REGISTRATION FORM
4th Annual INDIANA WOODCARVERS SUMMER CAMP
AUGUST 15 - 18, 2012 at Pla-Mor Campground, Bremen, Indiana
Questions? www.iwcsc.org or Call Marcia Yrineo at 574-204-2856
All Woodcarvers Names: _______________________________________________________________________________________
Non-Carvers - Spouse/Partner/Other Adults (over 18) in your party: _____________________________________________________
Children under 18 with you, Name/Age: ____________________________________________________________________________
Street Address: ________________________________________________________________________________________________
City, State, ZIP ________________________________________________________________________________________________
Home Telephone: _____________________________________________ Cell Phone: ______________________________________
Name or website of your hometown Woodcarving Club: ________________________________________________________________
Email Address: _________________________________________________________________________________________________
Website URL: __________________________________________________________________________________________________
Contact Name for Emergency: _________________________________________ Contact Phone: _____________________________
Circle one: CAMPING@Pla-Mor HOTEL MOTEL BED & BREAKFAST COMMUTING FROM HOME
All Carvers Please SIGN here to indicate that you have read the information on the Registration Page at www.iwcsc.org.
I understand and agree with the statement below my signature:
X___________________________________________________________________________________________________
Attention: Woodcarving is inherently dangerous. Carvers should wear gloves and finger guards to protect from injury. Use caution when handling tools and knives. Registering for this event includes your release harmless of all claims. By registering, you agree to release harmless all instructors and vendors at the event, Pla-Mor Campgrounds of Bremen, Council Oak Woodcarvers of South Bend, Good Time Carvers of Plymouth, the Indiana Woodcarvers Guild, and all members, owners, officers, directors and staff of these named organizations, for all accidents, injuries or deaths, damages to persons or property (including carvings) real and personal, and loss by theft or vandalism, caused by or arising from participation at this annual event. Email addresses shared with us will be added to our mailing list and may be shared with other woodcarvers & woodcarving vendors, but will NEVER be sold or given to non-woodcarvers.
Make check payable to Marcia Yrineo and Mail with this form by August 10, 2012 to:
MARCIA YRINEO
318 Teri Street
South Bend, IN 46614-2635
