Registration Form

PLEASE NOTE: 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 me within a week of sending your registration form it means I have not received it. Please call to confirm.

To register: There are two ways to register.

  1. Fill out the electronic form below and remember to click Send at the bottom. I’ll email you to confirm when I receive your registration. Then mail your payment of at least a 50% deposit to hold your space. Full payment is due 7 days before the start of camp.
  2. To register by mail, scroll to the bottom of this page and print the registration form and mail it along with your payment of at least a 50% deposit. Full payment is due 7 days before the start of camp.

Electronic Payment Option: Payments can also be made using Zelle. Use email deepeppe@gmail.com. Double check the email address as there are a lot of double letters there.

Cancellation Policy: 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 VERY BOTTOM OF THE FORM.

    Student's Name (required):

    Parent's Name (required):

    Parent's 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

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