Registration Form Page- Gloria Loughman, October 18 to 22, 2011
 

PRESENTS
Gloria Loughman

October 18 to 22, 2011
Canmore, Alberta, Canada

 

 

 

 

 

 

Registrant Contact Information

Name

Street Address

City: Province/State: Postal/Zip Code:

Telephone:   Fax:

Email:

Quilt Art Rockies - Gloria Loughman, October 18 to 22, 2011 - Workshop Fees

Please indicate the workshop of your choice. 5-day workshop is a combination of the 2day and 3 day workshops.
 2-day workshop- Playing on the Surface - $349 
3-day workshop- Paint a Landscape with Fabric - $499
5-day combined workshop - $749
Coffee breaks are included in workshop fees. All fees will have GST added. Lunches are not included.

Workshop Payment

Upon registration, a $100 deposit is required, with the balance of tuition fees payable by August 18, 2011.
Please indicate your payment preference by checking one of the following:  
Check
Money Order   Credit Card: Visa Mastercard  

We will contact you for credit card information; do not send credit information online or via email.
Please supply a contact telephone number:

To complete your Registration for Gloria Loughman, October 18 to 22, 2011,  please fill in the following areas:

Name: (please print)________________________________________

City:_________________________________________________

 

I have read and understood and agree to comply with all policies and conditions of the Sugar Pine Company pertaining to Quilt Art Rockies, including the requirement to carry valid travel health insurance.

I hereby further agree to indemnify and hold harmless Quilt Art Rockies and The Sugar Pine Company Ltd., it’s Trustees, officers, agents, employees, and volunteers from any and all claims, liability, and expenses, including without limitation, attorney’s fee arising from or in conjunction, with but in no event limited to, bodily injury, personal injury, death, or property damage resulting from any actions or inactions of The Sugar Pine Company Ltd., its agents, Trustees, officers, volunteers,  or employees. I expressly understand and agree that any performance bond or insurance protection required by law, this contract, or otherwise provided by The Sugar Pine Company Ltd., shall in no way limit my responsibility to indemnify, keep and save harmless and defend The Sugar Pine Company Ltd. as herein provided.

 

_____________________________________________________    ____________________________________________

Signature (Required for Attendance)                                             Date

Every attempt will be made to ensure that you get your first choice. If your first choice is unavailable, we will place your name on a waiting list for your first choice and you will be registered in your second choice classes. Where applicable, a refund will be issued for differences in fees between your first and second choices.

Please read the following carefully.  Electronic submission of this form will reserve a spot in a given workshop for 5 business days. Within that period, delivery of the $100.00 deposit is required for full registration in a given workshop(s). Payment can be made by: faxing the payment information (with Visa or Mastercard information and signature) to (403) 678-4703; or by mailing payment (cheque, money order, Visa or Mastercard information, with signature and date) to The Sugar Pine Co., 737 Tenth Street, Canmore, AB, T1W 2A3.

Please select one of the choices in the drop down menu below to signify that you understand & accept the terms and conditions of electronic registration, and will submit your deposit payment within 5 business days.

If printing this form to fax or mail, please use the space below to supply credit card information for deposit &/or final payment:

Card Number: _________________________________________________________ 

Expiration Date: ___________________

 

Return to Gloria Loughman Workshop information

 

Contact Us

The Sugar Pine Company

737 Tenth Street
Canmore, Alberta   T1W 2A3
Phone: (403) 678-9603  
Fax: (403) 678-4703
Email:  quilting@thesugarpine.com