Registration is by mail only and will be filled by earliest postmark. Confirmation in 2 – 3 weeks. (PLEASE PRINT)

Name__________________________________________________________________________________________

Address: _______________________________________________________________________________________

City____________________________________________________State________________Zip_________________

Telephone ( )________________________________________________________________________________

Email__________________________________________________________________________________________
Please indicate your choice of instructors for which you will accept enrollment on this registration form, later requests
will be put in order of postmark.

1stchoice________________________________________________________________________________________

2ndchoice_______________________________________________________________________________________

3rd choice_______________________________________________________________________________________

Meal options: Regular? __________Vegetarian? ___________

Deposit Policy: A $150 non-refundable deposit is due with the registration form and full payment must be made by
December 1, 2007. While classes may be available after that date, early registration should guarantee first choice
and avoid disappointment.
Acceptance by earliest postmark.

Cancellation Policy: All canceled reservations will have the following charges:
Now – 120 days $150.00 90 – 61 days $350.00
120 – 91 days $200.00 60 – 0 days No Refunds
Due to teacher and other related contracts and guarantees, cancellations cannot be made after 60 days prior to event. You may transfer your reservation to another person if unable to attend. All returned checks are subject to a $25.00 fee. We encourage the purchase of Cancellation and Travel Insurance.
www.travelguard.com is one option.

Deposit Enclosed $____________________________________________________________________

Your Signature______________________________________________________________________

Required signature for enrollment agrees to hold Quilters’ Escape, it’s staff, employees, and volunteers or leased facilities free from liability against injury, loss or damage to you or any person accompanying you for any reason.

Please send deposit payable to "Quilters’ Escape" with your completed registration form to:
Quilters’ Escape, 3414 K Street, Eureka, CA 95503
Additional information, Dixie McBride (707) 442-0081