Longarm Training Academy
June 24, 25, 26 and 27, 2010
Holiday Inn, Intercontinental Airport
Houston, Texas
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Please fax to 281-288-7801
If you do not want to put your CC# on this form, you can fax the form and call with your CC#
If you do not have access to a fax, you can email the info to us and call with your CC#
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Name:
Email Address:
Phone Number:
Cell Number at Academy:
Emergency Contact Number:
Comments:
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Thursday, June 24, 2010
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Friday, June 25, 2010
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Saturday, June 26, 2010
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Sunday, June 27, 2010
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Name On Credit Card _________________________________________________________________
Credit Card Number __________________________________________________________________
Expiration Date ______________ Security Code _________
Class Fees __________
Registration Fee $10.00
Canvas Show Bag __________
$10.00 (Optional)
Total Due __________
Minimal, Class Supply Fees, will be paid directly
to the teacher, when needed for a few of the classes.
Liability Waiver and Indemnification Agreement:
Your participation, including that of your spouse, and anyone accompanying you, in any of the Longarm Training Academy
Hands On classes, Lecture classes, Demo classes, parties, venues, paid for or not, is conditioned on your agreement to
hereby indemnify Longarm Training Academy, its employees, its volunteers, its contractors, the longarm machine
suppliers, its teachers, Carrie and/or Tom Dugan, from, and never to make any claim for injury, loss, or damage to you or
your spouse or anyone accompanying you, against Longarm Training Academy, its employees, its volunteers, its
contractors, the longarm machine suppliers, its teachers, Carrie and/or Tom Dugan, caused by its very first negligence,
strict liability or for any other reason. Further, you agree that, you, your spouse and anyone accompanying you, in any
Longarm Training Academy classes, Hands On Classes, Lecure classes, Demo classes, parties, venues, paid for or not,
is conditioned on your agreement to hereby indemnify Holiday Inn, its employees, its volunteers, its contractors, caused by
its very first negligence, strict liabiliby or for any other reason.
I have read the above Liability Waiver and Indemnification Agreement, and I agree to the terms.
X _________________________________________________
ABM Innova - Service 101 Class is free to Innova owners, their spouses, and/or business partners.
Please sign up for the times you want, and put in $0.00 in the Class Fee column.
Threadology Class - $15.00. Please Note: you will receive a thread pack = $15.00