LIZ MARKS CASTING
WORKSHOP REGISTRATION FORM

NAME:____________________________________Date of Birth_________________

ADDRESS:_____________________________________________________________

CITY,STATE,ZIP:_______________________________________________________

IF A MINOR, PLEASE GIVE YOUR
PARENT'S NAME:_______________________________________________________

PHONE
NUMBERS:_____________________________________________________________

SESSIONS DESIRED:____________________________________________________

AMOUNT PAID:_________________________________________________________

BALANCE DUE AT FIRST CLASS:_________________________________________

CREDIT CARD NUMBER:________________________________________________

CIRCLE ONE: MASTERCARD / VISA

EXPIRATION DATE:_____________________________________________________

NOW ACCEPTING CREDIT CARDS!
SEATING IS LIMITED.
HALF PAYMENT IS REQUIRED TO HOLD YOUR SPOT.
Please make check payable to Liz Marks, and send to:

Liz Marks Casting
Post Office Box 29388
Richmond, VA 23242

Please fill in the form above. Upon receipt of your registration, you will be called to acknowledge your acceptance.
(If you are using a credit card there will be an additonal $5.00 processing fee.)
QUESTIONS? Please call 804-740-0329
or visit our web site at www.lizmarkscasting.com/workshops.html (will open in a new browser window.)