Registration Form- Special Event Workshop

Please Enroll me in Charles Sovek's

Painting Workshop at Springmaid Beach
August 22-27, 2004

Name:________________________________________________

Address:______________________________________________

City,State,Zip:________________________________________

Phone Number:________________________________________

E-mail:_______________________________________________

Please provide the name and telephone number of a
relative of friend we can contact in the event of an emergency

Name:_______________________________________________

Phone Number:_______________________________________

Make check payable to: Leroy Springs & Co., Inc. and mail with deposit and enrollment to: 
Claudia Thompson
P.O. Box 1209
Fort Mill, SC 29716-1209
Website www.leroysprings.com