Registration

Arrow Rock Quilt Camp
 May 4 – 8, 2020

Name__________________________________________________________

Address________________________________________________________

_____________________________________________________________

Telephone____________________Email______________________________

  • T-shirt size:  (complimentary)     S   M   L    XL   2XL   3XL  4XL

Lodging:   I want  (     ) Camp registration with private 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
_______  “” – Klonda Holt           _______  “” – Candyce Grisham
_______  “”  – Mary Durham       _______   “”  – 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, 2020  –     Please make check payable to “Arrow Rock Quilt Camp” and mail to:     Paula Blevins, PO Box 142, Arrow Rock, MO 65320