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Request for registration

Location: Montréal
Event: Range MasterClass
Date: August 9, 2017 6:30 PM - 9:00 PM
Fee: $95.00 per person
Cancellation Policy: A refund will only be provided if notification to Miele is given at least 72 hours prior to the event

Please fill in the fields in the form below. Fields indicated by * are required.

Total Participants:
Salutation*
First Name*

Last Name*

Street Number*

Street Name*

Apartment Number

City*

Province*

Postal Code*

Phone*

Extension
Alternative Phone

Extension
Email Address*

Do you have any food aversion, allergies or dietary restrictions?*

What would you like to learn during the class?
Correspondence Preference