Ted E. Lane Photography

Please fill out all of the required information below. Fields that are marked with the * are required information and cannot be left blank. The cost for the Big Bend Photographic Workshop & Safari is $350.

*First Name:
*Last Name:
*Address:
*City:
*State:
*Zip:
Company:
Business Phone:
Home Phone:
*Email Address:

To make the workshop more meaningful, please supply the following information:
Primary occupation:
Years involved in Photography:
Do you have any medical condition of which management should be aware? (Will be kept confidential). If none, just leave the field blank.

Will you accept a roommate?:

*Required

By pressing the "I Agree" button below, I understand that I must furnish all my own equipment and film, and further agree to hold harmless, the instructors, for any and all liability which could or may arise from this workshop. I further understand that although efforts will be made to provide models native to the area, there are no guarantees.

Please press the button only once.