Registration Form for The Shamans of the Willow Moon Coven Workshops
You may register in person or by mail. You must first attend a Wiccan Wisdom meeting prior to attending a workshop. We offer a sliding fee scale for registration for those with limited funds. You decide where you slide. We ask that you pay your fee at registration. All monies are used to offset the cost of the Covenstead and no Coven members profit from monies raised.

To register by mail, print this application and mail it along with your registration fee to
      Shamans of the Willow Moon Coven
      PO Box 458
      Denver NC 28037

Please make checks payable to Shannon Walker

Please provide us with the following information:

Date:
                              

Name:
                                                                                          

Address:
                                                                                       

           
                                                                                       

Phone:
                                                                                          

Email:
                                                                                           

Date of Birth:
                                                                                 

Class requested:
                                                                             

                                                                                                    

Amount paid:
                                         

Signature:                                                                                       

*
*Disclaimer:  The Shamans of the Willow Moon Coven as a whole, and any individual member thereof, is not responsible for any loss or damage including theft or damage of personal property, or injury, real or imagined.  All costs and fees of the workshops are non-refundable, EXCEPT in the case of cancellation by The Shamans of the Willow Moon Coven (fees will be refunded) or rescheduling of the workshop (registrant may request refund).  Workshops are for adults only unless stated otherwise. When permitted children may attend with their parents. Please check with The Shamans of the Willow Moon Coven before bringing your children.
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The bottom portion of this form will serve as your receipt for fees paid.  If you would like this receipt mail to you please include a self addresses stamped envelope when mailing this form.

Date:                                                                             

Name:                                                                                           

Class:
                                                                                           

                                                                                                    


Amount paid:
                                   

Received by:
                                                                                 

Date received:
                                  

**Disclaimer:  The Shamans of the Willow Moon Coven as a whole, and any individual member thereof, is not responsible for any loss or damage including theft or damage of personal property, or injury, real or imagined.  All costs and fees of the workshops are non-refundable, EXCEPT in the case of cancellation by The Shamans of the Willow Moon Coven (fees will be refunded) or rescheduling of the workshop (registrant may request refund).  Workshops are for adults only unless stated otherwise. When permitted children may attend with their parents. Please check with The Shamans of the Willow Moon Coven before bringing your children.
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