Castle Chess Camp Registration

Please note: Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your response to this form to: Craig Stauffer, Chess Master. 

Name:                          

E-mail Address:                

Age:

Gender
Male
Female
 

Phone Number:                  

Street Address:                

City:                          

State:                         

Zip:                           

USCF ID Number:                

Rating:                        

Birthday:

My roommate preference is

Roommate:

Housing choice
Resident
Commuter

I would like to make a donation to help a needy youth attend

No
Yes
Multiple items may be chosen.

My shirt size is

Any Comments:

NOTE: Please make check payable to the Terre Haute Castle Chess Camp, and mail it to 125 Monterey, Terre Haute, Indiana 47803.

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