Kicking Goals for Rotary   Rotary District 9500 Conference Booking Form

Please fill in your details using the form below, then click the Make Booking button to proceed. Please note this form is only for bookings for 1 Rotarian and their Partner. If you want to make bookings for more please use the form as many times as necessary.

Registration prior to 30 Oct 2009 will put you in the draw for one full Rotarian Registration (excluding options) and Registration up to 14 Aug 2010 entitles you to the Early-bird Rate.

Booking Details
Please enter the personal details of the person making the booking
Category:	Categories: PDG - Past District Governor; R - Rotarian; P - Partner; G - Guest; GSE-I - Incoming; GSE-O - Outgoing; GS - Guest Speaker; Y - Youth Exchange
First Name:	*
Last Name:	*
Partner First Name:
Partner Last Name:
Partner Category:
Rotary Club:
District:
Home Phone:	* please enter either your home or mobile number
Mobile Phone:	*
Street:
Town / Suburb:
Postcode:
Email:	*
Special Requirements:	please enter any special access or dietary requirements
Please enter the number of people attending each event. The total price will be calculated on the next screen.
	Early Bird Price Normal Price
Registration - Rotarians and Guests:	0 1 2 at $125.00 $150.00
Registration - Non Rotarian Partner:	0 1 at $60.00 $70.00
Reception - Friday Evening:	0 1 2   $20.00
Saturday Breakfast (all welcome):	0 1 2   $20.00
Saturday Lunch:	0 1 2   Inclusive
West Lakes Cruise - Saturday PM:	0 1 2   $20.00
Conference Dinner	0 1 2   $70.00
Sunday BBQ Lunch:	0 1 2   $15.00
	Please check your booking carefully as it cannot be changed once you click the Make Booking button.

For more information on the conference please visit http://www.d9500conference.org.au