Registration Form
“Stitching in the Valley” 2015 Retreat
October 9th – 11th
Hosted by Valley Needleworks
Date: ________________
Name: ___________________________ Email: ________________________________
Address: _______________________________ Phone/Cell #: __________________
_______________________________
_______________________________
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Please check option below:
*Please see page 4
Number of People
Total Cost
___ Skyline Option ($150 per person)
______
_________
___ Blue Ridge Option ($420/$300/$365/$440)
______
_________
___ Shenandoah Option ($340/$250/$325/$400)
______
_________
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Classes: *Please make choices below. Do not include cost if class is included in the option chosen. If you are taking
additional classes or adding classes to the Skyline option – please include price from page 3.
Notforgotten Farm (Lori Brechlin)
Number of People
______
Pomegranate Crewel (Debbie Culp)
______
Barrick Samplers (Kathy Barrick)
______
Summer House Stitche Workes (Beth Seal)
______
*You may split the classes any
way you choose. For example, if
there are 2 retreaters that choose
an option with 2 classes – both
can take the same class or choose
different ones, or one retreater
can sign-up for both classes.
Total # of People/Classes: _________ Total Cost of Classes Added: _________
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Add Option Cost & Class Cost for the Total:
___________
Examples:
Skyline Option, add 2 classes:
$150 + $160 = $310 (Choose 2 classes & include cost)
Shenandoah Option w/ 4 classes, add 2 classes: $800 + $160 = $960 ($480 per person, choose 2 classes & include
cost for the additional classes)
Blue Ridge Option w/ 2 classes: $730 ($365 per person, choose 2 classes & do not include class cost)
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Office Use Only
Date form received: __________ Deposit Included: ________ Check # _____ Received by: ______(Please initial)
Room reservation made by: ________ Wayside Room # _____ Holiday Inn Room # ______ S or D _______
BD ____ WB ____ LU ____ L/MB ____ NFCL ____ SHSWCL ____ BSCL ____ DCCL ____