MID-SOUTH CHESS CAMP IN MEMPHIS "THE PREMIER CHESS CAMP OF THE SOUTH"

CAMPER'S REGISTRATION FORM

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5 day camp	Commuter lunch	Residential: Includes housing, all meals, evening activities, transportation
Evening activities for commuter students	Precare	Aftercare

Assumption of risk and release of liability: The undersigned parent, guardian, or adult in consideration of participating in Mid-South Chess Camp agrees to hold harmless said Camp and its representatives and employees and releases same from any and all liability for any injury suffered by the participant named herein, arising or connected with said Camp and parent, guardian, or adult assumes all risk of any injury.

Date:           Signature: ______________________________

Camper/Parent or Guardian of Camper

PLEASE MAIL COMPLETED REGISTRATION FORM, MEDICAL FORM, AND CHECK PAYABLE TO: MID-SOUTH CHESS 1614 VANCE AVE. MEMPHIS, TN 38104

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TUITION:      $375 by May 1st;      $395 after May 1st;      $425 at the door. DEPOSIT:      A $100.00 holds your spot and is applied to tuition. TUTION INCLUDES:      Camp T-Shirt, Trophy, Group Photo, Autographed Certificate, Daily Souvenir, and Entry to the rated or unrated Scholastic Section of our June 16th Open & Scholastic Tournament. COMMUTER LUNCH:      $40 (payable to Lausanne School). RESIDENTIAL CAMPERS:      $250.00 additional covers all meals, all in-home lodging, all transportation, airport pick-up and return, evening sports and chess activities with our titled players (includes Friday if staying to play in our June 16th tournament). COMMUTER CAMPERS:      $100.00 additional for evening sports and chess activities with our titled players. PRECARE/AFTERCARE:      Call (901) 276 4663 or email midsouthchess@hotmail.com for more information.