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Bloomington Chess Home Page

Sixth Annual Bloomington Scholastic Chess Open
Entry Form

Saturday, December 3 - REGISTRATION CLOSED
University Elementary School, 1111 N. Russell Rd., Bloomington, IN 47408

*Indicates Required Field

*Player Name


*Phone Number


*Email Address


*Grade


*School


*Section (1st 3rdU, 6thU, 12thU):


USCF membership information: visit http://www.uschess.org/msa/MbrLst.php


Current USCF member:


USCF I.D.


Expiration Date


If expiration date is November 2016 or before, please check membership renewal options below.


New USCF Member:

Home Address


Date of Birth


Sex:  Male    Female

Membership desired:
Free Junior Tournament Participant – available to 3rd Grade & Under only
$17 Regular Scholastic - available to age 12 and under (online access to Chess Life for Kids)
$24 Premium Scholastic - available to age 12 and under (6 bimonthly issues of Chess Life for Kids)
$22 Regular Youth - available to age 15 and under (online access to Chess Life)
$28 Premium Youth - available to age 15 and under (6 bimonthly issues of Chess Life)
$26 Regular Young Adult - available to age 24 and under (online access to Chess Life)
$33 Premium Young Adult - available to age 24 and under (12 monthly issues of Chess Life)

Please check:
New
Returning
If renewing, include USCF ID number:

Registration

  • By November 27 - Print registration form and mail with payment of $17 per student to the address below.
  • November 27 to December 2nd - Email registration information and send $20 registration fee to mailing address.

Mailing address: Michelle Burns, ATTN: University Chess Club, P.O. Box 8422 Bloomington, IN 47407

Email address: Uchessclub02@gmail.com

Phone Number:  812.327.1087

Checks payable to University Chess Club.

Please add USCF membership fee to tournament registration fee if applicable.