Clone of 2025 Camp Registrations ……………Northwest Church (year 2) ....….…. (1 student)

2026 Summer Super Chess Camps!

1 Student Registration Form ..... All Camps Use This Form 10th Year Providing Great Chess Camps!!!
Student Name:

First NameLast Name
Upcoming Grade:
School:
Gender:
Parent Name:

First NameLast Name
Parent Email:
Parent Phone Number:
Format: (000) 000-0000.
Parent Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Any allergies, or special concerns we should know about.
Coach's Name: (optional)
Has your child played in a chess tournament before?
These Chess Camps Include a Standard 4 Round Tournament:

Entry Fee for this Tournament ... is included in the camp fee.

1). Unrated Section:

Campers playing in this section do not need a US Chess membership.

2). US Chess Rated Section:

Campers playing in this section must have a current membership with the US Chess to participate.

If you do not have a membership ID, please go to their website www.USChess.org and click on the join tab.

Student memberships are $24 and are good for 12 months of tournaments.
What Section Do You Want Your Student to Play In?
US Chess Membership ID Number (if playing in the rated section):
These Chess Camps Include a FUN Blitz Tournament:

Directed by Coach James Alton...

The 2021 Florida State Scholastic BLITZ Champion!

Entry Fee for this Tournament ... is included in the camp fee.

(Optional Event) Players do not have to play if speed play gets them nervous!

Players ... will receive $2 to $10 for participating.
Parent agrees to provide lunch for their child
Camp Pick-up is 3:30 ... Please list persons authorized to pick-up your child:
How did you hear about these camps?
Any additional information you would like to provide:
Safety/Health Policy:

- All students will be supervised by an adult staff member at all times.

- We will have full use of the Church building and grounds ... No other adults will be on grounds during camp hours.

- All adults have a level 2 background check.

- Hand sanitizer bottles are placed at multiple tables

- No sharing of drinks or food is allowed
PARENT HEALTH WAIVER - My child is healthy and able to participate in this camp
Agree to Sign a Liability Waver (waver signing will be on the 1st day of camp)
Cancellation Policy:
A cancellation fee of $75 will be deducted from the amount refunded if cancellation is made more than seven days in advance of the first day of camp. No refunds are given if cancellation is made less than seven days before the first day of camp. Our camps are small and do fill up; we want them available to as many students as possible. We understand that situations do come up; we will try to work with you. Communication is key. Thank you for your understanding.
Do you need extended care for your child?
Extended care for your child is extra $10-15 for morning and $10-15 for afternoons. Please tell us what you need? Payment is separate from camp registration.
"Chess Makes Kids Smart, We Make it Fun!"

2026 Camps - 4 different one-week camps offered:
Please select as many camps you are interested in for your child.

This form is for 1 child registration. All camps are 5 days.

Camp Location ....

Northwest Community Church

14913 Hutchinson Rd

Tampa, FL. 33625
Chess camps will sell out! Only 25 Students!

Camp #1 ....... June 1st - 5th ........... FULL/CLOSED

Camp #2 ....... June 8th - 12th ........... FULL/CLOSED

Camp #3 ....... June 13th - 17th ......... FULL

If your child cannot attend Week 4 and would like to attend Week 3, please TEXT COACH KRISTA at 813-727-9007. We may be able to fit you in.

Camp #4 ....... July 20th - 24th ........... OPEN

Buy 1 week camp for $365
Notation Books:

Chess Camp will teach notation every day at camp.

Students need to bring their Chess notation book to camp or purchase a notation book from the coaches.

Notation Book ...... Soft Cover ................ $5

Notation Book ...... Hard Cover ............... $10

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Week 4 ... July 20 - 24

$365.00

Buy Chess Notation Book ... Soft Cover

Book delivered at 1st day of camp

$5.00

Buy Chess Notation Book ... Hard Cover

Book delivered 1st day of camp

$10.00

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Which multiple camps are you purchasing? EXAMPLE: Weeks 1 and 3
Please Contact System Administrator

Please Contact Tournament Director - Krista Alton @ kristaalton@yahoo.com
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2026 Summer Super Chess Camps!

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Please Contact System Administrator

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