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REGISTRATION FORM

September 10-14, 2023


(Arrive on Sunday, Sept. 10 Classes Sept. 11-14)


NAME________________________________


ADDRESS_____________________________


CITY_________________________________


STATE & ZIP__________________________


HOME PHONE & CELL__________________

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EMAIL_______________________________


EMERGENCY CONTACT & PHONE


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LIST SPECIAL NEEDS (FOOD ALLERGIES ETC.)


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4 DAYS * M-T* Sept. 11-14

1.________________________________________________

2.________________________________________________

3.________________________________________________

4.________________________________________________




Make Checks Payable to:

PORCELAIN ART SCHOOL OF INDIANA

Send $75 non-refundable deposit

(or full tuition) and this registration form to:


CJ Laster

6950 W. Arrowhead Dr.

Frankfort, IN  46041


614-582-7732  cj@rllaster.com

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