Adult Workshops Registration Form

Select a workshop:
*FULL- WAITLIST ONLY** DIY Kombucha, 05-11-2019 - 10:00AM - 12:00PM

Your Name (required)

Your Email (required)

Your Phone # (required)

Number of Adults (18 and over):

Number of Children (children 12 and over welcome at adult workshops)

How did you hear about this workshop?
Willow Bend's WebsiteWillow Bend's NewsletterFacebookAZ Daily Sun CalendarKNAU (Calendar or Radio)Flag365 CalendarRadio - otherFlyerI don't remember

Have you been to Willow Bend before?
Yes, I have been to Willow Bend.No, I have never visited Willow Bend.

Are you a member?
Yes, I am a member.No, I am not a member.Not sure

If not, are you interested in receiving information on becoming a Member of Willow Bend?
Yes interested in membershipNot interested in membershipNot sure

By checking this box I grant permission to Willow Bend Environmental Education Center to use photographs of my participation in program activities for publicity, advertising, brochures, web content, or other similar media for the purposes of promoting future educational programs at Willow Bend. I understand that my name will not be included in such publications.
YesNo