Ilan-Lael Workshops

Instructors: Brennan Hubbell with James Hubbell and Special lecture on Green Building by Drew Hubbell, AIA

Chapel: July 29th through August 15th, 2009 La Rosa Blanca: August 16th through August 18th, 2009 (please indicate your preference)

Activities: Building in cement, stone, steel, plaster, tile setting, landscaping. Will also work with James Hubbell studio on glass, iron forging, and other.

Registration Form

Name: ____________________________________________________ Address:             ____________________________________________________                ____________________________________________________                ____________________________________________________ Phone:            ___________________________ Fax:                      ___________________________ Email:            ___________________________ Emergency Contact Name & Phone:

Food Allergies:          __________________________________________ Medical Conditions and/or Medications: _________________________________________

We will not be providing medical insurance for your time to attend the workshop in either the U.S. or Mexico.  Please ensure your own coverage.  No parties involved in organizing the Chapel Workshop or the La Rosa Blanca Workshop, nor Ilan-Lael Foundation, nor Colonia Esperanza school, will be held responsible for any injuries or medical problems that arise during the workshops.  Attendance will be at your own risk. Please sign and return this waiver form before the start of the workshop.

Signature_________________________________________________Date____________________

(For Mexico workshops) I authorize the organizers of La Rosa Blanca or staff members of Colonia Esperanza to call a Mexican doctor in the event of an emergency where I will require immediate medical attention.

Signature_________________________________________________Date______________________