SCHOOL REGISTRATION FORM

Date:

Customer Name:  

Address:  

City:

State:

ZIP Code:

Phone/Fax:

Email:

Signature:

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Please Call For Remittance Information:  

Bill Gordon

(225) 936-2721 cell

(225) 261-5919 hm

• Classroom $150
• Classroom, Shop & Racetrack $600

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         *** *Must be pre-paid to attend****