Name______________________________________________

Address___________________________________________

__________________________________________________

__________________________________________________ Postcode_______________________________

Tel_______________________________________________ Mobile ________________________________

Email_____________________________________________

Art Course________________________________________

Dates from________________________________________ to________________________________________

Day Workshops_____________________________________

Dates from________________________________________to_________________________________________

Course Fee_____________________

Workshop Fee___________________

Total__________________________

Deposit________________________ 25% with booking, balance 30 days before departure

Balance________________________

Cheques Payable to : Charlotte Rintler

I accept full responsibility for my person and effects during the course and undertake Charlotte Rintler (CR)

cannot be held liable for any loss or damage to me or my property. If for any reason the course booked cannot be provided,

liability of CR will be limited to repayment of monies received.

I agree in the event of cancellation by me, unless previously agreed in writing by CR, no refund of course fees will be made.

I will ensure all artist furniture, materials and books on loan from the Turner House

will be returned to the Turner House prior to the end of the course.

Signature________________________________________Date________________________________________