|
Class
Reservation Please
fill out entire form
First Name Last Name
Street Apt#
City State Country Zip Code
Day phone -- Evening phone --
International phone
Email
Class Name (pull down for class selection) please submit separate
reservation requests for multiple class selections
Overnight
student? Class
fee total
Credit Card Number --- 
Exp Date (mm/yy)
By making
this class reservation I the above mentioned and listed, agree
to the terms of this contract. I authorize Balsam Inc. dba Primrose
on Superior and Primrose Gradations to charge my credit card
for the entire amount of the reservation plus any additional
charges as outlined in the Contract. Liability for class cancellation
by Primrose on Superior shall be limited to fee charged, Balsam
Inc. dba Primrose Gradations and Primrose on Superior shall not
be held liable for any other costs incurred due to class cancellation,
(ie: travel and/or misc. expenses incurred by attendee). Electronic
submission of this reservation constitutes my acceptance of the
aforementioned policies. I, the above mentioned and listed, hereby
further agree to indemnify and hold harmless Balsam Inc. dba
Primrose Gradations and Primrose on Superior, its trustees, officers
agents and employees from any and all claims of liability and
expense, including without limitations, attorney's fee arising
from or in conjunction with but in no event limited to bodily
injury, personal injury, death or property damage arising from
any action or inaction of Balsam Inc. dba Primrose Gradations
and Primrose on Superior, its agents, Trustees, officers or employees.
|