You
can also fax us your registration form to (847) 947-1717 and then send your deposit
via mail or by calling us with your credit card.
Name*:_____________________________________________________
Address:___________________________________________________
City, State, Zip:_____________________________________________
Telephone number:____________________________________________
E-mail:______________________________________________________
*Please note, participants must be at least 16 years of age.
How did you hear about Heart and Soul Memories, Inc.? ______________________
Have you attended another Heart and Soul Memories, Inc. event
? ______
Please circle the retreat you are registering for:
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Please PRINT and complete the following form and mail with a deposit to: Heart
and Soul Memories, Inc.
Please circle the package you are registering for:
single hotel
room double hotel room** triple
hotel room** quad hotel room**
Please
indicate who you would like to be seated with in the scrapping room: If yes, what
types of classes? _______________________________________ Methods of Payment:
Balance Due: The balance must be paid no later than two weeks prior to the beginning of the event. Refunds: Cancellations prior to two weeks prior to the beginning of the event will receive a refund for all but a $25 administration fee. Cancellations after two weeks prior to the beginning of the event will forfeit the entire deposit. Cancellations less than 1 week prior to the beginning of the event will not receive a refund of any monies, but may find a replacement to attend with no penalty. Penalties: A $25 fee will be charged for any returned checks. Waiver
and Release
The signature
below indicates that I, ___________________________, agree to the
following terms: I hereby release Heart and Soul Memories,
Inc., its sponsors, its offices, agents and employees, of all liability,
claims, lawsuits, damages, losses, costs, and expenses of any kind
which arise out of or result from my attendance at a Heart and Soul
Memories, Inc. retreat, whether or not foreseeable, including without
limitation, personal injuries to me or my invitees. Heart and Soul
Memoriesis is not responsible for lost or stolen goods. With my
attendance at this event, I realize that I may be included in publicity
photos. I hereby give my consent for the use of these photos
and my comments in future Heart and Soul Memories, Inc. promotional
materials. Thank you! We look forward to cropping with you soon!
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