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2010 Rug Hooking Retreat Registration Form
Complete
one form per student and mail to: Sauder Village, Rug Retreat, P.O.
Box 235, Archbold, Ohio 43502
or fax to 419.445.5251.
A confirmation will be
sent to you via email. If you prefer your confirmation be mailed to you,
please enclose a business size SASE when you mail in this form.
Questions? Contact
Retreat Reservationist, Dawn Hauter 800.590.9755 ext. 3076 or dawn.hauter@saudervillage.org
| Name: |
_________________________________________________________________ |
| Address: |
_________________________________________________________________ |
| City: |
______________________________ |
State: |
________ |
Zip: |
____________ |
| Phone: |
______________________________ |
| E-Mail: |
_________________________________________________________________ |
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Instructor
Preference:
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Who
is your first choice as instructor for the entire retreat?
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* Gene
Shephard
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*
Helen Jeffrey |
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* Jane
Halliwell Green |
*
Bea Brock |
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Who
is your second choice as instructor for the entire retreat?
|
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*
Gene Shepherd
|
*
Helen Jeffrey |
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* Jane
Halliwell Green |
*
Bea Brock |
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Who
is your third choice as instructor for the entire retreat?
|
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* Gene
Shepherd
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*
Helen Jeffrey |
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*
Jane Halliwell Green |
*
Bea Brock |
Registration: |
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*
Retreat Instruction Fee/ Non-Member
*
Retreat Instruction Fee/ Village Member
*
Wednesday "Pasta Your Way" Luncheon Buffet
*
Box Lunch
__ Tuesday
(select: __
Chicken Croissant
__ Ham Croissant
__ Spinach Salad or
__ Chef Salad)
__ Thursday
(select: __
Chicken Croissant
__ Ham Croissant
__ Spinach Salad or
__ Chef Salad)
__ Friday
(select: __
Chicken Croissant
__ Ham Croissant
__ Spinach Salad or
__ Chef Salad)
*
Companion Ticket
Companion's Name: ____________________
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$275.00
$255.00
$10.50
$8.50
$8.50
$8.50
$50.00
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TOTAL Payment Enclosed:: |
$____________ |
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Method
of Payment:
* Check
(payable to Sauder
Village)
*MasterCard * Visa
* Discover
* Am. Express
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Credit Card Number: _________________________________
Expiration Date: ________ |
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V-Code #
___________ (last
3 digits on signature line on back of card)
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Important Reminder!
Upon
our receipt of this Retreat Registration form and payment, you
will be provided both a Booking ID # and a Retreat
Confirmation #. You can then provide these numbers to
inquire about availability of a campsite or room at the Sauder
Heritage Inn from the block being held for confirmed Rug Retreat
participants, available on a first come basis until Monday, July 12,
2010.
Cancellations prior to June 25,
2010 will receive a refund of fees paid minus a $75.00
processing fee. No refunds given after
June 25,
2010. If classes do not meet minimum number of students
by June 25,
2010, we may be forced to cancel the class and all
fees will be refunded.. |
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