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2010 Online Registration Form
ON-LINE REGISTRATION
Full Name
*
:
Contact Number
*
:
No./Street
*
:
Suburb
*
:
State/Postcode
*
:
Date of Birth
*
:
Church you attend
*
:
Email Address
*
:
KIDS LIFE REGISTRATION - Please Note: Kids rego's close on 23rd August
Kids Names & Ages - any Allergies:
Friday Night $5/child/session:
0
1
2
3
4
5
6
Saturday AM $5/child/session:
0
1
2
3
4
5
6
Saturday PM $5/child/session:
0
1
2
3
4
5
6
Kids Lunch $8 per child:
Yes
No
Kids Total $:
PAYMENT DETAILS - Please Note: Full payment needs to be received within the bracketed dates to be eligible for specified offer
My Rego
*
:
$55 ADULT early bird rego ( 28th august – 31st august 2009 EXTENDED TO 7th SEPTEMBER 2009)
$65 ADULT (31st august 2009 – 31st december 2010)
$75 ADULT (1st january 2010 – 30th april 2010)
$85 ADULT (1st may 2010 - 17th august 2010)
$95 ADULT late registration (18th august 2010 – 27th august 2010)
$45 CONCESSION early bird rego ( 28th august – 31st august EXTENDED TO 7th SEPTEMBER 2009)
$55 CONCESSION (31st august 2010 – 31st december 2010)
$65 CONCESSION (1st january 2010 – 30th april 2010)
$75 CONCESSION (1st may 2010 - 17th august 2010)
$85 CONCESSION late registration (18th august 2010 – 27th august 2010)
Workshop Registration
*
:
Pick 1 of the following:
Your calling to rise
Being the light to your world & the next generation
Conquering fear
Spiritual health and growth
Relationships; grandmother, mother, sister,
Time management and organisation
Women in business and management
I would like to sponsor delegate/s
*
:
No thank you
YES - please contact me for their details
Lunch $10 per delegate
*
:
no lunch
1 lunch
2 lunches
3 lunches
Kids Rego $ (including lunch if applicable):
Total Conference Cost
*
:
I wish to pay by:
*
:
Direct Debit/Transfer
Cash
Credit Card
Cheque
Conference Paid - registering for workshop/Lunch Order/Childcare Booking Only
Todays Date
*
:
Comments or Questions:
Verification:
Banner photos courtesy of Andrew Arkapaw, Sasha Crofts and Cindy Ross
