FOURTH ANNUAL LAKE CITY QUILT WALK

Section 1

Owner’s Name:_______________________________________

Address: ___________________________________________

City/State/Zip _______________________

E-mail: ________________________Tel. #: _______________

Section 2

Entry Fee: $5.00 per Quilt Show entry.  Entry Fee: $1.00 per Quilt Walk entry.  A separate Registration Form is required for each entry.

Title of Quilt: ________________________________________

Quilt Maker (if other than owner): _______________________

Quilted by (if other than owner): ________________________

Pattern (Optional): ______________________________

Enter in Category ____:  Is this quilt For Sale: Yes __  No__  

If yes, selling price: $_________ (20% of selling price to Quilt Walk)

Section 3

_____ I will mail the quilt entry to arrive between March 15 – 19,  2010.  Please enclose a check with your quilt made payable to Lake City Quilt Walk for return postage and insurance.  Please check with your shipper to determine postage/insurance costs.  Mail to:

                                             Lake City Quilt Walk

                                             c/o Amygene’s Embroidery Studio

                                             218 N. Marion Ave.

                                             Lake City,  FL 32055

Section 4

HOLD HARMLESS AGREEMENT

(Agreement must be signed to enter your quilt in the show)

I agree to allow the Lake City Quilt Walk Committee to display and photograph my quilt entry at their show, to be held at the First Baptist Church on March 26 – 27, 2010.  I understand that great care will be taken to protect my entry and that no responsibility for loss or damage to my entry will be assumed by the Lake City Quilt Walk Committee.

Signature: _________________________________________ 

Date: _______________