Orchard Valley Ceramic Arts Guild

OVCAG Workshop Registration Form

To register for the Pit Fire on April 7th 2007, complete this form, print it, and mail it with your check (or if paying by Paypal simply send the form) to:

OVCAG Pitfire 04.07.07
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 pitfire with approval of the pitfire coordinator, Sue Vincent, and with parental supervision.

OVCAG Members	Item Name: OVCAG Pitfire Workshop Item Number: Pitfire_07_Apr_2007_Mbr Price: $25
Non-members	Item Name: OVCAG Pitfire Workshop Item Number: Pitfire_07_Apr_2007_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. Please also make sure that you complete and return a Photo Release form with your application.

Workshop Name:	OVCAG Pitfire 04.07.07	Date: April 7, 2007
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: