Registration Form
Name: _______________________________________________________
Address: _____________________________________________________
______________________________________________________
Home Phone: _________________________________________________
Work Phone: _________________________________________________
Email: _______________________________________________________
Hearing_______ Deaf ____________ Hard of Hearing _________________
Accommodation Request ________________________________________
____________________________________________________________
Please return registration and $50 Money Order to
BAIT, Inc.
P.O. Box 285
Sterrett, AL 35147.
In the event the workshop is cancelled, you will be notified by email.
Cash or money orders will be accepted for registration at the door. No personal checks will be accepted for registration.
Please feel free to contact me if you have any questions about this workshop opportunity, any need for specific accommodations or any cancellation concerns. Pat Smartt (205) 222-9690 call or text or email [email protected].