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Interprovincial 2016 Registration form
Bank details for payment of entry fees:
ABSA
Cheque account: 4062132762
Branch Code: 500902
Put the players name as reference and email to
ncchess.secretary@gmail.com
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* Indicates required question
Name
*
Your answer
Surname
*
Your answer
ID Number
*
Your answer
Age Group Team
*
u8
u10
u12
u14
u16
u18
u20
Adult
Parent/Gaurdian Contact No 1
*
Please not the school's number!
Your answer
Parent/Gaurdian Contact No 2
*
Please not the school's number!
Your answer
email address
*
Not the schools email address if possible
Your answer
Special Dietary requirement
Your answer
School/Town
*
Your answer
Payment
*
Entrance/registration fee is R260 per player. This fee must be paid into the account number on the top of the page. This must be done before 26 April 2016 and is NON refundable in case of late withdrawals. Note that player should also be registered and Affiliation fee paid for 2016
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