Workshop Signup

*Denotes required field

*Participant Name:

*Street Address:

*City, State, Zip:

*Phone:

*Email:

*How did you hear about us?

*Workshop Choice:

*School:

*Age:

*Parent/Guardian Contact Info:

*Emergency Contact Info (different from above):

*Allergies or Medical Conditions :

*Please check the following boxes if you permit, or do not permit us to publish your work during or after the conclusion of our workshops. If you are under 18, your parent or legal guardian should check the boxes below.

I give permission to The Telling Room of 225 Commercial Street, Suite 201, Portland, Maine 04101, to publish my work and my likeness, name, or art in all forms of media including:
Video
Audio
Text
Photography

I DO NOT give permission to The Telling Room of 225 Commercial Street, Suite 201, Portland, Maine 04101, to publish my work and my likeness, name, or art in all forms of media including:
Video
Audio
Text
Photography

Questions/Comments:

Come visit us at:

The Telling Room
225 Commercial Street
Suite 201
Portland, ME 04101
(207) 774-6064
writers@tellingroom.org

Workshop Signup

More Info