Registration Form

Early registration is highly encouraged. A waiting list will hold the names of those with late registrations. You will be contacted to confirm your registration and to give you further information in regards to preparing for your course. If you don’t hear from us within a week of sending your registration form it means we have not received it. Call us.

To register: There are two ways to register. One is to fill out the electronic form below and click send. The other is to scroll to the bottom of the page and print that form and mail it. Once you have filled out the form you will then need to send at least a 50% deposit. The balance is due three days prior to the beginning of your course. Deposits are refundable up to one week prior to the course. In the event of a course cancellation all moneys will be refunded.

Send check (payable to Dee Peppe) to:

Mid-Coast Community Darkrooms, 407 Main St., Rockland, Maine 04841

REMEMBER TO CLICK SEND AT THE BOTTOM OF THE FORM.

Your Name (required):

Your Email (required):

Address (required):

Your City/State (required):

Your Phone (required):

Course (required): Date: Cost:

Course: Date: Cost:

Course: Date: Cost:

Total Fee (required):

Total Deposit (required):

For Youth & Teen Programs Only:

Age:

Parents' Name:

Daytime Phone:

Doctor:

Doctor Phone:

Alternate Emergency Contact & Phone:

Notes/Comments:

Or, print this form and send with a check

Registration form