HOUSTON CHESS CLUB MEMBERSHIP FORM

Check ONE: NEW or RENEWAL

Name: _______________________________________

Address: _______________________________________

City: _______________________________________

State: ________

Zip: __________

Phone: ________________________________

Cell: ________________________________

Email Address: _______________________________________

MEMBERSHIP LEVEL

	ADULT (1 YEAR): $150.00
	ADULT (6 MONTHS): $90.00
	ADULT (3 MONTHS): $60.00
	SENIOR (1 YEAR)): $100.00 AGE 60 OR OLDER,
	SENIOR (6 MONTHS): $70.00 AGE 60 OR OLDER,
	COLLEGE (WITH ID, 1 YEAR): $100.00 WITH ID
	COLLEGE (6 MONTHS): $70.00 WITH ID
	JUNIOR (1 YEAR): $80.00 AGE 18 OR UNDER
	JUNIOR (6 MONTHS): $50.00 AGE 18 OR UNDER
	PARENT (1 YEAR): $100.00 NON-PLAYING
	PARENT (6 MONTHS): $70.00 NON-PLAYING
	FRIEND (1 YEAR): $100.00 NON-PLAYING
	FRIEND (6 MONTHS): $70.00 NON-PLAYING

I AGREE TO ABIDE BY THE RULES AND POLICIES OF THE HOUSTON CHESS CLUB. I UNDERSTAND THAT MEMBERSHIP FEES ARE NON-REFUNDABLE.

SIGNATURE: ___________________________________________

DATE: ____________________

If applying for a Junior Membership, application must also be signed by a parent. Parent – you are responsible for the behavior of your child and understand that he or she must abide by the rules and policies of the Houston Chess Club.

SIGNATURE: ___________________________________________

DATE: ____________________