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John Seerey-Lester Master Class

Registration Form

Name: _____________________________________________________
Address: ___________________________________________________
City/State/Zip: _____________________________________________
Phone: ________________________ Fax: _________________________
E-mail: ____________________________________________________

Please specify your preferred medium: ________oil _______acrylic

For registration to be accepted a $450.00 non-refundable deposit is required with the return of this completed form. Spouses are welcome, but will be unable to join the class. The balance of $500.00 is due one month prior to the start of the class.

Three slides of your paintings are required with this registration form.

I will be attending (date of class): ____________________________

_______________Check enclosed,    ______________amount
Please make checks payable to John Seerey-Lester.
Or: VISA ___ / MasterCard ___
Account #: ___________________________ Expiration date: ________

*** For emergency purposes ***
Contact
Name: _____________________________________________________
Phone
# ________________________________________________________

Waiver of Liability
I understand that Seerey-Lester Master Classes assumes no liability for any personal injury, property loss or accident that may occur during the Seerey-Lester Master Class. Seerey-Lester Master Class reserves the right to cancel the Master Class at any time prior to the week of the class. In the event of a cancellation, full tuition will be refundable.

Signature_________________________________________________________________

Seerey-Lester Studios "Treetops"
208 Shoreland Drive, Osprey, FL 34229 USA

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