US Chess Memberships (Click here ONLY if MD Chess emailed you separately. Otherwise, purchase within tournament registration.)

Purchaser's Name (Last, First) *

Purchaser's Email Address *

Player's First Name & Middle Name or Middle Initial *

Player's US Chess Membership ID # (Enter "none" ONLY if the player has never had a membership) *

Player's First Name & Middle Name or Middle Initial *

Player's Last Name *

Date of Birth (ALL 8 numbers: mm/dd/yyyy: 12/31/1999) *

US Chess Membership Type (player’s age during tournament) *

ages 1 - 12, $17, Scholastic: Regular (12 months), Chess Life for Kids (online) [UN1]

ages 1 - 12, $25, Scholastic: Premium (12 months), Chess Life for Kids (6 issues) [U1]

ages 13 - 15, $22, Youth: Regular (12 months), Chess Life for Kids (online) [YN1]

ages 13 - 15, $30, Youth: Premium (12 months), Chess Life for Kids (6 issues) [Y1]

ages 16 - 24, $26, Young Adult: Regular (12 months), Chess Life (online) [JN1]

ages 16 - 24, $35, Young Adult: Premium (12 months), Chess Life (12 issues) [J1]

ages 25 - 64, $40, Adult: Regular (12 months), Chess Life (online) [RN1]

ages 25 - 64, $49, Adult: Premium (12 months), Chess Life (12 issues) [R1]

ages 65+, $40, Senior (12 months), Chess Life (12 issues) [E1]

Gender *

Male

Female

Unknown / Not Available

Address 2

Address *

City *

State *

Zip Code *

Are you a K-12 MD resident rated 1400+ who wants to be invited to the annual Maryland Sweet 16 in March? See MDChess.com for more details. *

No

Yes

Coupon

Amount

$

Discount Amount

$

Gross amount

$

Payment Method

Paypal

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

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