Program Registration Form

Please use this form to send your registration information. One is not officially registered for a workshop until deposit is received. Please mail check or call the office with your credit card information.

Personal Information

Name: *

Address:

Address 2:

City:

State:

Zip Code:

Phone Number (Home):

Phone Number (Work):

E-mail address:

Participants

Number of Adults

Male:

Female:

Number of Children under 12

Male:

Female:

Housing Preference:

Cabin/House

Dormitory

Camping

Commuter

Transportation

How will you be traveling:

Driving

Train

Would Like a Ride?

If you can take passengers, how many?:

Additional travel info:

Financial Information

One is not officially registered for a workshop until deposit is received: *

I will mail a check

Call me for my Credit Card Information

Additional comments:

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Program Registration Form