BURLINGAME CHESS CLUB
MEMBERSHIP APPLICATION/TOURNAMENT ENTRY FORM
CLUB MEMBERSHIP DUES
Adult BCC Membership - $45/yr
Junior (19 & under) BBC Membership - $25/yr
U. S. CHESS FEDERATION MEMBERSHIP
(REQUIRED FOR TOURNAMENT PLAY UNLESS NOTED)
Adult - $49/yr (regular) or $36/yr (senior 65 & over), includes monthly Chess Life Magazine
Youth (19 & under) - $25/yr, includes monthly Chess Life Magazine
Scholastic (14 & under) - $19/yr, includes 5 issues Chess Life
Magazine & 1 Scholastic Yearbook
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TOURNAMENT ENTRY FEES |
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| Regular Tournaments: | Goodwin Memorial Club Championships: | ||
| Adult - $15 | Adult - $20 | ||
| Junior (19 & under) - $10 | Junior (19 & under) - $15 | ||
| Special Scholastic/Youth Tournaments (5 to 7 pm early play time, grades K thru 12): | |||
|
All players - $7, Club & USCF membership not required for these special tournaments |
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BURLINGAME CHESS CLUB MEMBERSHIP/TOURNAMENT ENTRY FORM
| Name _________________________________________________ | USCF: | Number ______________ |
| Address _______________________________________________ | Exp Date __________ | |
| City ________________________________ St _____ Zip _______ | Rating _________ | |
| Phone: [Home] (_____) _________________ [Work] (_____) _________________ | ||
| Email Address: _____________________________@________________________ | ||
|
Birth Date (Required for Jrs.) ____/____/____ (mo/day/yr) School _______________________ Grade ______ |
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FEES ENCLOSED |
|
| CLUB MEMBERSHIP - Check one: ___ Adult [$45] ___ Junior [$25] (19 & under) | |
| Burlingame Chess Club membership expiration date, if current ____/____/____ |
$ ________ |
| U. S. CHESS FEDERATION MEMBERSHIP - Check one: | |
| ___ Adult [$49] ___ Senior [$36] ___Youth [$25] ___ Scholastic [$19] |
$ ________ |
| TOURNAMENT ENTRY - Check one: ___ Adult ___ Jr. ___ Spec Scholastic | |
| Tournament name ____________________________ & date ____/____/____ |
$ ________ |
| TOTAL (Checks payable to Robert Blatt, TD, Burlingame CC) Today's date ____/____/____ |
$ ________ |
Correspondence to:
Robert Blatt, T.D./President, Burlingame Chess Club, 190 Loma Rd., San Carlos, CA
94070
For information: Robert Blatt - (650) 591-8857 or email
ALL INFO PROVIDED STRICTLY CONFIDENTIAL, HELD PRIVATE & USED ONLY BY BCC OR USCF