Pottery Classes Registration Form

Antje's Pottery

519.664.2372

email: info@antjespottery.com

4 High Crest Lane W.

St. Jacobs ONTARIO CANADA N0B 2N0

NAME:__________________________________________

ADDRESS:_______________________________________

Home Phone:_________________________ Business Phone:___________________________

Check Course Selection

ADULT CLASSES ($ 150.00 + HST)

Monday 7 pm - 10 pm_______

Tuesday 7 pm - 10 pm_______

Thursday 7 pm - 10 pm_______

 

CHILDREN CLASSES ($ 95.00 + HST)

Wednesday 5 pm - 7.30 pm______

FEE : ___________HST 13%_________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 :__________________

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