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
























