Contact Staff Workshop Registration Form
Full Name
*
First Name
Last Name
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Workshop you wish to attend:
Please Select
Intro to & Beginner Contact Staff (101) (Beg+)
Int. level Contact Staff (102) (Beginner+)
Steves and variations (103) (Intermediate+)
Need a practice toy for the workshop?
*
I will need a staff to spin
I have my own staff thanks
I would like to purchase a staff ($40)
By checking this box I agree to wave the right to claim all potential, mental or physical injuries to myself or other workshop attendants as any fault other than my own. I am a responsible adult in good physical health, capable of physical activities, and I lay no responsibility on Fire Technicians, James Overturf or the venue Third Degree Glass Factory for my actions or injuries while attending this workshop or practicing on my own time. By selecting the "agree" checkbox on this form I have electronically provided my signature.
*
I agree to the terms of this waiver.
I do not agree.
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