Register for Navs Student Camp 2022 - The Australian Navigators

Please do not use Smart Phones and iPads as they may not work. If you need help using this Registration form please contact Tim Mapperson on 0437 579 471

Accommodation(Required)

Choose from the drop down box below.

I am registering as an...(Required)

Choose from the drop down box below.

First Name(Required)

Last Name(Required)

Spouse First Name(Required)

Children's Details(Required)

Click "+" to add another child.

Child First Name

Age

Phone(Required)

Spouse Phone

Email(Required)

Address(Required)

Street Address City State Postal Code

Additional tent capacity(Required)

APART from everyone on this registration form, how many other people can realistically fit in your tent(s)? Please fill this out, even if you have already arranged who will share your tent. (Select 'None' if you would prefer not to accommodate other people)

Do you have any Dietary Requirements?(Required)

Yes

Please list your Dietary Requirements(Required)

Click + to add another person.

Diet First Name

Dietary requirements

Do you require transport?(Required)

Yes

Are you able to provide transport?

Yes

APART from yourself, how many passengers can you take?

What is your Affiliation?(Required)

Please tell us how you heard about this event

Special Comments or other notes

PAYMENT INFORMATION

Staff Code

If you have a staff code enter it here.

Total Conference Fee Payable Today (A$)

I would like to pay with(Required)

Credit Card

Bank Transfer

I would like to pay with(Required)

Personal Staff Account

Credit Card

Bank Transfer

Bank Account Name(Required)

Bank Account BSB(Required)

No dashes or spaces between numbers.

Bank Account Number(Required)

No dashes or spaces between numbers.

Credit Card

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

This field is for validation purposes and should be left unchanged.