Indulge in Stitches

 

 

I would like to register for

Country Hart’s
Indulge in Stitches
May 25 & 26 3013
 
Name......................................................................................................................................................
 
Address.................................................................................................................................................
 
.................................................................................................................................................................
 
Phone.....................................................Mobile..................................................................................
 
Preferred name.....................................................................................................................................
 
Dietary req.............................................................................................................................................
 
I would like to share accommodation with......................................................................................
 
................................................................................................................................................................
 
 
I would like to book for Friday night also , I understand that this is an additional expense which will incurred by me.....................................Yes/No
 
 
 
The total cost of the weekend is $520.00. A deposit of $80.00 is required upon registration.
$50.00 of which is non refundable.
 
I authorise Country Hart to charge my credit card $80.00 being my deposit for Indulge in Stitches
 
 
Card number..........................................................................................
 
expiry..................................ccv.......................................................
 
Name on Card.....................................................................................
 
Signature...........................................................................................
 
I understand that my final payment is due by March 29th 2013
 
Please card my final payment of $440.00 on 29/3/2013
I would like to pay by instalment's
Please charge my Credit Card
 
$    . 00 weekly / fortnightly/ monthly
beginning ......  /......./2012
I authorise the remaining balance will be charged on March 29th 2013


 

If you would like bank details for direct deposits please email

robyn.welsh@bigpond.com

Fax 0886332175

 


  

 


 




 

The Back Shed