Lego Printmaking Workshop “Lego Printmaking” Workshop "*" indicates required fields "Lego Printmaking" Registration FormDATE: Tuesday, June 24, 2025 TIME: 9-11 AM INSTRUCTOR: Hannah Roser LOCATION: Arts Council Galleries at Campbell House (482 E. Connecticut Ave., Southern Pines)ARE YOU AN ARTS COUNCIL MEMBER?* Yes No If you’re not sure, please call the Arts Council at 910-692-2787 or join at MooreArt.org/Join-Now."Lego Printmaking" Workshop – Member* Price: Quantity*Please enter a number from 1 to 5.Total "Lego Printmaking" Workshop – Nonmember* Price: Quantity*Please enter a number from 1 to 5.Total Child's Name(s):* Add RemoveEnter the child’s name in the field above. Click the “+” sign on the right to add more names. The maximum number of children you can register per form is 5.PAYMENT METHOD:* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name Cardholder Name* First Last Phone Number for Cardholder*Email for Cardholder* Mailing Address* Mailing Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Consent* I agree to the following terms & conditionsI assume all risks involved in my child participating in this program. I am aware that the activity may cause accident, injury, or contagion as a direct or indirect result of participation. I agree to release & discharge the Arts Council of Moore County and its staff, volunteers, & sponsors from any & all claims from damages suffered by me or damages to my property as a direct or indirect result of my participation in or traveling to or from said program. I understand no refunds will be issued unless the workshop is cancelled.CAPTCHA
