Registration Form for Events and Classes
Name: ______________________________________________________
Address: ____________________________________________________
____________________________________________________
Phone: ______________________________________________________
Event or class name: _________________________________________
We accept check or credit cards
Please remit to: John Carroll 715 Rte 28, Kingston NY 12401
Credit Card Information ~
Name on Card: _________________________________________________
Billing Address: _________________________________________________
_________________________________________________
Card number: __________________________________________________
Security Code: __________________________________________________
Expiration Date: ________________________________________________
Signature: ______________________________________________________
