School Chess Club, Tournament or Camp Registration for 2011 - 2012
Required fields marked with asterisk (*)
Select one:
* School Club
* Tournament
* Camp
Enter Start Date:
*Month:
January
February
March
April
May
June
July
August
September
October
November
December
*Day:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*Year:
2011
2012
2013
*Child's Name:
*Age:
* Grade:
Does your child play chess?
*Yes
*No
If applicable:
USCF Rating
USCF Member #
*
School or Event Location:
*Parent's Name:
*Home Address:
*City:
*State:
*ZIP:
*Primary Phone#:
*This is a
home
cell
work
phone number
*Alternate phone#
:
*This is a
home
cell
work
phone number
*Second Alternate phone#:
*This is a
home
cell
work
phone number
*Email Address:
Fees due: $
Add Optional Items:
Standard Chess Set -- board and bag pieces $20:
Yes
Choose Board Color:
Red
Forest Green
Royal Blue
Choose Bag Color:
Red
Forest Green
Royal Blue
Deluxe Folding Magnetic Set 10" x 10" in box -- $12:
Yes
Next Step:
Select the Submit button to continue to payment form
