Pottery Classes Registration Form
Antje's Pottery
519.664.2372
FAX 519.664.3082
4 High Crest Lane W.
St. Jacobs ONTARIO CANADA N0B 2N0
NAME:__________________________________________
ADDRESS:_______________________________________
Home Phone:_________________________ Business Phone:___________________________
Check Course Selection
ADULT CLASSES ($ 150.00 + GST) Monday 7 pm - 10 pm_______ Tuesday 7 pm - 10 pm_______ Thursday 7 pm - 10 pm_______ |
CHILDREN CLASSES ($ 95.00 + GST) Wednesday 5 pm - 7.30 pm______ |
FEE : ___________GST 7%_________TOTAL : ______________
Make all Cheques payable to Antje's Pottery,please no postdated cheques.
ANTJE's POTTERY reserves the right to cancel any course due to insufficient registration.
A full refund will be made,if ANTJE's POTTERY has to cancel the course.
I hereby release ANTJE's POTTERY from all claims for damages or loss arising
from any accident or injury which are caused or arise from participation in any pottery program.
SIGNATURE:__________________________________________ DATE :__________________