Paul Matteson in Buffalo, NY

May 5-7, 2017

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* 1. First Name

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* 2. Second Name

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* 3. Birthdate

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* 4. Home Address

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* 5. Email Address

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* 6. Phone Number

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* 7. Emergency Contact Information -  Please provide Emergency Contact Information (Phone number, address, relationship to you & email) for at least one person below.

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* 8. Medical Conditions Please let us know if you have any medical conditions we should be aware of.

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* 9. How did you hear about the intensive?

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* 10. Event Fee
$ 125.00 - Early Bird registration by April 5
$ 150.00 - Regular Rate 
Single classes available too,
You will be registered when we receive your payment.
Questions: contact Nancy Hughes at buffalocijam@gmail.com.

Please write YES in the box below if you agree to pay the event fee.

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