Oct 12-15, 2012 Retreat Registration Form

Name:

Address:

City:

State:

Zip:

Country:

Phone:

Fax:

E-mail:

Name as it should appear on your name tag:

I will be sharing a room with (if known):

Registration
Option Cost Qty
(please enter)

Option 1 : Cost per person (sharing room with two queen beds, 3 nights accomodation, all meals, stitcher package)

$749.00

Option 2 : Cost per room - Sole occupancy room (one stitcher/one queen bed ), 3 nights accomodation, all meals, stitcher package).  If you will be accompanied by your non-stitching spouse or companion then you must also choose Option 4 below.

$849.00

Option 3 : Commuter - cost per person (stitcher package, all meals excluding breakfast) - this package does not include any accommodation.

$549.00

Option 4 : Meal package only (this package is only available (and is compulsory) to a non stitching companion/spouse sharing with a stitcher in a Sole occupany room)

$150.00

Option 5 : Additional night accommodation per person (night before retreat) - sharing with one other person

$52.50

Option 6 : Additional night's accommodation per room - sole occupancy room

$105.00

Total Amount

$0

Payment Options

I would like to pay $200 deposit now and the balance on August 12, 2012.

$200.00

Charge my credit card for the total amount now.

$0.00

Additional Comments: