Private Lesson Request Form

Student Name(s):*	Please fill in first and last names of all students. First name on the list is the contact person. All students must be 16 years or older.
Address*	Street, city, and postal code please.
Phone:*
Email:*
Emergency Contact Name*
Emergency Contact Phone:*
Type of Lesson*	Glassblowing Flameworking Beadmaking Sandblasting In Glassblowing lessons, students work in the hot shop and gather molten glass from the furnace on the end of a blowpipe. Using traditional techniques, students will create paperweights, vessels and sculpture. In Beadmaking lessons, students use soft glass (Effetre) to create small, colourful glass beads at a table-mounted torch. In Flameworking lessons, students use borosilicate (boro) glass rods and tubes to create pendants, marbles, small sculptures and vessels using a table-mounted torch. Flameworking or Beadmaking lessons are 3 hours long. Glassblowing lessons are 4 hours long. Sandblasting 3 hours.
Preferred Date(s) of Lesson(s):	Please give us your availability. For example: Any Monday or Wednesday evening. Or: Anytime between September 15 and 22. We will line up an instructor based on the dates you give us. NOTE: Glassblowing lessons are not available on Tuesdays, as this is when we add glass to our furnace.
Preferred Start Time:	9:30am 2:00pm 6:30pm Lessons can start only at 9:30 am, 2:00 pm and 6:30 pm.
Instructor	If no preference, please leave blank.
Previous Experience: (If any)
Any questions?
Payment Method	In order to accommodate your requests and be as flexible as possible, we schedule our private lessons individually, and must confirm availability with each instructor. As well, we must hold the appointment in the resource schedule to ensure the booking is available to you. Full payment of lessons is due upon receipt, and lessons will not be held for more than 48 hours.
PLEASE READ ---------------- Submission of any registration form constitutes your acceptance of the payment method you chose and all terms and conditions in the registration policies, including the conditions of Terminal City Glass Co-op’s refund policy and the waiver below. Payment Policy All lessons must be paid at time of booking. Refund Policy If you cancel 14 days or more before the lesson: Full refund less $25.00 administration fee. If you cancel 8-13 days before the lesson: 50% refund less $25.00 administration fee. If you cancel 7 days or less before the lesson: No refund. Missed lessons will not be refunded under any circumstances. Rescheduling Policy If you reschedule 14 days or more before the lesson: $25.00 administration fee. If you reschedule 8-13 days before the lesson: $25.00 administration fee + 25% of lesson fee. If you reschedule 7 days or less before the lesson: $25.00 administration fee + 50% of lesson fee. You may only reschedule once. After that you have to cancel (see policy above). Finished Work You are expected to collect your finished work within 30 days of the last day of your course or lesson. Any work left after 30 days becomes property of Terminal City Glass Co-op. Finished work can be shipped to you for a fee of $10.00 plus the actual cost of postage. We will use the safest and most economical shipping method. In the event of unreasonable conduct, Terminal City Glass Co-op reserves the unconditional right to terminate a student’s enrollment in a private lesson. All the above terms and conditions apply to any lessons added to this registration. Waiver In consideration of my participation in the educational programs and use of the facilities, I hereby discharge and forever hold harmless Terminal City Glass Co-op and all agencies whose property and personnel are used as part of Terminal City Glass Co-op’s program and any sponsoring, cosponsoring or funding agency(ies) or individual(s) for responsibility for any injury, illness, death, damage, less, accident, delay or irregularity which may be occasioned for any reason whatsoever during the course of my participation. I certify that I am physically able to participate in all the activities for which I am enrolled. Terminal City Glass Co-op assumes no responsibility for losses or additional expenses due to injuries obtained while enrolled in classes or within the facilities of the Co-op. I also give my permission for Terminal City Glass Co-op to use without limitation or obligation photographs, film footage, tape or video recordings that may include my image or voice.
I agree to all the terms above*	I Agree