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First name  Last name

Phone Nbr Email Address

Please enter below the information you want on your badge in addition to your name.
Examples: HSK 66-81 TID 81-95, and/or HSK-X 66-73, or Apollo Enthusiast, or SO Joe Blogs CRO 64-75 (SO stands for Significant Other :-). Please limit to 255 Characters total and avoid commas! You do not need to repeat your name on the badge - that will happen from the First/Last name entries above and below. Every person attending needs a name badge - it will be your entry ticket to the various events.

What would you like on your name badge?              

Will you go to So.Cross club on 19th July? YES NO
How many people in addition to yourself will be coming with you? 0 1 2 3 4 5 6

Will you go to TID & HSK on the 20th? YES NO
How many people in addition to yourself will be coming with you? 0 1 2 3 4 5 6
Would you like seats on coach transport on the 20th? NO YES

Will you go to the LUNCH on the 21st? YES NO
How many people in addition to yourself will be coming with you? 0 1 2 3 4 5 6
How many under 12 years old on the 21st? 0 1 2 3 4 5 6

Movies at Questacon on the 22nd? YES NO
How many people in addition to yourself will be coming with you? 0 1 2 3 4 5 6
 

Jump over the following section if you are coming on your own.....
 

I will be bringing with me:

1. First name Last name
Please enter here as in the examples above.
Name Badge?                      

2. First name Last name
Name Badge?                      

3. First name Last name
Name Badge?                      

4. First name Last name
Name Badge?                      

5. First name Last name
Name Badge?                      

6. First name Last name
Name Badge?                      

Comments and special meal requirements:

If you are coming to the lunch please calculate total cost: $50 per adult for the 21st July lunch and $25 per child under 12 (Suggest that children under 8 would probably get bored quite quickly :-). All charges are in Australian Dollars.
 
All other events are FREE!

Please Pay Treasurer Geoff Seymour the total amount within 10 days of sending this form:

By Cheque to made out to Geoff Seymour - post to Geoff Seymour, PO Box 219, Mawson, ACT, 2607

You can pay Geoff by Direct Bank Transfer Please Email  geoff.seymour@bigpond.com and he will respond with the required details.

 You may also pay now via Credit card and PayPal

Finally please decide how you will pay and make your selection. Cheque Direct Transfer Pay Pal