Registration Form

REGISTRATION FORM

September 8-12, 2024

(Arrive on Sunday, Sept. 8 Classes Sept. 9-12)

NAME________________________________

ADDRESS_____________________________

CITY_________________________________

STATE & ZIP__________________________

HOME PHONE & CELL__________________

____________________________________

EMAIL_______________________________

EMERGENCY CONTACT & PHONE

_____________________________________

LIST SPECIAL NEEDS (FOOD ALLERGIES ETC.)

________________________________________

4 DAYS * M-T* Sept. 9-12

1.________________________________________________

2.________________________________________________

3.________________________________________________

4.________________________________________________

Make Checks Payable to:

PORCELAIN ART SCHOOL OF INDIANA

Send $75 non-refundable deposit

(or full tuition) and this registration form to:

CJ Laster

6950 W. Arrowhead Dr.

Frankfort, IN 46041