Membership Registration

Individual Information
* fields are mandatory

Note: All information below is of participant/student
First Name *
Last Name *
Phone *
Age as of September 1, 2017 *
Present School *
Present Grade *
Address *
Address Line 2
City *
State *
Zip/Postal Code *
Country *
Reference # (Enter USCF # for Chess)
Email *
Username *
Password *