2010 Summer Scrapper’s Summer Camp Registration Form

Mid South Scrappers Summer 2010 Weekend Retreat

When: Friday, July 23, 2010 at 9 a.m. through Sunday, July 25, 2010 at 2 p.m.

Where: Kirkwood National Golf Course, 277 Palmer Lane, Holly Springs, MS 38635

Cost: Two options to choose from, each listed in detail below.

Name :_______________________________________

Address :_____________________________________

City/State/Zip :_________________________________

Phone :_______________________________________

Your Email Address :____________________________

Alt. Phone :____________________________________

Emergency Contact Person:

Name :_______________________________________

Phone :_______________________________________

This is your registration form and contract for the Mid South Scrappers Summer 2010 Weekend Retreat. This is an “all-inclusive” package which includes your lodging, crop space, brunch on Friday, Saturday and Sunday, dinner on Friday and Saturday, along with all snacks and beverages for the course of the weekend.

There are two options to choose from:

Luxury Option – Have a double bed & 3’ x 6’ table to yourself at $225 per cropper.

A 3-payment plan is available! Deposit of $75 due at booking with two remaining payments of $75 each.

(There are only 10 of these available and will sell out fast! These are filled on a first come, first served basis.)

Thrifty Option - Sharing a double bed with another cropper & have a 3’ x 3’ table for cropping at $175 per cropper. A 3-payment plan is available! Deposit of $60 due at booking with two remaining payments of $60 and $55, respectively.

You have selected: _____ bed/table to myself at $225.

OR ­­­­­_____ shared bed/table at $175.

(Bed/table mate will be: __________________________.)

(Please note: There are two beds per room, so groups of four are the optimum.)

All balances must be paid in full by June 4, 2010. (No exceptions.)

You are always welcome to pay for the event in full! There are three options for payments! You may send checks or money orders or use PayPal if you’d like to pay with your debit or credit card. PayPal is a new option for you! Their website is: www.PayPal.com. My email address for payment is: terry@midsouthscrappers.com

Please note that menus are yet to be determined. If you have any food allergies, please send me an email to let me know so I can avoid those foods.

I understand that submission of this form along with my deposit or payment in full commits me to this event. If I am unable to come, it will be up to me to find my replacement and/or sell my spot. If there is a Waiting List, Mid South Scrappers will be glad to assist me in recuperating my fee but cannot guarantee that they will be able to do so.

Cropper’s Signature_________________________

Date_____________________________________

Please make checks payable and mail to:

Terry Dunlap, 488 Hill View Circle, Byhalia, MS 38611

Confirmations will be sent via email. Please make certain that I have your correct email address.