City:_____________________________ State:_____ Zip:________________
_____ Saturday - Crystal on Black
_____ Sunday - Gold & Silver Metal
_____ Both days
Complete this form and return it with a $25/one day, or $50/two days
non-refundable deposit to reserve a seat, with the balance due prior to the
Reservation deadline is Feb. 16, with the balance due March 2, 2019.
Make the checks payable to CPSA DC 117.
Mail registration and check to:
7 Franciscan Lane
Palm Coast FL 32137
(Sorry no credit cards accepted).
Barabara Dahlstedt CPSA, CPX Workshops Registration
$80/day members, $95/day non-members
Deposit - $25.00/day (non-refundable) due with registration Feb 16, 2019
Balance - $55/day members, $70/day non-members due March 2, 2019
Saturday & Sunday, March 16 & 17, 2019 - 9 AM to 4 PM