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​​Artist Getaway in Murphys, CA, June 4-9, 2017 Pay by credit card here(cc payment includes a 3% processing fee)
To pay by check, please print this form and mail with your check to the address below. To pay by credit card go to the link above and also mail this form. 


Address _________________________________________________________________________

City __________________________State ____________________Zip_______________

Phone number (Home) _____________________Phone number (Cell Phone)_______________________

Email address______________________________________________________________


Please email an image of one of your paintings to info@artistgetaway.com and I will add it to the Murphys Gallery. 

In case of emergency contact (name and relationship to you)___________________________________

Contact info for that person (phone number and email)__________________________________

Room Choices - these are the total prices for 5 nights including tax. ​​This is the check payment amount. There's 3% added for credit card payments for the processing fee.A two room suite has a sitting room and a bedroom​.The deadline to cancel for a full refund is May 4, 2017, no refund after May 4.
​​​$725 for a two room suite, single occupancy
​$542 each to share a two room suite

​​Do you want to share a two room suite with two Queen beds? ($542 each)____________

​​Do you have someone you want to share with (who)?______________________________________________________________

​​Would you like me to try to match you with a roommate?________________

Do you want a private two room suite all to yourself? ($725)__________________

There is an elevator, do you prefer the first or second floor?_________________________________​​​​

Do you have any special needs? _______________________Handicap room? ______________​​

Would you like to paint as a group at specified locations each day?____________________

Would you like to participate in the 'show and tell' discussion each evening?___________________​​

What is your art medium? ____________​​How did you hear about this Artist Getaway?________________

Sign here
_________________________________________ (“Participant”), acknowledge that Artist Getaway, Inc., is merely an organizer of the event, and agree to forever release and discharge Artist Getaway, Inc., from any and all actions, claims, or demands relating to injuries or damages resulting from or arising out of my participation in the event.

Please print and fill out this form (please be sure to sign the release above) and mail it with your check made out to Artist Getaway:

PO BOX 20214
EL SOBRANTE, CA 94820-0214