Samhain Registration Form

* Indicates Required Field

*First Name	*
*Last Name	*
*E-mail	*
*Mailing Address	*
*City and State	*
*Zip/Postal Code	*
*Phone Number	*
*Allergies or health problems, if any (put "none" if no allergies).	*
*Emergency Contact (name & phone number)	*
*Dietary Preference/restriction (vegetarian, vegen, etc... put "none" if no restrictions)	*
	Sign up here if you would like to present a workshop. To allow as many workshops as possible, please plan for yours to last no more than an hour.
*Name of workshop
*Short description of workshop (please limit to 500 characters)