Quilt Camp 2010 Sign Up Form

Please complete the registration below and mail it with $100 nonrefundable deposit to:

Heartbeat Quilts, 765 Main Street, Hyannis, MA 02601
(800) 393-8050 toll free Fax: (508) 790-2711
www.heartbeatquilts.com helen@heartbeatquilts.com

Name:____________________________________________________________ Street:____________________________________________________________ City:___________________________________________ State:_____________ Zip:____________________
Phone: (home)______________________ (work)_________________________ Email:___________________________________________________________

I would like to sign up for:
□ 2 nights: Fri, Oct 15 & Sat, Oct 16, $559/pp double
□ 3 nights: Thu, Oct 14, Fri, Oct 15, & Sat, Oct 16, $729/pp double
□ 4 nights: Thu, Oct 14, Fri, Oct 15, & Sat, Oct 16 & Wed, Oct 13 OR Sun, Oct 17, $799/pp double
□ 5 nights: Wed, Oct 13 through Sun, Oct 17, $849/pp double

□ Rooming with:_____________________________ □ Please assign a roommate

In case of emergency contact:____________________________ Phone:_______________________
Form of Payment: □ Check □ Cash □ MasterCard □ Visa
Account #:______________________________________
Expiration Date:____________________ Signature:________________________________________________________