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OFFICIAL REGISTRATION
CHRISTIAN CLOWN CONNECTION 2005
November 4 & 5, 2005
Prince of Peace Lutheran Church, 1515 Semoran Blvd, Orlando, FL 32807
REGISTER
SOON - CONNECTION LIMITED to 125. MAKE ADDITIONAL COPIES OF THIS FORM
PLEASE PRINT or TYPE
NAME MALE
FEMALE_____
ADDRESS___________________________________________________________________________
(Street)
(City) (State) (Zip)
q
Check here if this is a new address or if
this is your first time with us.
PHONE including AREA CODE( )
e-mail________________________
CLOWN NAME
_______________________________________________________________
(Print clearly in upper and lower case exactly as you
want it to appear on the name tag)
I have been clowning for years.
q
I am representing
my church and have very little or no clowning experience.
T-SHIRT SIZE (Circle)
S M L XL XXL XXXL
I clown with:
_________________________________________________________________
(Troop/Group/Church)
(City) (State)
I attend:
_________________________________________________________________________
(Church)
(City) (State)
WORKSHOPS
So you can benefit from as many of this
year’s great workshop leaders as possible, please pick your favorite 7
choices. You will be assigned 3 workshops. Rank your choices from 1 to 7
with #1 being your top choice, #2 your second choice, etc. We will do
our very best to assign you to the classes you pick; however, some workshops
will be limited in size. Please read the class descriptions carefully then
number your 7 choices in the spaces provided below.
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Out of my pocket |
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Tell me a story |
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Clown magic |
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Prop shop |
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Face art |
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Creative (and
cheap) clown costuming |
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Mime you're
looking well today |
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Motions and emotions |
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How to make your
clown funny |
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Clown history
101 |
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Beginning clown make-up |
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Hospital
clowning—healing power of laughter |
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Advanced
make-up* |
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Help! I'm clowning and I can't
cut-up! |
*
please check your make-up type and bring a recent photo of your clown face:
qWhite
Face qAuguste
qTramp
q
I Don't Know!
qJust
beginning
REMEMBER TO MAIL YOUR APPLICATION SOON
REGISTRATION LIMITED TO 125!
Registration Fee: $69
includes: Conference Fee, All Workshops Attended, Saturday
Lunch, Clown Name Tag, Goody Bag, T-Shirt
Hotel registration is separate. Please see the hotel
information page for details.
Make Checks Payable to:
PRINCE OF PEACE LUTHERAN CHURCH
Mail Registration and
Check to: Christian
Clown Connection, Attn: Jim Nocks,
C/O Prince of Peace Lutheran Church, 1515
S. Semoran Blvd, Orlando, Fl 32807
SORRY,
APPLICATIONS CANNOT BE ACCEPTED WITHOUT FULL PAYMENT.
QUESTIONS:
Call Jim Nocks at (407) 277-3945 (Please leave message.)
or e-mail your questions to
nocks@bellsouth.net
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