Name (Print)_____________________________________________   Phone (       ) ___________________

Address_______________________________________________________________

City______________________________State_________Zip________ Email________________________

Saturday Workshop $60.00 x______=____________   After Oct. 27th     $70.00 x______=___________

(Pre-registration only-includes Lunch)       (After Oct. 27th Does not include Lunch)

Sunday Master Class $40.00 x _____=___________    After Oct. 27th    $45.00 x ____=__________

Saturday Evening Performance (Reserved Tables-10 per table): $14.00 (per person) x______=__________

Total amount enclosed (seminar, master class, performance tickets): $____________


Liability Release - (must be signed prior to participation in the workshops or show)


  I_____________________________ understand that the American Serb Hall, Pat Kellar and any of the organizations' representatives are not responsible for any loss, theft, or damage of personal property.
Further I acknowledge that the parties shall not be held responsible for any personal injuries sustained
during the course of the event.