Registration - Mighty Men Conference

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Fields marked with an * are required

Please note, one form must be completed per person.

Personal Information

Name *

Contact Number *

Email Address *

Postal Address

Church

Special Dietary Requirements/Medical Conditions:

Emergency Contact Information

Medicare Card Number

Name *

Relation *

Contact Number *

Optional Activities

Expression of Interest

Please indicate the activities you would be interested in participating in. Final numbers will be collated and if the activity is to go ahead, you will be contacted with final payment details.

PRICING

Adult: $190

Child (7-17): $163

Deposit: $50 per person to be considered registered.

The strict registration deadline is 13 July 2018.

Direct deposit:

NOTE: YOU MUST REFERENCE: "MoG" and include your first initial and last name.
For example: "MoG D Searle"

BBC General
BSB: 032 724
Account: 172373