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Please
PRINT and complete the following form and mail with a deposit to:
Heart
and Soul Memories, Inc.
1938 Sheridan Road
Buffalo Grove, IL 60089
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:
Jan. 25-27, 2008 |
Feb.
22-24, 2008 |
March 7-9, 2008 |
| April 11-13, 2008 |
Sept. 19-21, 2008 |
Oct. 17-19, 2008 |
| Nov. 7-9, 2008 |
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Please circle
the package you are registering for:
ULTIMATE
SCRAPPER PACKAGE
(full
weekend) |
DIEHARD
SCRAPPER PACKAGE
(Fri./Sat.) |
WEEKEND
WARRIOR SCRAPPER PACKAGE
(Sat./Sun.) |
single hotel
room double hotel room** triple
hotel room** quad hotel room**
**Please indicate roommates:
____________________________________________________________________
| LOCAL
SCRAPPER PACKAGE (no lodging) |
QUICK
FIX SCRAPPER PACKAGE (Sat. only) |
| MINI SCRAPPER
PACKAGE (Sun. only) |
NIGHT
OUT SCRAPPER PACKAGE (Fri. only) |
Please
indicate who you would like to be seated with in the scrapping room:
____________________________________________________________________
Are you interested in participating in classes? _______
If yes, what
types of classes? _______________________________________
Deposit: Please enclose a deposit for 50% of
the package price to hold your place.
Methods of
Payment:
- Checks
made payable to Heart and Soul Memories, Inc.
- Credit
card payments: Call (847) 478-1931 to pay by credit card.
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.
___________________________ ________________________
Signature Date
Thank you! We look forward to
cropping with you soon!
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