WORKSHOP REGISTRATION FORM: 
Print, fill in, sign and mail this form with your deposit. Sorry e-Mail registrations are not
accepted.
Use this registration for:
ANASAZI POTTERY at MESA VERDE: Ancient Culture Through Pottery- June 16-21 2008
|
Registering for: |
ANASAZI POTTERY at MESA VERDE 6/16-21 2008 |
| Name: | |
| Address: | |
| City State Zip: | |
| Phone: | |
| E mail: | |
| Occupation: | |
| Clay experience/ability level: | |
| Workshop T-shirt |
M L XL (circle one) |
| How did you learn about this course? | |
| Will you take this course for college credit? $45 per credit hour collected at workshop. |
Yes No |
| Mesa Verde Workshop FEE: $395 | |
| Enter applicable Early Bird or Group rate | |
| Enter CAMPING FEE to camp at Workshop Site: $40 per person (2 maximum) | |
| Subtract DEPOSIT*: $100 | |
| SUB TOTAL: $ | |
| BALANCE DUE** : $ Due by May 17 for Mesa Verde Workshop |
Ancient Arts® has permission to use any photos taken of me
during the workshop for educational or promotional purposes. As a participant I understand that I am solely
responsible for any illness or injuries that I may incur during the workshop and that I am
responsible for all resulting medical costs or other expenses.
Participant Signature
and Date (required):________________________________________________________________
Date_________________
REGISTRATION IS INCOMPLETE WITHOUT DEPOSIT
and
SIGNATURE
*Your deposit/tuition is refundable less a $50.00 administration
fee if written cancellation notice is emailed or postmarked 45 days prior to the scheduled
workshop. After that it is non-refundable unless the workshop is canceled or your space can be
resold.
**Balance is due in full
by May 17, 2008 or you may lose your deposit and forfeit your space.
Lodging and meals are not provided. Limit one non-participant companion per paid registrant.
No children or pets please.
Upon receipt of the registration form and deposit, you will receive an
email course schedule, map
and other related information as workshop nears and it becomes available.
We look forward to seeing you soon...
Please mail completed registration form and payment payable to:
Gregory Wood
Ancient Arts® P.O. Box 27 Masonville,
CO 80541