The Source of LIGHT Registration Form
followed by your 50% deposit with form below. Deposits may be refunded if cancellation is made prior to 2 weeks of event date.
From:
Name __________________________________________________
Address: _______________________________________________
City, State, Zip __________________________________________
E-Mail _________________________________________________
Phone: _________________________________________________
I would like to register _____ people for the following Class, Lecture or Workshop:
Class Name _____________________________________________
Class Date ______________________________________________
Amount Due _____________________________________________
Amount Paid _____________________________________________
Please mail your deposit along with this form to:
The Source of LIGHT
321 Main St, Suite 8, Niantic, CT 06385