CHESS ACADEMY WORKBOOKS
CHESSPLAYER CAMPS Inquiries to: chess64@comcast.net WGM Elena and IM GEORGI ORLOV CHESS CAMP

REGISTRATION FORM
Chess Star Co. Mail to: 7212 Woodland Ave NE Seattle WA 98102
2501 152nd Ave NE Redmond WA 98052

phone & fax 206/363-6511, cell 206-387-1251

EVENT YOU ARE REGISTERING FOR: _______________________________________________

Email for confirmation and updates______________________________________________________

NAME(s)_______________________________________________Grade

in 2011/2012_____RATING?__________SCHOOL_______________________Phone_______________________
PAID:______________________(Please check the event information)

CREDIT CARD INFORMATION: (VISA____MASTER CARD_____)
Card Number ____________________________Exp Date_________________ Name______________________________

ADDRESS______________________________________________________CITY________________________STATE____ZIP__________
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