2024 Fall Quiltapalooza Retreats

Registration Information for our Guests of both Fall Retreats, important for emergency contact forms.

Full Name (First, Last)*

Home Street Address*

Home City and State*

Home County*

Email Address*

Phone Number (Cell)*

Emergency Contact Name*

Emergency Contact Phone Number*

Please list any Food Allergies we should know about. (Note, this is for MEDICAL ALLERGIES that if ingested will cause harm)

Do the Allergies listed above require medical attention if consumed or contacted?*

If you have Medical Dietary Restrictions, it's imperative that you complete the Retreat Center's Form at the top of this page. Click the link above and fill out the form, then submit to teamAQR@amysquiltroom.com. Have you already completed this task?*

Do you have any Special Needs we would have to make accommodations for?

Requested Sewing Mates (3-6 Suggestions. If None, please respond N/A. We will do our best to honor your request, but please understand there's no guarantee.)

What is your Preferred Shirt Size?*

Do you plan to leave Retreat early? Regular Check out of your room is 10am (Monday or Friday, given if you are First or Take 2) Please list the day and time you expect to leave.*

Would you like to Schedule a Massage? (Only Chair Massages will be offered in 15 or 30min increments, $1/Min paid in cash directly to the masseuse) *

I am Registered for Retreat:*

Any Additional Comments about your Registration?

GET MEDICAL DIET REQUESTS/FOOD ALLERGY FORM HERE

Return Completed form to teamaqr@amysquiltroom.com

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Contact Us

Amy's Quilt Room
69 Romeo Lane
Uniontown, PA 15401
Call us now: (724) 434-9987
Email: info@amysquiltroom.com
Click here for our store hours.

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2024 Fall Quiltapalooza Retreats

GET MEDICAL DIET REQUESTS/FOOD ALLERGY FORM HERE

Return Completed form to teamaqr@amysquiltroom.com

Site Links

Contact Us

2024 Fall Quiltapalooza Retreats

GET MEDICAL DIET REQUESTS/FOOD ALLERGY FORM HEREReturn Completed form to teamaqr@amysquiltroom.com

Site Links

Contact Us

GET MEDICAL DIET REQUESTS/FOOD ALLERGY FORM HERE

Return Completed form to teamaqr@amysquiltroom.com