THE AMELIA ISLAND ARTISTS WORKSHOP ENROLLMENT FORM

  REGISTRATION FORM

By Enrolling in this workshop you certify that you have read and understand the   terms of the enrollment below.   We do not keep credit card information on   file.  Your information will not be shared with anyone without your permission.
PLEASE NOTE THERE ARE NO REFUNDS AFTER 45 DAYS AS THE TEACHER HAS COMMITTED TO TEACH AND WE ARE RESPONSIBLE FOR HIS/HER FEES.  
 
You may register in one of four ways:  1. print the form below and mail it to us with your check or credit card information, or  2. copy and paste the form to your email, or 3. print, scan it and send it to us as an attachment, then phone in your credit card info or send your deposit in via PayPal on the button below , or  4.  CAll US, we would love to chat with you. 

Our address is:
The Amelia Island Artists Workshop
Amelia SanJon Gallery
218-A  Ash Street
Fernandina Beach, Florida 32034
904-491-8040

  Email any comments or questions to either principal below:
Mikolean Morgan Longacre or Sandra Baker-Hinton

Name (Mr., Mrs, Ms.)____________________________________

Course Instructor________________________________________

Address:______________________________________________

City:______________________________State_______________

ZipCode__________________Country. Telephone______________

Email Address:__________________________________________

  Enclosed $100.00 deposit
Check
Money Order
Visa__Mastercard__Amex____

  Card Number____________________________exp date________

  Signature:__________________________Date:_________________

  I have read all the policy information and I agree to assume all risk of personal harm or injury relating to or resulting from my participation in all workshops and activities associated with Amelia Island Arts Workshops, and hold AMELIA ISLAND ARTISTS WORKSHOP, LLC and its instructors, harmless as to liability for any such harm or injury.

 Signature_____________________________Date

Workshop

Armand Cabera $675.00 Akira Blount $600.00 Susan Oglive $650.00 Leah Lopez $295.00 Gary Greene $350.00 Koo Schadler $650.00 Charles Reid $695.00 Jane Angelhart $550.00 Soon Yoon Warren $375.00 Elizabeth St. Hilliare Nelson $350.00