Liga Catur: SAKTI RUSMAN NATHANAEL TOFIK 1 : USCF Registration

Tournament Date: Sunday, July 03, 2022 (4:27 AM - 4:27 PM)

Register a new K-12 Player

This form is to register a K-12 player who later can be submitted to USCF by club/center using voucher.

Referred By	:
Title (Examples: Dr, Lt)	:
First Name and Middle Name	:
Last Name	:
Suffix Name (Examples: Jr, III)	:
Gender	:	Male Female No Response
Date Of Birth	:
Address (Line 1)	:
Address (Line 2)	:
City	:
State/Zip Code	:
Email	:
Phone	:
Registered By (your name/parent/coach/TD)	: