Registration Per Person (Please print)
Name______________________________Address_____________________________
City_________________________St_____
Zip______________________
E-mail address________________________
Phone (day)__________________________
(night)______________________________
Please put course number in order of preference under the date. We will try to accommodate everyone’s requests in the order of completed registration—including paid tuition.
Mon 6-25 Tues 6-26 Wed 6-27
Course # Course # Course #
1st choice _______
_______ ________
List Back up Classes in case the class you want is full
Monday Back Up Class ________
Tuesday Back Up Class _______
Wednesday Back Up Class ________
Tuition June 25,26,27
$175
AFTER June 1
($200)
________
Tuition per day $75
AFTER June 1 ($85)
________
Yes, I am attending the Welcome Reception on Sunday
June 24th. (free to registered
students) ________
I am bringing guests to the Quilt Camp Reception ($15 per person)
Number of guests: _________ x $15= _________
Extra Materials Fees Payable with tuition
Carr (Class # 2
-$30)
_________
Woodworth (Class #7 -$30)
_________
Woodworth (Class #14 -$30) _________
Woodworth (Class #19 -$15) _________
Kids Class (Class # 10 - $110) _________
TOTAL DUE ____________
Payable by CHECK OR MONEY ORDER ONLY to
TOWN OF LONG
LAKE
c/o Adirondack Quilt Camp
PO Box 496
Long Lake, NY 12847
Sorry no credit
cards accepted.
Class Assignments will be available in June.
We will let you know as soon as possible.
Thank you so much for registering!
Phone: 518-624-3077
Fax: 518-624-2010
www.adirondackquiltcamp.com or
www.mylonglake.com
All ADULT CLASS MATERIALS are additional fee - please pay with your
tuition or you will not be fully registered in the class.
All materials for Quilt Camp and are not included in registration fees
except for the Children's Class.
CANCELLATION FEE OF $25 WILL BE CHARGED IN THE EVENT REFUND IS REQUESTED.
Full payment required at time of registration.
Registration after June 1 for 3 day workshop increases to $200 and daily rate increases to $85 so Register Early!