:
Terms of Participation:

Before we finish your registration, I need to read you a brief statement about program content. This is the same agreement participants see when registering online. It explains that all program materials belong to our organization and can’t be used or shared without our permission. After I read it, I’ll ask if you agree so we can complete your registration.
The content of this program is the property of DOROT, Inc. and is intended solely for the personal, non-commercial use of authorized participants. All rights are reserved. Any recording, screen scraping, copying, storage, display, or distribution of this content without DOROT, Inc.'s express written permission is strictly prohibited. Unauthorized use may subject violators to civil and criminal penalties.
DOROT staff, read this to participant: The content of this program is the property of DOROT, Inc. and is intended solely for the personal, non-commercial use of authorized participants. All rights are reserved. Any recording, screen scraping, copying, storage, display, or distribution of this content without DOROT, Inc.'s express written permission is strictly prohibited. Unauthorized use may subject violators to civil and criminal penalties.
Please verify that you are human
Please check your responses carefully for accuracy. You will not be able to revise this form after submission.
Updated 9/2026
Should be Empty:

I understand that as a DOROT volunteer it is my responsibility to:

Terms of Participation:

Terms of Participation: