Summer THRIVE :: Registration Agreement

Please fill out form to acknowledge acceptance of the terms and policies set forth herein and return with your registration fee, $275.

Acceptance of Terms (please mark with your initials) *

Date *

Full Name as you would like it to appear on all marketing materials *

Street Address *

City, State, Zip *

Phone Number *

Email Address *

Type of Work *

my work is 2 dimensional my work is 3 dimensional my work is both 2-D & 3-D

Website

Name as it appears on Facebook

Twitter handle

Professional Development Registration Cost *

Thrive Artist Consulting & Exhibition Experience $ 275.00

Additional Consultation - 1hr $ 75.00

Total $ 0.00