Chess Camp
Registration Form

Name: _________________________________________________

School: _________________________________________________

Grade: __________________         Age: _______________________

E-mail: _________________________________________________

Phone: _________________________________________________

Address: _______________________________________________

Camp Date: __________________    Location: _________________

Check One:     AM: ______          PM: _______          

Check #: ______________         Amount Enclosed: $______________

Mail this completed registration form and check to Sal Chehayeb   
P.O.  Box 99432    Troy, MI  48099-9432

Questions?  Call (248) 219-5624.  I'll be happy to help!

Space is limited, so please register ASAP!