BlackberryRose - Classes - Registration Form

Blackberry Rose I 109 N. Mitchell I Cadillac, MI 49601
phone: 231-876-9501 I e-mail: carol@blackberryrose.com

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COOKING CLASS REGISTRATION FORM

Note: * indicates required fields.

* Full Name: (First and Last)
* E-mail Address:

* Food Allergies: (Select one)		Yes No
If 'Yes' to Food Allergies, please specify:

* Address:
* City:
* State:
* Zip Code:
* Phone:

* Name of Class:
* Class Cost:
* Class Date:
* Class Time:		A.M. P.M.

Note: By checking 'I Agree' and 'Submitting' this Registration Form, I release Blackberry Rose of any responsibility for injury or accident while attending this class.

I Agree I Don't Agree

FOR OFFICE USE ONLY

Amount Paid:
Form of Payment:
Date of Payment:

Blackberry Rose, how did the name originate?

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