Quality Patterns, Kits, and Supplies for Traditional and Contemporary Rug Hooking

 Registration Form

Scrub Hooking Camp - January 25-28, 2019

The Inn On The Lakes

3101 Golfview Road & US 27 South

Sebring, Florida, 33872

Please print this form and return by mail to Seaside Rug Hooking Company (address below) No email registrations will be accepted.

Please fill in all blanks and make check payable to Seaside Rug Hooking Company for the registration fee of $85.00. Balance of $320.00 payable by January 20, 2019. Deposit of $85.00 is not refundable. Prices are subject to change.

Enclose a SASE so I may mail your confirmation to you or I will send it by email if you prefer.

 

Check #_____________________ & amount of check: _______________________, Date_________________________

 

Name:_________________________winter-Phone#_______________________summer phone____________________

 

Winter-Street:________________________________City:__________________________State:_____Zip________­____

 

Summer-Street:_______________________________City:__________________________State:_____Zip____________

 

E-mail Address: ___________________________________________________________________Please print clearly

 

Name and # to call in case of an emergency_______________________________________________________________

 

Who will your room mate be? _________________________________________ Do you need a roommate?__________

                                                                                  

*Teachers: Joan Reckwerdt, Diane Stoffel or Sheila Abrogast

 

1st choice_______________________________________, 2nd choice __________________________________________

 

Please list any necessary diet restrictions:________________________________________________________________________________

__________________________________________________________________________________________

 

I will not hold the director or teachers responsible for any accident or illness. Please Initial ________________

 

Confirmation will be sent by email upon receipt of registration or

enclose an SASE if you prefer & it will be snail mailed to you.

 

If a guest is coming and wants all meals the price is $210.00 including gratuities payable upon arrival.  Price is subject to change.

Name of guest____________________________________, Will guest be partaking of all meals? ___________

 

Comments_________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________                    

Laura Kenyon

Seaside Rug Hooking Company

133 Old Tower Hill Rd.

Wakefield, RI 02879

(401) 932-6994

email: Laura@rughookseaside.com