The Registrar

Denman Island Arts Centre

Box 78, Denman Island, BC V0R 1T0
(250) 335-1224 Toll Free: 1-888-335-1221
www.artsdenman.com

To register use this form or visit www.artsdenman.com

If using this WORD DOCUMENT form to register - fill out relevant information and
email form to: artsdenmanregistrar@telus.net. If paying by cheque, please send cheque to
the Denman Island Arts Centre within one week of emailing form. Registrations will be
confirmed upon receipt of payment.

Participant Information:

First Name:
Last Name:
Address:
City:
Province:
Postal Code:
Phone:
Email:
Arts Denman
Member? (y/n)
Emergency
Contact:
Phone:

Workshop Information:

1.
Workshop/Event Title:
Instructor:
Date:
Fee$:

2.
Workshop/Event Title:
Instructor:
Date:
Fee$:
3.
Workshop/Event Title:
Instructor:
Date:
Fee$:

Total Fees for all workshops: $

The Denman Island Arts Centre offers a 10% discount on fees for workshops to Arts
Denman members whose registration fees are received no later than 3 weeks prior to the
start date. The discount does not apply to material fees.

Apply discount (if any): $

Add annual Arts Denman Membership @ $10.00 $
Material Fees (if any): $

Total Payment Enclosed $

Payment by (make bold):

Cheque Money Order Visa

Visa Card Number:

Expiry Date:
Name on Card:

Cancellations: Arts denman reserves the right to cancel a course if there is insufficient
enrolment, or unforeseen circumstances. In this case, full fee will be refunded.
Refunds: Registrants who cancel 4 weeks or more before the course start date will receive
a refund, minus 10% administration fee. After the cutoff date, fee will be refunded only if
your place can be filled.