Jackie's Sewing Service
Creating Heirloom Quilts for the stories of Your Life!
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REGISTRATION FORM
Quilting with Jackie Quilting Camp
November 4 - 6, 2016
To REGISTER you must do these two steps:
#1 Complete form below and click submit.
#2 Pay your deposit or full registration
You will not be registered until
BOTH
form and payment are submitted.
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Which quilt will you make at camp?
*
Convergence Quilt - Easiest
Churn Dash Quilt - Confident Beginner
Double Irish Chain Quilt - More Challenging
Select One
Do you have any dietary restrictions?
*
None
Gluten-Free
Lactose-Free
Diabetic diet
Other
Check all that apply
If Other please specify:
*
Optional Lunches - Choose One
*
Option 1 Friday and Sunday lunch
Option 2 Friday lunch only
Option 3 Sunday Lunch only
Option 4 NO lunch on Friday or Sunday
Please select the option that reflects your intentions at camp here and again on the payment page. Thank you.
Rooming Preference
*
Tell us if you have a person(s) you'd like to share a room with or if you would prefer a single room. FYI, there are only 2 or 3 single rooms available, usually 2 or 3 women share one room.
Emergency Contact Person
*
In the event you become suddenly ill or are injured, who should we contact?
Emergency Contact Phone Number
*
Emergency Contact Email
*
When you click on the SUBMIT button, you will be redirected to the secure on-line payment portal.
(Jackie does not see your credit card information).
If you would rather mail a check than pay online to complete your registration, click on submit to send your registration information. Then, simply close the portal when it opens and mail your payment as quickly as possible to Jackie. Your registration is not complete until you do so. If you have any questions about the registration process or camp, please contact Jackie at 906-779-5852. Thank you.
Jackie's Sewing Service
W8371 Merriman West Road
Iron Mountain, MI 49801
Submit
Convergence Quilt - Easiest Option and very awesome!
Churn Dash Quilt - Confident Beginner
Double Irish Chain - More Challenging
✕
