Arrow Rock Quilt Camp
April 28-May 2, 2025
Name_________________________________________________________
Address_______________________________________________________
_____________________________________________________________
Telephone____________________Email_____________________________
Lodging: I want ( ) Camp registration with private housing: $850.00
Or ( ) Camp registration as shared housing: $750.00
Room mate/ Housing Request___________________________________
Or ( ) I do not need housing~~ Camp cost $500.00
_____ I am paying for housing but don’t want breakfast(price reduced by $40).
Indicate your choice of classes and number of days taking the class.
_______ Klonda Holt(On Point) _______ Candy Grisham(Turbine)
_______ Mary Durham(Mystery)
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Release of Liability: I assume the risk of the activities at Arrow Rock Quilt Camp and waive any right to file a claim against Arrow Rock Quilt Camp, its employees and volunteers for injury, loss or damage to me or anyone accompanying me for any reason.
Emergency contact number: _____________________________________
Signed:____________________________________________________
To Register: Print & complete this form ~ send it along with $100 deposit. The total payment will be due before March 1, 2025. Please make check payable to “Belinda Essmyer” and mail to: Belinda Essmyer, 125 West First, Milan MO 63556