Class & Workshop Registration Form
City:_____________________________ State:________________ ZIP:_______________
This is for (circle one) Class or Workshop____________________________________(Title of Event)
Form of Payment:
Check#:___________ Enclosed check in the amount of $_______________
Credit Card: VISA MasterCard Total Amount of Charge$_______________
Name of Cardholder:_________________________________________________________
Credit Card #:____________________________________
ZIP Code for billing on card:_________________________
Policies for workshop registration:
• Space is limited, reservations are required
• Payment in full is required at registration, to reserve your space (unless otherwise specified)
• You may request to be placed on a waiting list if the workshop is full.
• No cancellations within 30 days prior to workshop
• Cancellations prior to 30 days will be charged a 15% processing fee for cancellation.
• Lunch for workshops will be arranged based on majority preference. o Please circle your preference for lunch
o Order-in from a local restaurant. Pay for lunch at time of arrival
o Bring your own bag lunch
o Potluck – everyone bring a dish to pass (studio to provide tableware & beverages)
I look forward to hosting this experience for you at Khnemu Studio LLC – Dawn Soltysiak. Please contact me with any questions, or to check workshop availability.
6322 113th Ave
...a connection to the artist and the land
Khnemu Studio LLC on Fernwood Farm