Nordic Skater ..... Workshop Registration Form
Please fill out the entire form, then click "Submit Form".
We will call you if there is a problem with your registration.

Name:
Street / PO Box:	Apt.:
City:
State / Province:	Zip/Postal Code:
Telephone:	Best Time To Call:
Email:
SHOE SIZE:	Men's or Women's:Select Men's Women's
Credit Card Type:	Select Visa Mastercard  Card Number:
Expiration Month:	Select 01 0203 04 05 06 07 08 09 10 11 12   Year:Select 2007 2008 2009 2010 2011 2012 2013 2014 2015   Last 3 Digits On Back:
Workshop Session:	Select Sat. Feb. 2, 1pm-4pm
Message:

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