REGISTRATION FORM

Clown Workshop on March 13, 2008 at 4:00 PM

Location: Circus Sarasota Big Top

Miromar Outlets in Estero

 

Please print this form and mail in with payment

 

Name:_______________________________________________

 

Address:_____________________________________________

City__________________  Zip__________

 

Telephone #___________________   Email_______________

 

 Workshop ________  Fee $25.00

Fee includes one ticket to the March 13th performance
of Circus Sarasota at 7:00 PM.

 

The workshop and lecture are a fundraiser for Laugher Unlimited,

a comprehensive care service program providing professional circus

entertainers to nursing homes, assisted living facilities, day care centers

and other institutions bringing joy and laughter to "children of all ages".

Please enclose payment with registration form. 

The fee is non-refundable.

  

Please circle:  Check,  
                           MC,   Visa,  Amex  add $2 handling fee per registration

Credit Card: Name as it appears on card_________________________

Card #__________________________________________

Security Code (3 digits on back of card):____________

Expiration date:________________Telephone Number________________

 

You can also pay with credit card by calling our office 941-355-9335 

 

Make checks payable to:

Circus Sarasota

8251 15th Street East

Sarasota, Florida 34243

 

For more information please contact:
Chuck Sidlow

941-928-2246