Bishops Bash IX Entry Form

================== PLEASE FILL IN APPLICABLE INFORMATION ============== ADVANCE Registration(White Paper)Form


Name: ___________________________________USCF ID ______________Exp. Date____________
(Name as shown on USCF Card if member)   ("NEW" if first time m'ship)

Address: _______________________________________________Section: ________Grade______

City & State ________________________________Zip__________Date of Birth ____________

Team/School/Club ___________________________________Coach___________________________

If player requests BYE/BYEs enter Round Number(s):__________________________________

Enclosed:___Entry Fee(s) @ $20.00 or $30.00 on-site (circle one) + USCF Membership $_____ = Total Submitted ______. Specify USCF Membership as New_____or Renewal_________ (Check one). Submit one form for each entrant. Single check for all entry and USCF Membership fees payable to: Huntsville Chess Club. Please include PLAYER name(s) on check. Send proof of USCF membership: Copy of card, magazine mailing label or printout. On-site Entrants bring proof of membership. USCF memberships available on web at uschess.org.