OUTSIDE ART WEEKEND ------- Registration Form          

Name*_______________________________________________
MailingAddress:*_______________________________________
Artistic Level:(circle one)    novice   taken some art classes 

                                                  experienced   professional

Work Phone:* ________________________
Cell Phone: *__________________________
Home Phone:*____________________________
Email:*_____________________________________________________________

EmergencyContact: *______________________________________________________
Emergency Contact phone # ________________________
Do you have a medical condition or allergies? If so, please explain: _________________________________________________________________________

Do you have special dietary needs If so, please explain: _________________________________________________________________________

Doctor’s Name:*_____________________________________
Doctor’s Phone:*____________________________________
Overnight Adventure Dates, Inn and B&B: ___________________________________________

OPTIONAL ADDITIONAL WORKSHOP CHOICES:

These add-on choices incur additional charges- please circle your choices.

FRIDAY NIGHT :  Studio Tour (additional $50 per person)

SATURDAY EVENING: (These add-on choices incur additional fees)

Evening Studio Tour (Additional $50 per person)

Creativity, Color and Kayaks (Additional $100 per person)

ADDITIONAL PROGRAMMING FEES :

______Friday Evening Studio Tour (Additional $50 per person)

______Saturday Evening Studio Tour (Additional $50 per person)

______Saturday Creativity, Color and Kayaks (Additional $100 per person)

$__________ADDITIONAL PROGRAMMING FEES SUB-TOTAL

$349 ______OUTSIDE ART WEEKEND ADVENTURE FEE

$____________________ SUB-TOTAL

$____________________TOTAL FEES

$________ AMOUNT ENCLOSED (This may be a half-down deposit, or full payment for the entire weekend.)
Check #:__________________

$__________ REMAINING BALANCE:  *Please note: Workshops must be paid for in total at least one day prior to the scheduled day of the workshop.

Please make checks payable to Aesthetic Alternatives.

Final payment must be received by Outside Art /Aesthetic Alternatives by the day before the scheduled workshop day. We do not accept credit cards at this time. Please call (410) 212-9320 for inquiries.

Please mail registration forms and a check 

made payable to Aesthetic Alternatives  to the following address:

P.O. Box 41, Sherwood, MD 21665

You may also email registration forms to dmalosh@outsideartlessons.com

By signing this registration form, I hereby and forever discharge, release, and hold harmless, Dawn Malosh, Aesthetic Alternatives, Wades Point Inn and any other connected parties from all liabilities and law suits regarding any damage, loss, or injury resulting from my participation in Outside Art Adventures. In case of an emergency, I do hereby authorize Dawn Malosh consent to determine any medical treatment or care deemed advisable for me. I understand that if the emergency is deemed life-threatening, paramedics will be called first. I have read the policies for Outside Art Adventures and understand them to the best of my ability.

 _________________________________________                   ____________

      Signature                                                                                             Date