WRITING WORKSHOP FOR KIDS

REGISTRATION FORM:

regular registration:  payment Due by Feb. 15 ($25)

Late registration:   payment due by feb. 28 ($35)

At-The-Door Registration:  $45

Please print this form and mail it with payment or copy it into an email and send to julie at juliekenner@gmail.com; Payment by check or Paypal (see below)

One Form Per Child, Please

The workshop will be held MARCH 1, 2008

in a conference room on the 2nd floor of the

Georgetown, TX public library

CIRCLE: 

Morning session 9-1pm (primarily pre-teen, though parents of enrolled kids are welcome)

                           

Afternoon Session (teen and adult) 2-6pm

PARENT INFORMATION:

Name: ____________________________________________

Address: ___________________________________________________________________________________

Home phone:  __________________________  Cell phone:  _____________________________

Work phone: ____________________________

Email address(es):  ___________________________________________________________________

Emergency Contact Info: _______________________________________________________________

Circle:  Will a parent or guardian by staying in the library during the workshop?  Y/N  

Circle:  Will a parent or guardian be staying in the workshop room?  Y/N 

Participant/Observer

CHILD INFORMATION:

Name:  ________________________________________________

Age:    _________________________________________________

Are you currently working on a story?  Y/N 

If yes, do you see it as a novel, short story or other?

List your three favorite movies:

__________________________________________

__________________________________________

__________________________________________

List your three favorite books:

__________________________________________

__________________________________________

__________________________________________

WORKSHOP COST:  See fee schedule, above, payable by mail or by Paypal to julie@juliekenner.com

For multiple children, The first child is full price, and additional children are $15 (when you submit multiple registration forms, simply make a notation noting the multiple child discount)

Please indicate if you are mailing or sending payment electronically.

If using mail, send  payments to:

Julie Kenner

PMB #12

2800 E. Whitestone Blvd. Suite 120

Cedar Park, TX 78613