Quilting On The Rim  

Registration Form

Today's Date:  ___________________________

Group Name:  ________________________________________

Contact Name: ____________________________________________________________  

Address:  _______________________________________________________________

Phone:  __________________________    E-mail:  _______________________________  

Requested Retreat Date: ________________________ Alternate Date: _________________

Number & Name of guests in your group (6 guest minimum)    ___________ 

___________________________________    ___________________________________

___________________________________    ___________________________________  

___________________________________    ___________________________________

___________________________________    ___________________________________  

___________________________________    ___________________________________ 

If you have less than 10 guests, is it OK to add guests to your weekend? _____________

Deposit:  ($50 per guest to hold your weekend, $300 Minimum): ________________

For more information or questions please call Barbara at:   602-618-6371 or Barb@QuiltingOnTheRim.com
Please mail this form with deposit check to:  
Barbara Hale     Quilting On The Rim     1207 Elliott Lane, Show Low, AZ  85901