Summer Chess Camp Registration Form
Participant Name
First Name
Last Name
Participant Age
12
13
14
15
Must be between the ages of 12 and 15
Participant Chess Skill Level
1
2
3
4
5
Camp Registration Payment
prev
next
( X )
One Week
$
450.00
Two Weeks
$
800.00
Total
$
0.00
Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Date
Postal Code
Submit
Should be Empty: