2012 Buckeye Clay Bash Registration Form

Please fill in all blanks and answer all questions.  If mailing, please print clearly.  Registration opens October 1, 2011 and closes on December 15, 2011.

Name: _______________________________________    Phone #: ___________________

Address: ______________________________ Email address: ______________________

Emergency contact person & phone #: ______________________________________

Roommate Info, check one:  [  ]  I have a roommate; name ___________________

  [  ]  I need a roommate         [  ]  I prefer no roommate    

*If you have special needs (food allergies, perfume allergies¸etc.) please let us know:  _____________________________________________________________________________

_____________________________________________________________________________

EARLY BIRD REGISTRATION-- October 1-November 15, 2011:

[  ] Guild Member—4 day $145            [  ] Non-guild member—4 day $160

[  ] Guild Member—3 day $125            [  ] Non-guild member—3 day $140

 

REGISTRATION FROM NOVEMBER 16-DECEMBER 15, 2011:

[  ] Guild Member—4 day $170             [  ] Non-guild member—4 day $185

[  ] Guild Member—3 day $150             [  ] Non-guild member—3 day $165

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Make your check payable to and send your check to: Lynda Gilcher  

                                    Loveland Art Studios on Main

                                    529 Main Ave.

                                    Loveland, Oh. 45140    Ph# 513.697.9290

Please also send an email to Lynda at lyndag@lyndasartistichaven.com to make sure she signs you up—things have gotten lost in snail mail before!  **Checks will NOT be cashed until the first week of January 2011. ***FULL REFUND available for cancellations by 1/6/12, refund minus $25 charge between 1/16/12 and 1/31/12, NO REFUND for cancellations after 1/31/12.***

Be sure to make room reservations separately with HOPE HOTEL @ 937.879.2696 by January 15, 2012.  Mention the BUCKEYE CLAY BASH to receive the lower room rate for BCB participants.