Registration Form

Quiltport USA

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Quiltport USA Registration Form

Please print:

Name: _____________________________________________________

Address: ___________________________________________________

City, State, Zip_______________________________________________

Phone: ____________________ E-mail address_________________________ (You will receive confirmation by e-mail)

Rooms are to be booked and paid for through the Hilton Garden Inn, Freeport, Maine (207) 865-1433, located at 5 Park Street Freeport, Maine. Please let them know you are attending QuiltPort USA for event pricing, limited rooms available at the special price of $99. per room. To visit the Hilton Garden, go to: www.freeportdowntown.hgi.com Registration cutoff date is March 19,2012 to receive the discounted room rate. For your convenience, the Hilton Garden Hotel will be making available to you an A la Carte lunch buffet of sandwiches, salads, chips, cookies and soft drinks for a nominal fee (only cash is accepted for the lunch buffet). Per Hilton Garden's policy, no outside food is allowed in the ballroom.

Registration fee: $125.00 Mystery: $15.00 Yes_____ No______

No need to leave the ballroom to participate in the mystery! It will start Friday morning and go through Sunday and you may work on it at your leisure and still sew along with your friends. The cost is $15.00. There will be show and tell Sunday morning at 10:00.

Block Swap, "Free" - We just need to know if you want to participate.

Yes_______ No_______ Boats are the theme for Quiltport 2012!

Refunds for cancellations will not be given after April 1st, no exceptions. __________ please initial.

After April 1st, if you are unable to attend, only if you find a replacement will a refund be issued.

Registration fee: $125.00 Mystery: $15.00 Total amount: _________________

Please make check payable to: QuiltPort USA, Registration will not be processed if not paid in full
A $25.00 charge will apply to all checks returned by the bank

Please mail registration form to: QuiltPort USA, 46 Merriman Cove Rd., Harpswell, ME 04079

Please note, QuiltPort USA will not be held responsible for injury, theft, loss or damage to either yourself or property. QuiltPort USA has taken all precautions to offer you a safe and secure environment in which to learn, sew and enjoy your workshop and quilting experience.

I agree to the above policy as well as the Cancellation and Refund Policy set forth above:

Signature____________________________________ Date:

(Registration form and payment will be returned if not signed and accepted upon signature your spot will be temporarily held for 10 days)

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For office use only: Date received__________ Amount Enclosed____________ Registration #_______________

Check sent to Treasurer: _______________________