Classic Rock Jamshop Registration
Name
*
First Name
Last Name
Instrument
*
Please Select
Electric Guitar
Vocals
E-mail Address
*
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
-
Area Code
Phone Number
Please describe any past musical experience:
Do you have any song ideas from the 60s or 70s that you'd like the teachers to consider for this class?
If this is your first time in a She Rock class, how did you hear about us?
Payment- $189
Note: In the event you need to cancel, you must notify us by February 7th to receive a refund (less a $25.00 deposit). Use coupon code 'earlybird' to receive $20 off your registration if registering before January 23rd.
Participant Name (this helps with our payment records)
*
Payment options
*
Paypal
Check
Pay by Check:
Please mail your check for $189 to: She Rock She Rock, 5115 Excelsior Blvd #316, Minneapolis, MN 55416. Checks must be received within three (3) business days of registration in order to hold your spot. Checks that are postmarked on or before January 23rd can use the earlybird discount and can be written out for $169.
Pay by Paypal:
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Classic Rock Jamshop Class
$
189.00
Tax deductible donation to help economically-challenged girls and women attend our programs
$
1.00
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