CSC Series Online Entry Form 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 Parent/guardian name * Street Address * 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 * Having your contact information enables us to communicate with you if we have any question about your entry and to notify you if there is any change regarding the tournament. Primary phone number with area code * Secondary phone number with area code Primary email address * Secondary email address PLAYER INFORMATION Last name (and suffix, e.g., Jr, III) * First name and middle name/initial * Date of birth (month/day/year) * Sex * FemaleMale Grade * K 1 2 3 4 5 6 7 8 9 10 11 12 Select the player's grade for the 2019-20 school year, or grade equivalent for home-schooled players. USCF membership status * USCF membership is required to play in any rated section (that is, any section except the K-6 Non-Rated section). To purchase or renew a USCF membership as part of this entry, complete the USCF MEMBERSHIP INFORMATION section below. Current Active MemberNeed to Renew MembershipNeed New MembershipNot necessary (playing in Non-Rated section) USCF ID Enter the player's USCF ID if he or she has one; otherwise enter "none". USCF membership expiration date If the player is a USCF member, enter the membership expiration date here; otherwise enter "n/a". Section * Check only one section. You may change sections for any future tournament provided that you meet the rating requirement of the section you want to move into. ChampionshipU1000U700U400K-6 Non-Rated Tournaments and Entry Fees * Registration for the December 7 tournament at Lakota West is now closed. Jan 11, 2020: Walnut Hills HS - $15Feb 1, 2020: Lakota East HSMar 7, 2020: Princeton HS Bye request * You may take one half-point bye in each tournament. If you take more than one bye in any tournament, any bye after the first will be a zero-point bye. If you do not want to request any byes, please enter "none" in the text box below. If you want to take a bye in any tournament(s), enter for each bye you are requesting (1) the tournament's month and (2) the round(s) for which you want a bye. For example: Oct rd 4, Jan rd 1. Please note that you can request or cancel a bye at any time up until the pairings are posted for the bye round. Additional Information If there is any other information you want to provide with your registration, please enter it in the textbox below. USCF MEMBERSHIP PURCHASE OR RENEWAL If you are purchasing or renewing a USCF membership as part of this entry, select the membership type here. Select desired USCF membership option Premium Young Adult - 1 year: $35 Premium Young Adult - 2 years: $65 Regular Young Adult - 1 year: $26 Regular Young Adult - 2 years: $48 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 Premium memberships include a subscription to Chess Life or Chess Life for Kids. Regular memberships include only online access to Chess Life or Chess Life for Kids. Whether paying for one year or two years, Young Adult members must be 25 years old or less at the expiration of the selected membership term, Youth members must be 16 years old or less, and Scholastic members must be 13 years old or less. TOTAL PAYABLE Please note that this charge will show up on your statement as “PayPal Chess Fee” or “PayPal Chess Fee CSC”. WAIVER AND SIGNATURE I (Parent/Guardian) understand that these chess tournaments are not organized or sponsored by the host school. I acknowledge that the organizers of these tournaments 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 them. I understand that the tournament director(s), tournament organizer(s), school officials, and the Board of Education 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. Phone number for emergency contact * Alternative phone number for emergency contact Signature * A parent's/guardian's 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.