2012 Mark H. Deschinny
Navajo Weaving & Dyeing Workshops
P.O. Box 4677
Window Rock, 86515
Registration Form
Name______________________________Title_______________________________
Company/School/Program________________________________________________
Address_______________________________________________________________
City____________________________State____________Zip Code_______________
Country__________________________
Telephone_________________________Emergency Contact_____________________
Website_________________________________E-Mail _________________________
WORKSHOPS Cost Check Write Amount
* Navajo Cultural Colorants $250.00 __ _______
* Introduction to Navajo Tapestry Weaving $525.00 __ _______
TOTAL AMOUNT _______
FORMS OF PAYMENT: Cashier's Check, Money Order & Personal Check
Make Payment Payable to,
Mark H. Deschinny
Mail To: P.O. Box 4677
Window Rock, AZ 86515
For more information, contact Mark H. Deschinny at (928) 871-5587 or write to P.O. Box 4677, Window Rock, AZ 86515 or [email protected]
LIABILITY:
The Deschinny and Kahn-Begay Family are not responsible for any loss, damage, theft, accidents or injuries that might arise by your participation at this event. I shall indemnify, defend and hold harmless the Deschinny and Kahn-Begay families or their representatives from any damages or injury to any person or to the property of any person, claims, demands, losses, liabilities, damages of any kind, and obligations pertaining to or arising out of or in connection with my activities and any agreements entered into by me in connection with the DESCHINNY Weaving and Dyeing Workshops under this agreement.
Signature: ______________________________ Date: _________________
Updated 05/30/12 by MHD
Copyright (c) 2004-2012 Mark H. Deschinny
U.S. Copyright Law