Diana Tulman
  28 Canterbury Lane
  New Milford, NJ 07646





2010 Summer Camp Half Day
6/28–7/2; 7/5–7/9; 7/12–7/16; 7/19–7/23; 7/26–7/30; 8/2–8/6; 8/9-8/13; 8/16-8/20; 8/23-8/27 We promise 5:1 student - teacher/instructor ratio, prizes and trophies for tournaments and competitions, camp T-shirts and FUN!

ENTRY FORM
First Name:  Last Name:  Date of Birth: 
Home address: 
City:  State:  ZIP: 
Mother's Name:  Phone #: 
Father's Name:  Phone #: 
Home phone #:  E-mail:  USCF rating: 
Emergency Contact: 
Weeks' numbers: 1  2  3  4   5   6   7   8   9  Please check the week(s) number(s)
TOTAL ENCLOSED $________


Check should be made out to International Chess Academy
Mail the registration form and check to
Diana Tulman, 28 Canterbury Lane, New Milford, NJ 07646