ALL SECTIONS OPEN FOR REGISTRATION

Date: 22 June - 23 June 2019

Venue: Proteaville Recreational Centre Bellville South

Map: https://goo.gl/maps/EuNcYjWELspyiwh8A

BANK DETAIL
Bank: Capitec Bank
Account Name: Elsies River Chess Club
Account No: 1578979151
Branch: Parow Center
Branch Code : 470010
Account Type: Savings Acc

Please email proof of payment and direct any payment queries to Marc Petersen: elsiesriverchessclub@gmail.com

Please answer all the questions & complete one form per player.

Event *
Section *
Please select the relevant playing section.
First Name(s) *
Your answer
Surname *
Your answer
Gender *
Residential Area *
In which area or suburb do you live? eg Rondebosch? Parow? Grassy Park? Athlone? Stellenbosch?
Your answer
E-Mail Address *
Your answer
Cell Phone Number *
Do not type hyphens or spaces.
Your answer
Landline
Do not type hyphens or spaces.
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Current School or Tertiary Education *
Enter the name of your current school or university under "Other" below.
Payment *
Player Specific Payment Ref # Used or To Be Used *
Please use the player's first 3 letters of the player’s surname + initials, followed by date of birth in the format of DD MMM YYYY, as the reference number. (e.g. SmiJ23Jan1973 or KasG17Nov2001)
Your answer
Payment Amount Paid or To Be Paid *
Please do NOT type R for Rands • Simply type the number
Your answer
Payment Description
Please take a moment to describe what payment was made for (in words), which will help us identify deposits.
Your answer
Comments
Please indicate if you will be absent for any rounds • Also indicate anything further which you feel we should know about, including disabilities.
Your answer
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