Registration Form
The Bloomington Indiana Scholastic Chess Club (BISCC) is a 501 (c) (3) non-profit organization for young chess enthusiasts who are interested in competitive chess and skill building. In addition to chess skills, we also emphasize good citizenship, sportsmanship and leadership. BISCC is a USCF Affiliate.

Cost: $70/semester or $120 for the year. Each additional sibling: $40/semester or $80 for the year.

Make checks Payable to: BISCC

Mail checks to:
BISCC
PO Box 8422
Bloomington, IN 47407

Parent's/Guardian name(s) *
Your answer
Student 1 (Name, Grade, Relationship) *
Your answer
Student 2 (Name, Grade, Relationship)
Your answer
Student 3 (Name, Grade, Relationship)
Your answer
Home Phone
Your answer
Cell #1
Your answer
Cell #2 (If applicable)
Your answer
Email #1 *
Your answer
Email #2 (If applicable)
Your answer
EMERGENCY CONTACT NUMBERS (during chess club meeting) *
Your answer
MEDICAL, BEHAVIORAL OR OTHER IMPORTANT INFO: *
Your answer
Skill level (please check): *
USCF member? *
If yes, please provide USCF ID#
Your answer
Which session(s) will your child attend? *
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