Registration Form

Title (choose one) Dr., Mr., Mrs., Ms, Miss

Age (if under 21) ___ Parent/Guardian (if participant under 18) _____________________________

Name ___ _________________________________________________________________________

Address___________________________________________________________________________

City________________________________ State__________________ Zip code________________

Phone ____________________________ Email Address___________________________________

           Course Title ______________________________________________________ Fee_______________

Course Title ______________________________________________________ Fee_______________

Course Title ____________________________________ _________________ Fee_______________

            Total Fee $________________

Course fees must be paid at the time of registration.

Make check payable to NMSU Carlsbad and mail to the following address or by Credit cards are accepted by calling Business Office 575-234-9200.

Please note prior to paying with credit card there is the need to print, complete the form and mail to the following address or email to mtmcnair@nmsu.edu.

NMSU Carlsbad Community Education

1500 University Drive

Carlsbad, NM 88220

If you have any questions, or if you will be unable to attend this class, please contact Business Office 575-234-9200

Media Waiver- I hereby grant to the Board of Regents of New Mexico State University, its employees, agents and assignees, the right to use photographs, video and/or digital recordings of me and materials created by me.

Waiver- As the undersigned, I hereby agree and promise that I will not hold the Regents of New Mexico State University, their employees, their agents, or others who are involved in supervision or operations of activities sponsored by Community Education responsible for any damages and/or personal injuries which I may receive as a result of participation in Community Education courses.

Health Waiver- My signature below attests to the fact that I have medical clearance to engage in the activities in the courses listed above.

Participant’s Signature: ________________________________________________________

By signing I acknowledge that I have read and understand the Registration/Cancellation/Refund Policy.

(Parent Must Sign if Student is Under 18)

Electronic Parental Signature______________________________________________________________

By signing I acknowledge that I have read and understand the Registration/Cancellation/Refund Policy.

Date________________________________________

Registration/Cancellation/Refund Policy

Registration

Payment is due at the time of registration. Registration is required at least 48 hours (two business days) prior to the class start date. Early registration is encouraged to ensure enrollment in the class and to prevent cancellation due to low enrollment. We accept Visa, MasterCard and Discover credit cards. Checks must be payable to NMSU Carlsbad. Course fees must be paid at the time of registration. If your registration is to be paid by your employer, we can bill your organization/company when the purchase order is received in advance. We will contact you if the class is full or cancelled.

Cancellation/Refund Policy

Because of the nature of Community Education classes, refunds will be issued only as follows:

· 1 day class; any time before the start of the class minus a $10.00 processing fee per person.

· All other classes; any time before the start of the second class minus a $10.00 processing fee per person. Refunds may take up to 30 days to be processed.

· If you do not attend, you will be responsible for the entire payment without benefit of a refund. You are welcome to send a substitute if you cannot attend. A working day is defined as Monday through Friday, with the exception of published holidays.

· A full (100%) refund will be given only for classes that are cancelled by Carlsbad Community Education.