Please fill out the following information below to register for Opal Moon courses. A 50% deposit will be required to hold your place at the time of registration for a course. The balance of the registration fee will be due one week before the start of class. Cancellations received within less than two weeks of the start of class will result in forfeiture of the registration deposit.
For strict security purposes you will be contacted by phone to confirm your registration and billing information. You only need to indicate the form of payment you will be using. If you are planning to use your credit card, you will not be asked to include that information in the form below. You can provide your credit card information when we call you.
Most classes have a minimum attendance requirement so early registration is a must to ensure both that a place is reserved as well as that the class will be held. Registration is required for ALL sessions whether a free lecture, special event or on-going class or workshop.
Areas marked with a red * are required.
If you would rather fill out this form by hand, click here to download a copy to print out.
Personal Information
*Name:
*Address:
*City/Town: *State:   *Zip Code:
*Home Phone:                       Work Phone:    
*E-mail:
Course Information
When entering the number of attendees and the course fees below, you do not have to enter a course total.
Scroll down and click the calculate button to total up all the infomation entered. You must fill in all course information.
*Course Title:
*Course Dates:   *# Attendees:    *Fee: $    *Total: $
Course Title:
Course Dates:    # Attendees:     Fee: $     Total: $
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Course Dates:    # Attendees:     Fee: $     Total: $
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Course Dates:    # Attendees:     Fee: $     Total: $
Course Title:
Course Dates:    # Attendees:     Fee: $     Total: $
Course Title:
Course Dates:    # Attendees:     Fee: $     Total: $
*Total Fee: $   *Deposit Due: $
Payment Information
*Payment Method: Cash    Check    Credit Card    Free
If you've selected Credit Card Payment, we will call you for your credit card information.
If you plan to use a credit card, which type?
AMEX    MasterCard    VISA    Discover
Additional Comments: