Arrow Rock Quilt Camp
April 29 – May 3, 2019
Name__________________________________________________________
Address________________________________________________________
_____________________________________________________________
Telephone____________________Email______________________________
- T-shirt size: (complimentary) S M L XL 2XL 3XL 4XL
Lodging: I want ( ) Camp registration with single room: $800.00
Or ( ) Camp registration as shared room (2 beds, sharing bath): $700.00
Roommate / Lodging request ___________________________________
Or ( ) I do not need lodging ~~ Camp Registration: $500.00
Indicate your choice of classes and number of days taking the class
_______ “TBD” – Klonda Holt
_______ “TBD” – Candyce Grisham
_______ “Mystery Quilt” – Mary Durham
_______ “TBD” – Shelly Pagliai
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Release of Liability: I assume the risk of the activities at Arrow Rock Quilt Camp and waive any right to file a claim against Arrow Rock Quilt Camp, its employees and volunteers for injury, loss or damage to me or anyone accompanying me for any reason.
Emergency contact number: _____________________________________
Signed:____________________________________________________
To Register: Print & complete this form ~ send it along with $100 deposit. The total payment will be due before March 1, 2019 – Please make check payable to “Arrow Rock Quilt Camp” and mail to: Paula Blevins, PO Box 142, Arrow Rock, MO 65320