First Name: *
Last Name: *
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Address: *
Date of Birth: *
Gender: -Please Select-MaleFemaleOtherPrefer not to say
Age Confirmation: * -Please Select-I am 18 or olderI am under 18
Joining as: * -Please Select-New to ChessReturning PlayerExperienced Club PlayerTournament Player
Members under the age of 18 must have this section filled out.
Parent/Guardian Name:
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I confirm I am the parent/guardian and consent to this membership application
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