THE LOS ANGELES CLUB 11514 Santa Monica Blvd. LA, CA 90025 (The Most Active Chess Club on the West Coast)

Date: ______CLUB MEMBERSHIP (Required for class attendees – optional for tournament players)

 New  Renewal (circle membership type and amount)

PLATINUM GOLD SILVER BASIC Membership (basic+24) (basic+12) (basic+6) (1 free annually) Adult $715 $545 $445 $345/ $225/ 6 mo. / Senior $695 $525 $425 $325/ $195/ 6 mo. Family (all) $995 $825 $725 $625/ $375 6 mo. Life $2,375 $2,195 $2,095 $2,000 Family Life $3,875 $3,695 $3,595 $3,500 Membership comparison 10 membership benefits - see club brochure V V V V

BASIC => Membership + 1 free tourney V SILVER => Basic Membership + 6 tourneys V GOLD => Basic Membership + 12 tourneys V

PLATINUM => Basic Membership + 24 tourneys V Tournament Packages LACC members non- lacc 6 tournaments (1 free) (Major events count as 3) $100 $150 12 tournaments (2 free) (Major events count as 3) $200 $300 24 tournaments (4 free) (Major events count as 3) $380 $600

USCF MEMBERSHIP (Required for tournament players only)

 New  Renewal (circle membership type and amount) TYPE 1 Yr 2 Yrs  Adult $49 ($40) $95 ($75) (incl. 1 monthly Magazine) (CL Online only)  Prem. Young Adult (U25) $35 ($26) $65 ($48) (incl. 1 monthly Chess Life Magazine) (CL Online only)  Prem. Youth (U16) $30 ($22) $55 ($40) (incl. 6 bi-monthly Chess Life issues) (CL Online only)  Prem Scholastic (U13) $25 ($17) $45 ($30) (incl. 6 bi-monthly Chess Life for Kids) (CLFK Online only)  Family Plan I $80 Parents+children <24 (incl. 1 monthly Chess Life Magazine)  Family Plan II $50 Children <24 only (incl. 1 monthly Chess Life Magazine)  Senior (65+) $40 $75 (incl. 1 monthly Chess Life Magazine)  LIFE $1,500 (incl. 1 monthly Chess Life Magazine)  2 mo. $20 ------

Member Name ______Member’s DOB ______/______/______Guardian’s name ______USCF ID Number (if any) ______Address______Exp Date ______

City/State______Zip ______Rating ______Phone ( ______) ______- ______School (if scholastic) ______Email ______@______(over) Age/Grade ______/______FEES Membership Benefits

LACC Membership $ _____ 1. Free class attendance (3 levels)

st 2. Tournament discounts (1 one free)

USCF Membership $ _____ 3. Free casual games

Tournament Entry Fee $ _____ 4. Library access (free book checkouts)

 Saturday or Sunday G/60 $30/$20 $ _____ 5. Monthly club emails  Sat / Sun Juniors G/30 $30/$20 $ _____ 6. Free special events & movies  Saturday& Sunday G/60 $55/$35 $ _____ 7. One free  Saturday Nite Blitz G/5 $20/$15 $ _____ 8. Discounted USCF memberships/Renewals  2-day Memorial Tourney $75/$55 $ _____ 9. Free tournament on your B/D week 10. Free Q&A on all chess topics Private Lessons $ _____

 5-Hour Package - Club $790  5-Hour Package - Club $395  5-Hour Package - Offsite $890  MASTER’S RATES  5-Hour Package - Offsite $445  NON-MASTER’S RATES  10-Hour Package - Club $1,490  10-Hour Package - Club $745  10-Hour Package – Offsite $1,590  10-Hour Package – Offsite $795

Chess equipment $ _____

TOTAL $ ______

I agree and abide by the rules and policies of the Los Angeles Chess Club. I understand that membership and private lessons fees are non-refundable after 7 days.

Signature (Member/Guardian) ______Date ______

payment  CASH ➔ (5% off – applies to club memberships and private lessons)

➔ (3% off - To: LA Chess Club – applies to club memberships and private lessons)  Visa  Master Card  AMEX

Credit Card No. ______-______-______-______Exp ______Code ______

Print Name ______Signature ______(as it appears on the card)

Telephone ______Billing Zip Code ______

Correspondence: LA Chess Club P.O. Box 251774, Los Angeles, CA 90025 Information: Mick Bighamian (Director) (310) 795-5710 or [email protected] ALL THE INFORMATION PROVIDED WILL BE STRICTLY CONFIDENTIAL, HELD PRIVATE & USED ONLY BY LACC. Rev 08/18