Play Together, Stay Together Workshop Registration
Participant Name
*
First Name
Last Name
Parent/Legal Guardian Name (if applicable)
First Name
Last Name
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 experience being in bands or performing as a solo artist.
Are there any topics that you would like the teacher to include in the workshop?
If this is your first time in a She Rock class, how did you hear about us?
Payment- $15
Note: In the event you need to cancel, you must notify us by October 24th to receive a refund.
Participant Name (this helps with our records)
*
Payment options
*
Paypal
Check
Pay by Check:
Please mail your check for $15 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.
Pay by Paypal:
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Stay Together, Play Together Workshop
$
15.00
Tax deductible donation to help economically-challenged participants attend our programs
$
1.00
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