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Please print the form below, legibly enter your information and mail to the address at the end of the formor scan and email it.
All information submitted on this form is strictly confidential.

We accept MasterCard, Visa, Discover, bank wire-transfers and money orders. Credit Cards are TrustWave™ Certified.
__________________________________________

Great Lakes Course Registration

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Please print this form, legibly enter your information, mail to the postal address at the end of the form, or scan/attach and email to courses@schooloflogbuilding.com  All information submitted on this form is strictly confidential.

Full Name (first, middle, last):

________________________________________________

Address:                     ____________________________________________
City:        _____________________________________
State/Province:   _______________________________
Zip/Postal Code: _______________________
Country:     _______________________
Phone (day and eve): ___________________________
Email address: _______________________________
Emergency contact
(name, A/C, ph. #):  ____________________________
Gender:  ______________
Date of birth:  ________________________
Occupation: _________________________________
Employer or school: ___________________________
Physical condition: ___  Poor

___  Fair

___  Good

___  Excellent

Disabilities:
Past injuries:
Where did you learn about course?
Reason for taking course: ___  Planning to construct log building

___  Academic interest

___  Currently working on structure.

If you are paying by credit card please complete the following information

Card type: ___ VISA
___  MasterCard     ___ Discover
Name printed on card:
Card number:
Card expiration date:                Code 
Agreement

I understand and agree that my fee is non-refundable. If I am unable to participate in a course for which I have paid, I may take another course within six months with notice. Otherwise, my fee is forfeited. I agree to abide by all rules of the school and understand that if I do not, I may be dismissed from the course. Rules include no firearms or drugs, smoking confined to personal vehicles, mandatory lecture attendance, wearing prescribed safety apparel on the worksite, and observing all other safety regulations.

In making this application to attend a Great Lakes course, I affirm that I am in general good health and that I accept as my personal risk the hazard of such participation, and will not hold Great Lakes School of Log Building or its representatives responsible or liable for any injuries, mishaps, loss of or damage to personal property, or any other eventualities on or relative to a Great Lakes School of Log Building course.

In consideration of Great Lakes School of Log Building accepting my application, I hereby release and forever discharge Great Lakes School of Log Building, its officers, directors, employees, volunteers and agents from any liability whatsoever arising from my participation in the course, and I declare that this release is binding upon me, my heirs, executors, administrators and assigns.

[Important: Be certain of your intentions. No refunds are given for any reason except if the course for which you register is full or if we cancel a course.]

Signature(s):
Date:
Dates of session for which I am applying:
Notary or non-related witness (print):
Full Address of notary or witness:
Signature of notary or witness:

[We suggest you make a copy of this document for your records]

_ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

After printing, please read, fill out and have your signature witnessed on the form. Mail the form with your check, money order, or credit card information for the full tuition amount to our office or scan form and email it to courses@schooloflogbuilding.com

Great Lakes School of Log Building, 1350 Snowshoe Trail, Isabella, MN 55607.

You will be sent a receipt/acknowledgement, our Log Building Bibliography for future readings, preliminary safety handouts for study, detailed information on required and optional tools/safety gear and a map to the school.


Great Lakes School of Log Building 
1350 Snowshoe Trail,  Isabella, MN 55607
 218.365.2126
courses@schooloflogbuilding.com

Copyright ©2016, Great Lakes School of Log Building