2018 Ohio Elementary Championships Online Entry If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Information requested on this form is for the exclusive use of Cincinnati Scholastic Chess and, as applicable, the US Chess Federation. Cincinnati Scholastic Chess will not give, sell, or make available this information to any other organization or individual except as required by law. CONTACT INFORMATION Having your contact information enables us to communicate with you if we have any questions about your registration and to notify you if there are any changes regarding the tournament. Parent/guardian name * Street address or PO box * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip code * Phone number with area code Email address PLAYER INFORMATION You may register only one player on this form. If you have more than one player to register, you will need to complete and submit this form once for each player. Last name (and suffix if any, e.g., Jr, III) * First name * Middle name or initial Sex * FemaleMale Date of birth (m/d/y) * 2017-18 school grade * K 1 2 3 4 5 6 School/home schooling organization (name) * Enter the complete name of the player’s school or home schooling organization and (below that) the city where it is located so that players from the same school playing in the same section can be correctly identified and compete as a team for a team trophy. School/home school location (city) * Section * K-6 ChampionshipElementary Premier 4-6 U700Elementary Reserve 4-6 U400K-3 ChampionshipPrimary Premier K-3 U500Primary Reserve K-3 U300 USCF membership status * A current US Chess Federation membership is required to play in any section for grades K-6 or 4-6. USCF membership is optional for all sections for grades K-3. A USCF membership can be purchased or renewed by selecting a membership option below. Players choosing to play in a K-3 section without a USCF membership must select the Junior Tournament Player option. Current active memberRenewing membershipPurchasing new membershipJunior Tournament Player USCF ID number * Players who have a current or expired USCF membership or who have played previously under the JTPP are required to provide their eight-digit USCF ID number. This can be found on the player’s membership card or chess magazine mailing label, or online at www.uschess.org/Ratings/Player-Rating Lookup by searching on the player’s name. If the player has no USCF ID number, enter “New”. USCF Membership Option Premium Youth - 1 year: $30 Premium Youth - 2 years: $55 Regular Youth - 1 year: $22 Regular Youth - 2 years: $40 Premium Scholastic - 1 year: $25 Premium Scholastic - 2 years: $45 Regular Scholastic - 1 year: $17 Regular Scholastic - 2 years: $30 If purchasing or renewing a USCF membership, select the desired membership option. Premium memberships include a subscription to Chess Life (Youth) or Chess Life for Kids (Scholastic). Regular memberships include online access to the applicable magazine. Whether paying for one year or two years, Youth members must be 16 years old or younger at the expiration of the membership, and Scholastic members must be 13 years old or younger at the expiration of the membership. USCF memberships always expire on the last day of the month of purchase one or two years later. For example, a two-year membership purchased on June 10, 2017 will expire on June 30, 2019. Byes requested Players may take one half-point bye in rounds 1-4. Half-point byes are optional; most players take no byes. If more than one box is checked, we will assign half-point byes for the first round selected, and a zero-point bye for each later round selected. No half-point byes are permitted for round 5. A player who does not want to play round 5 must withdraw from the tournament, with notice to a tournament director, before round 5 pairings are posted. Round 1Round 2Round 3Round 4 CLOSING INFORMATION Total Payable Please note that this charge will show up on your statement as “PayPal Chess Fee” or “PayPal Chess Fee CSC”. Additional Information If there is any other information you want to provide with your registration, please enter it in the textbox below. I (Parent/Guardian) understand the organizers of this tournament will take all reasonable precautions customary and usual to conducting such tournaments, and beyond this I assume any risk associated with my child’s participation in it. I understand that the tournament directors, tournament organizers, the host venue and its staff are not to be held responsible in case of accident, and I agree to hold same harmless in the event of accident. In the event of a medical emergency, I hereby authorize emergency medical treatment for my child (if deemed necessary by a physician) if I am not at the tournament site and cannot be reached at the telephone number(s) listed below. Mobile phone number for emergency contact Other phone number for emergency contact Signature * Parent/guardian name here indicates acceptance of waiver and authorizes submission of this entry form. Click on the button below to submit your tournament entry and proceed to the payment page.