Pottery Class Registration with payment

Pottery Class Registration Form - 7 Weeks

Jenanne Longman Ceramic Studio Liability Waiver and Emergency Contact Form
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

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CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Which session of classes were you interested in? (please check one)

Beginner, Tuesday Evenings,Jan 14- Feb 25, 6:30-8:30pmIntermediate - Thursday Evenings, Feb 20- April 3, 6:30-8:30pmBeginner, Wednesday Evenings, Feb 26 - April 9, 6:30-8:30pm
Phone Number

Area CodePhone Number
Emergency Contact Name
Emergency Contact Phone #
Class Cost

7 Week course sessions are $360 (+HST) which includes all materials and firings.

You can pay a $180 deposit through Paypal at the end of this form. (follow link after hitting "submit")
Or You can send an E-transfer to: jenanne.longman@gmail.com
Or you can mail a cheque to: 15 Credit St, Halton Hills, Ontario L7G 2W5

Payments are to be made to: Jenanne Longman

The remainding payment will be paid to the instructor on the first day of class.
RELEASE OF LIABILITY AND HOLD HARMLESS

Students taking classes hereby agree to be responsible for all or any injury, loss or damage, of every nature and kind whatsoever, to itself; the Student hereby releases and discharges Jenanne Longman and other studio members from any and all claims, actions, causes of actions, or demands which may arise as a result of the Student's use or occupation of the Jenanne Longman Ceramic Studio.
I acknowledge the inherent risks that may result from my participation in the class. Including falls, cuts, fractures, muscle pain. I hereby assume these risks, including those caused by negligence of the studio, and release all claims held by me and accept full responsibility for the cost of all medical treatment as a result of any injuries caused by or through risks. I further agree to indemnify and hold harmless Jenanne Longman and other studio members from any injuries, liabilities, claims, damages and expenses, including attorney fees, incurred by the studio, or myself with exception of gross negligence or reckless misconduct of the ceramic studio.

I have read all of the above terms and conditions and understand and agree to be bound by them.
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7 week Pottery Class Payment Deposit$180.00CAD

$360+ HST for 7 week class

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Subtotal $0.00CADTax $0.00CADTotal $0.00CAD

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Pottery Class Registration Form - 7 Weeks

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