Registration Form – Wooden Surfboard Making Class

(Please Print)
Today’s date: Board required

PARTICIPANT INFORMATION

Your  Last Name: First: Middle: q Mr.q Mrs. q Missq Ms.  
   
Street address: Mobile Phone no.: Home Phone no.:
    (          )
Suburb: State: Postcode: Email Address:
       
Occupation:    
     

IN CASE OF EMERGENCY

Name of friend or relative : Relationship to participant: Home phone no.: Mobile phone no.:
    (          ) (          )
 

COURSE INFORMATION

(Please nominate your Preferred Class – Stuart Bywater Design will do our very best to accommodate your request.)
        Insert board price
Woodensurf boardMaking(7nights) Start Date:Tuesday Class Time:6.00pm to 9.00pm Venue:182 Crockford Street Northgate QLD Course Fee:(incl GST) Payable Upfront Board price$
Woodensurf boardMakingSat, Sunday TBA/ please advise expression of interest Class Time:9.00 am to 5.00pm sat9.00pm to 5.00pm sun Venue:182 Crockford Street Northgate QLD Course Fee:(incl GST) Payable Upfront Board price$
           
 I , _______________________________________ have read through the information regarding these Stuart Bywater Design Woodwork classes               (Insert your name)and wish to register to participate in the nominated  class above. I understand that by registering and signing this form that I agree that I mustpay the Full Course Fee before my registration will be confirmed.__________________________________________              (Please Sign & Date)

ONCE COMPLETE PLEASE e mail or MAIL to

Stuart Bywater Design, C/182 Crockford Street, Northgate QLD 4013 Payment of Fees required prior to commencement (Remittance of Payment)

Thank You for Your Registration!



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