WATAUGA CHESS TOURNAMENT
                                                   REGISTRATION FORM
                                                       

(Please Print)

Name of Tournament_____________________________ Date of Tournament___________

Last Name_____________________________ First_________________________ MI_____

Address_________________________________________________________

City, State, Zip______________________________________________________________

Date of Birth_________________ Telephone ( ____ ) _____________________
(Date of birth required for Jr & Sr entries, USCF renewal, and for persons joining or rejoining the USCF.)

E-mail Address__________________________________________________

Are you a USCF member? ___Yes  ___No    If no, have you ever been a USCF member? ___Yes  ___No

USCF ID #____________________ Expires________________USCF Rating__________
(Previous members who rejoin the USCF retain their old USCF ID #.)  (Note: Once rated, always rated.)

Entry Fees: See webpage or flier for tournament fee information.

Entry Fee . $__________ (Add $5 for on-site registration - )

Adult USCF Mem. ($49/yr)*.......... __________ (or $32 for 6-month trial - 1st time mem. only)

Youth USCF Mem. ($25/yr).......... __________ (19 & under - receives monthly Chess Life)

Scholastic USCF Mem. ($19/yr)** __________ (14 & under - receives six publications / yr)

Senior USCF Mem. ($36/yr)......... __________ (65 & over)

Total Amount Enclosed...............$__________ Make checks payable to Watauga Chess Club

*   Economy Regular $39/yr (receives NO publications)
** Economy Scholastic $13/yr (receives NO publications)


Make check payable to Watuaga Chess Club. Mail this pre-registration form with payment to:

   Watauga Chess Club
   c/o Aurelio Gonzalez
   6432 Ridglea Dr.
   Watauga, TX 76148

Mail so as to arrive 3 days before date of tournament. Early registration helps us tremendously.

If you are registering on site, complete this form, bring it with you, and make payment on site.  

   *Note - onsite registrations costs $5 dollars more than prepaid.

For more info: Visit the Watauga Chess Club Website at www.wataugachess.thinkhost.com
or call Tom Crane at
(817) 427-2208.

Anything else we need to know? If so, use the space below:

__________________________________________________________________________

__________________________________________________________________________