Entries close 8 October 2010
School (if applicable)
Address: Contact person:
Phone:
Fax:
Email: (If supplied you will receive a copy of your form as a receipt)
Names (one per line):
Name M/F age,
Total number of entries:
GST receipt required? Yes No
After submitting your entry, payment of $3.00 per entrant can be sent on one cheque to:
'Chess Entries' Hastings Sports Centre, Private Bag 9002, Hastings 4156
