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Mid-Mountain
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QIM 2013 Registration Form

Please complete the following registration form.

You will be contacted by our administration department upon receipt of your registration form to arrange for payment.


Your information
First name:    
Last name:    
Address:    
City:    
Province:    
Postal code:    
Phone number:    
Email address:    
Quilt information
Name of quilt:    
Category:
(Please see entry rules)
   
Quiltmaker:    
Quilted by:  
Other participants:
Width:     
Length:     
Perimeter:
(If not square or rectangular)
 
Irregular shape?
 
Artist's statement:
(Up to 75 words)
   
Basic colours:    
Techniques used:    
Original design?
   
Credits or pattern used:
For sale?
   
If 'Yes', price:
Upload photo(s) of your quilt:
NOTE: Maximum 1MB file size per image.
 
Will you be picking up your quilt?
 
Name of person if other than self:
I have read, understand and agree to the Quilting in the Mountains 2013 Judged Quilt Show Rules and will not hold QIM, its sponsors, staff or volunteers liable for my quilt. I also consent to have a picture of my quilt in the QIM Show Guide and allow photos of my quilt to be taken during the show.  
Registration Pricing
$10 per quilt for those picking up quilts
$25 per quilt if they must be shipped to address provided