tel. 203-323-2222
fax 203-406-9999
studio@lakesidepottery.com
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543 Newfield Avenue, Stamford, CT 06905
* required information
2010 REGISTRATION FORM
TO ENROLL
:
Please
fill
in this form,
print
&
mail with a check
(made to Lakeside Pottery) to the address above
Press "Tab" to go to the next field
*
Program Name:
8 wk adult, 8 wk children, camp or workshop
-
Classes Info
*
Start Date /Time:
Example: Sat 9/8/10 / 10:00AM
--
To Calendar
Program Fee:
Adults or Children 8 wk program = $340; 6 wk program = $255; 1 wk camp = $275
Tool-set:
Please pay $20 now if don't have a
tool-set
T-shirt
(optional)
:
$20 - Lakeside Pottery T-shirt w/ print in front & back. (call or e-mail for color)
Enclosed check #
Paid with
charge card
*
TOTAL:
Student's Informations
Second Student
*
Student Name:
Name 2:
*
Street:
How did you hear about us?
Street:
*
City/State/Zip:
Children's Programs Info:
*
Phone - Day:
*
Kid's Age:
Allergies:
*
Phone - Eve:
*
Parent name:
*
E-mail:
Comments:
Cancellation:
Lakeside Pottery LLC reserves the right to cancel, combine, or reschedule classes in order to adjust for enrollment. The min. number of participants needed to establish a class is six. If Lakeside Pottery cancels a class due to insufficient enrollment, registered participants will be informed and given the opportunity to register for another class. If participants do not want to transfer, a full refund will be given. Tuition is refundable only with at least two weeks notice before the start of class.
Missing Class Policy
SIGNATURE:
DATE:
I read the above
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THANK YOU
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