Mid Year Conference 2022 - Relationships

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Contact Details

First Name *

Last Name

Email (Primary) *

Phone-Mobile (Primary)

Rego Options *

Full Ticket (All food, All sleeps) - $ 415.00

3 Days, 2 Nights - $ 315.00

Day Pass - $ 120.00

Alumni Night - Thursday Session and Dinner (Alumni Only) - $ 30.00

Alumni Night + Accomodation (Alumni Only) - $ 110.00

Total

Faculty

Faculty Area *

Transport Info

Transport *

What suburb/location are you travelling from? (whether driving or need a lift)

Transport from *

Emergency and Medical

Emergency contact person

Emergency contact number

Emergency contact person (relationship)

Please list any medical conditions we should be aware of

Dietary Requirements

Other dietary requirements

Vegetarian	Vegan
Dairy free	Gluten free
Nut free	Kosher
Halal	Other - let us know below

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