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The Chess Learning Center
 KnightMare Chess Club

Membership Application

Instructions for completing this KnightMare Chess Club Membership Application Form:

  1. If you leave this form for any reason, use your Web browser BACK BUTTON to return to this form.
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  2. Please complete ALL form fields, except where indicated by the following text: "(optional)".

You may also register by:
Telephone: 614-231-9591
e-mail: ChessMaster@ChessLearn.com

Student Profile:

1.1

Name:


First Name
Middle Name
Last Name
1.2

Date of Birth:


Month
Day

  Example: 1988
 Year .........................
1.3

Grade/Age/Gender:
1.4

School:


(Enter name of school here.)

KnightMare Chess Club Membership Application:

2.1

Please accept my application for KnightMare Chess Club Group Lessons: $225.00 for 12 weekly group lessons.

2.2

Please accept my application for KnightMare Chess Club Open Play: $175.00 for 19 open play sessions.

Student's Contact Information:
3.1

Street Address (line 1):

(Residence Address)
3.2

Street Address (line 2):

3.3

City:    State:   Zip Code:

(Enter State name here, if it's not listed in the drop down menu, above.)
3.4

Home Telephone:

 Example: 614-456-7890
Parent's or Guardian's Contact Information:
4.1  
First Name
Middle Initial
Last Name
4.2

Day Telephone:

Example: 614-456-7890
4.3 Evening Telephone:

Example: 740-456-7890
4.4

e-mail Address:

United States Chess Federation (USCF) Information:

5.1

Is the student a USCF Member: 

5.2

USCF ID#:

USCF Chess Rating:
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Comments/Questions?

Mail Application(s) to:

6.1

The KnightMare Chess Club
Post Office Box 09726
Columbus, Ohio 43209-0726

Telephone: 614-231-9591
Fax: 614.231.9592
e-mail: ChessMaster@ChessLearn.com

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The Chess Learning Center
 Post Office Box 09726
Columbus, Ohio 43209-0726
Telephone: 614-231-9591  *  Fax: 614.231.9592
e-mail: Info@ChessLearn.com
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