Maryjo Koch's Class Registration Form
Name:
Address:
City, State, Zip Code:
Day Phone:
Evening Phone:
E-mail Address:
CLASS DATE COST
     
     
     
     
     
     
     
     
     
     
SIGNATURE DATE TOTAL
     
All classes you're attending must be listed on the registration form, with your signature and date.

A 50% deposit is required; balance due on class day. Please make check payable to: Maryjo Koch. Send to: 555 Martin Road, Santa Cruz, CA 95060.

Cancellations made two weeks (14 days) before class, may have full credit for another class. Although, cancellations amde after the two weeks before class will NOT be refunded nor credited.

Please specify diet restrictions and allergies on your registration form.

The undersigned understands that participation in these courses may present possible risks and hazards including, but not limited to, hiking on or off trail with limited emergency access. I assume any risks associated with the foregoing and agree to hold Maryjo Koch from any loss or damage I may suffer as a result thereof. I certify that I am in good physical condition and am safely able to participate in the courses and study tours for which I am registering.