CSCL Championship Registration Form

Player Name: ___________________________________________________________

Address: _______________________________________________________________

_______________________________________________________________________

School: ______________________________________________ Grade: ___________

Phone: ______________________ Email: ____________________________________

USCF ID#: _________________________  Exp.  __________ 

For USCF signups:  Birth Date ________________        Gender:     Male    Female

Section  (Check one):

______ High School  Championship   
______ Middle School Championship ______ Middle School Reserve(U-500)
______ Elementary Championship ______ Elementary Reserve(U-500)
______ Novice K-2 (unrated)  

        

 

 

Entry Fee (Circle One):

Championship Tournament Entry (free if you paid your $20 CSCL entry fee)    $10

USCF Membership (Valid for one year; Circle One):

Membership is current      $0
Novice player; none required      $0
Scholastic (Age 12 & under) $16 regular $23 premium
Youth (Age 15 & under) $20 regular $27 premium
Young Adult Membership (Age 16 and older) $24 regular $32 premium
Family I : Both Parents and all children under 25 in same house      $70
Family II: All children under age 25 in same house      $44

For Family Memberships, include the names, USCF ID's and birthdates of the
other family members.
 

Total Fees Enclosed      ________   

Make checks payable to CSCL.  Send COMPLETED form and fees to:

CSCL

P.O. Box 2373

North Canton, OH 44720