quilters)paradiseretreat)–)quilting)at)the)beach) …paradiseretreat)–)quilting)at)the)beach)...
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Quilters Paradise Retreat – Quilting at the Beach Hosted by Quilting by the Bay
January 23-‐25, 2015 Retreat Registration Form
Name: _________________________________________ Email address: ______________________________________
Address: _________________________________________________ Phone number: ___________________________ City: __________________________________ State: ____________ ZIP: ___________________ Emergency Contact _______________________________ Phone _______________________ Accommodations -‐ Please check one: Double Occupancy ($325) Triple/Quad Occupancy ($300) – you must arrange your own roommates
Single Occupancy ($400) No Accomodations Required ($250)
Name of Roommate/Roommates: _____________________________________________________ Payment Information A minimum deposit of $100 is required to confirm registration. Your balance due/final payment will be automatically charged to your credit card on file between the 1st and 10th of November 2014. Your signature below is an acknowledgement that you have read, understand and agree to all terms and conditions of registering contained in this registration form. The undersigned agrees to indemnify and hold Quilting by the Bay harmless for any loss, damage, injury and/or other harm sustained during our retreat events. Further, you agree to make no claim against Quilting by the Bay, its owners, officers, employees, contractors, agents, or volunteers for any loss, damage, injury, and/or other harm sustained during our retreats. CANCELLATION/CHANGE POLICY If you are unable to attend the Retreat and you must cancel your registration entirely, Quilting by the Bay will charge a cancellation fee. Cancellation policies apply to all students. Cancellation notices must be emailed to [email protected] faxed to (850)215-‐7283 or mailed to: Quilting by the Bay, 2303 Winona Drive, Panama City, FL 32405 All cancelled reservations will have the following charges: -‐ Postmarked/emailed on or before November 1, 2014 -‐ $25 cancellation fee -‐ Postmarked/emailed between November 1, 2014 – January 5, 2015 -‐ $50 cancellation fee -‐ Postmarked/emailed on or after January 6, 2015 – No refund Your registration is fully transferrable to another student at any time with advance Signature: _____________________________________ Date: __________________ Payment by Credit Card (Visa/MasterCard/Discover only) -‐ Only include your credit card information if you are not making an online payment. Deposit Amount $ __________ Credit Card # _______________________________________ Card Expiration Date ______________ 3 digit CVV _________ Name on Card ______________________________________ Billing address if different from mailing address ___________________________________________________________________
We do not accept registrations by phone. Incomplete registration forms will delay your class confirmation.
I have read, understand, and agree to the Quilters Paradise Retreat Cancellation and Change Policy. Initial Here: ____________