Event Services & Camps - Ceramics Class Registration

Community Ceramics Class 2018

CLASS REGISTRATION

Ceramics Class 2018

*First Name
*Last Name
*Home Address
*City
*State
*Zip Code
*Email Address


Parent/Guardian Information (If under 18)

Parent/Guardian Name
Relationship to participant
Phone Number ### ###-####
HomeWorkCell
Contact person must have authorization to make medical decisions for class participant.

*Name
*Relationship to participant
*Phone Number ### ###-####
HomeWorkCell


Program Waiver

Covers:

I have read the waiver and I fully understand the contents, meaning and impact of this release.

Please note: Choosing yes and submitting this form serves as your electronic signature and applies to all class participants.

*I agree to the above. Yes


Payment


We're also wondering...
How did you hear about this class?

Please provide further explanation. If you picked up a class brochure, tell us where.

If "Other," specify.







This registration cannot be processed without payment in full.

After submitting this form you will directed to our secure online payment gateway where you can pay the registration fee.

OFFICE OF EVENT SERVICES & CAMPS

Event Services | 700 Terrace Heights #47 | Winona, MN 55987-1399 USA
800-635-5987, Ext 6921 | 507-457-6921 | eventservices@smumn.edu | www.smumn.edu/camps