Galway Chess Congress – Entry Form

 

 

Name:            _______________________________________________________

 

Address:        _______________________________________________________

 

Phone:           _______________________________________________________

 

Email:            _______________________________________________________

 

Date of Birth:   _______________________________________________________

(if under 16)

 

Club:             _______________________________________________________

 

Rating:          ___________________ ICU No:  ___________________________

 

Section:         _______________________________________________________

 

 

 

 

 

(print this page and send it to the above address)