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* 1. Name

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* 3. Phone (optional)

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* 4. Company/Organization

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* 5. What days do you plan on attending the event?

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* 6. Do you follow any of the these dietary restrictions? (Please select all that apply.)

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* 7. Cost for this event: $150 per person. Please pay via direct deposit to:
Kallara Conference Centre
BSB: 067873
ACC: 12418934

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* 8. Please bring your own bedding including doonas, pillows, sheets.

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* 9. EMERGENCY CONTACT - please leave phone and email contacts

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* 10. DO YOU PREFER TO CAMP?

Shared accommodation is available for 116 people.

Please note that Elders will be given priority over all bedding and
accommodation.

Camping grounds are available if you wish to stay in your own tent.

If you wish to stay in a tent please let us know in the box below.

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* 11. Do you have any accessibility requirements?

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