STONE CARVING WORKSHOP WITH PARIS ALEXANDER
REGISTRATION FORM

Please send a check (made out to Paris Alexander) and the completed the registration form and mail to Paris Alexander at 201 E. Davie St., Raleigh, NC 27601. Registration will not be confirmed until payment is received.

Name:__________________________________________________________

Email: __________________________________________________________

Day Phone: ____________________ Eve. Phone: _____________________

Address: ________________________________________________________

City: ______________________________State: ________ Zip: ____________

Emergency Contact : ____________________________________________

Phone 1: _________________________Phone 2: ______________________

_________________________________________________________________

Waiver of Liability: I hereby release Paris Alexander from any and all liability, cost or expense associated with an injury I may sustain while participating in the Stone Carving Workshop.

Signature

:_______________________________________Date:____________________

MARK YOUR CALENDARS!

TOTAL : $375.00

(Please make checks payable to: Paris Alexander) CHECK # :_________