Rug Hooking / Rug Braiding Retreat Registration Form
Please print out this form and mail it with payment to:
cheapsheep.com
Linda Dipert
4709 El Salvador Court
Arlington, Texas 76017
877.462.0046
We accept all credit cards: MasterCard, Visa, Amex and Discover.

Retreat Location/Date:*

___________________________________________________

Name:	_________________________________________________________
Address:	_________________________________________________________
	_________________________________________________________
City:	______________________________	State:	________	Zip:	______________
Phone:	______________________________ (include area code)
E-Mail:	_________________________________________________________

Room Details:

___ Double Occupancy   ___ Private Room   ___ Commuter   ___ Spouse/Guest

Teacher Choice (if applicable):

______________________________________

I would like to room with:

______________________________________

Check Enclosed:

$_____________________________________

(or) Credit Card Information:

Card Type:   ___MasterCard   ___VISA   ___Discover   ___AMEX   Card No.:__________________________________________   Expiration Date: _________(mm/yr)   Charge amount: $______________________   Your Signature: ______________________________________________________

*Your attendance indicates that you release the retreat of responsibility for injury or illness that might occur during your stay.

Please make check payable to cheapsheep.com. Mail form to: cheapsheep.com, Linda Dipert, 4709 El Salvador Court, Arlington, Texas 76017