Orchard Valley Ceramic Arts Guild

OVCAG Workshop Registration Form

To register for a workshop, complete the following form, print it, and mail it with your check to:

OVCAG Pitfire Workshop
c/o Sue Vincent
180 Brahms Way
Sunnyvale, CA 94087

The fee for this workshop is $25 for OVCAG members and $35 for non-members. Persons under 16 may attend the workshop with approval of the workshop coordinator, and with parental supervision.

OVCAG Members	Item Name: OVCAG Pitfire Workshop Item Number: Pitfire_26_Aug_2006_Mbr Price: $25
Non-members	Item Name: OVCAG Pitfire Workshop Item Number: Pitfire_26_Aug_2006_NonMbr Price: $35

Registrations are not complete until the workshop chairman receives a signed copy of this registration form, and a check for the total amount of the workshop (including material fees, if any). Please allow adequate snail mail time! Refunds for this workshop will be made only if the workshop chair receives your cancellation three weeks prior to the workshop date. See our refund policy for details.

Workshop Name:	Pitfire on the Beach	Date: August 26, 2006
First Name:		Last:
Address:
City:		State: Zip:
Phone:
E-mail:
	Are you an OVCAG member ? YES NO

PARTICIPANT LIABILITY RELEASE:

I, the undersigned or parent/guardian of the individual named above do hereby agree to allow the named individual to participate in this activity, and I further agree to indemnify and hold harmless the Orchard Valley Ceramic Arts Guild and its members, officers and agents, the instructor(s) of this workshop, and the owner(s) of the premises, from and against any and all liability, save and except for their sole negligence, for injury associated with the named individual’s participation in this activity. I understand that participation in this activity may involve exposure to chemicals and materials known to be hazardous. I further agree to the use of the aforementioned individual’s photograph for program publicity.

Check the appropriate box:

Participant (18 or over)

Parent or Legal guardian

Signature:

Date: