Name_________________________________________________ Address________________________________________________ ______________________________________________________ Phone #________________________________________________ E-mail address___________________________________________ (Used for confirming your registration) Please print clearly. *Please check which type of weekend you are registering for* Scrapbooking____ Quilting____ Free For All_____ (food and pampering included) 0R Just Wanna Scrap Weekend_____ Date __________________________________________________ check-in time 5 p.m. Thursday_______ 10 a.m. Friday_________ Please make check made out to A Time To Create Check number_______ Amount of check_________ Please be aware we will no longer be taking credit cards for payment. Check or cash only please. How did you hear about us?________________________________________ Is this your first visit with us? yes_____ no_____ I am booking with a group and the coordinators name is ____________________________________ Yes, I would like to book a massage______ Must be booked in advance but paid for at the time of massage Please print form and mail to: A Time to Create 4976 181st Street Chippewa Falls, WI 54729 |
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