Event Registration Form - Empire Safety Council Accident Prevention Workshop

Empire Safety Council Accident Prevention Workshop

Event Registration Form
- Save up to 10% on your auto insurance upon completion of the class
- Participants must bring their drivers license and a pen (Blue or Black ink)
- Pre-Registration and Pre-Payment is required. Checks must be made payable to "Empire Safety Council"
- Fee is $40
- The Class is open to everyone and will be filled on a first-come, first-served basis.
- YOU MAY BRING A SNACK OR LUNCH.
Date: September 15th

Time: 10:30am - 4:30pm

Address:

Montauk Library (Lower Community Room)

871 Montauk Hwy

Montauk, NY 11954
Attendee Information

Please fill name and contact information of attendees.
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Contact Number*
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Guest Name

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Email Address
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Contact Number
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