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Falling Needles Retreat 2012
September 26 – 30, 2012
                                          HEG “Falling Needles” Retreat
                                         Camp Allen, September 26 – 30, 2012
                                                 Registration Form






Name ___________________________________________________________________
Address ____________________________   City, State, Zip ______________________
Email ___________________________________________________________________
Home Phone         ____________________________        Cell Phone _____________________
Emergency Contact Name _________________        Relationship ____________________
               Phone (Day) _________________        Phone (Night) ___________________
Roommate _______________________________________________________________
We have only 15 rooms this year so get your registration form and deposit in early to secure your room.  Please
select one of the following options.  All meals are included.  Check-in is 3:00pm.  Check-out is 12:00pm.




____ 4 days double occupancy:  $316
____ 3 days double occupancy:  $237  (which nights? □ Wed.  □ Thurs.  □ Fri.  □Sat.)
____ 2 days double occupancy:  $158  (which nights? □ Wed.  □ Thurs.  □ Fri.  □Sat.)
____ 1 day double occupancy:      $79  (which night?   □ Wed.  □ Thurs.  □ Fri.  □Sat.)
____ 4 days single occupancy:   $456
____ 3 days single occupancy:   $342   (which nights? □ Wed.  □ Thurs.  □ Fri.  □Sat.)
____ 2 days single occupancy:   $228   (which nights? □ Wed.  □ Thurs.  □ Fri.  □Sat.)
____ 1 day single occupancy      $114   (which night?   □ Wed.  □ Thurs.  □ Fri.  □Sat.)
You must be a member of the Houston Embroiderers’ Guild to participate.  If you are not a member we
welcome you to join as a Primary or Plural member.  Find our membership form on our website at www.myheg.
com.
Payment Deadline: A non-refundable $100 deposit is due with your registration form to hold your place.  Full
payment is due by June 28, 2012.  If full payment is not received by June 28, your place may be released.
Cancellation Policy: The $100 deposit is non-refundable.  If you cancel before June 28, 2012, any fees you have
paid in excess of the deposit is refundable.  There are no refunds after June 28, 2012.
Return registration form and check payable to “HEG” to:
                              HEG Falling Needles Retreat
                              c/o Shannon Shock
                              2011 Inscho Ln.
                              Katy, TX 77450.  
Questions?  Contact Shannon Shock at 281-693-4417 or email her at shandee12@aol.com.