KHQS REGISTRATION FORM

QUILTING ADVENTURES 2010 WITH BARBARA OLSON
SEPTEMBER 20-23, 2010
CLIFFVIEW RETREAT CENTER
LANCASTER, KY
 

I would like to register for the KHQS Quilting Adventures 2010 with Barbara Olson workshop, Intuitive Images , September 20-23, 2010, Cliffview Retreat Center, Lancaster, KY. 

 

I understand that spaces will be filled on a first-come, first-served basis.  Additional names will be placed on a waiting list.  A NON- REFUNDABLE deposit of $50 will register me, with a balance of $400 (includes all meals and lodging) due on July 15, 2010. 

You must be a KHQS member to attend.
 
Name:     KHQS Member Yes No
Address:
City: State: Zip:
Phone:
Email:
 

Indicate your preference:
 
$50 non-refundable deposit (balance of $400 due on July 15, 2010)
 
KHQS membership-$20
 

I enclose my non-refundable registration fee of $50:
Check #:     Amount :     Date :
 

Make check payable to KHQS and mail it, along with this form and any questions to:

Karen Templeton, Administrator
698 Briarfield Road
Scottsville, KY  42164
(270) 618-0013
ktempleton@tcemc.org

 
Please complete this form, print it out, sign and mail it with your check.
 

I hereby grant permission for photographs of my quilts and/or photographs of my participation in Kentucky Heritage Quilt Society (KHQS) activities to be used by KHQS in newspapers and magazine articles, on television, in brochures, on posters and postcards, and on the KHQS website.

Signature______________________________________________   Date:________________