REGISTRATION FORM
May 22 - 23 2012, Sanctuary Cove, Queensland

Please complete this form online and submit. Upon submission, a tax receipt will be generated and submitted to you. All rates are quoted in Australian Dollars (AU$). All Registration fees include 10% GST. Please complete entire registration form. One form per delegate.

Title*

First Name*

Surname*

Position*

Organisation*

Address*

Suburb*

State*

Postcode*

Country*

Phone (inc Area Code)

Email*

Mobile Phone

Please indicate special dietary requirements / needs:

Emergency Contact Person:*

Emergency Contact Person Telephone:*

Registration Fees: These fees are inclusive of conference social program and GST. There are excellent discounts for industry members.*

Conference Registration (2 days) $350 incl GST

AIMEX Member (2 days) $275 incl GST

Superyacht Australia Member (2 days) $275 incl GST

SCIBS Exhibitor (2 days) $275 incl GST

Social Program: Monday 21 May Welcome Registration 'Poolside Party' at the Hyatt (6pm - 8pm):

I will be attending (included in registration fee)

I will not be attending

Welcome Registration - State below the quantity of additional tickets required for accompanying persons:*

Social Program: Tuesday 22 May Conference Dinner (6pm - 11pm):

I will be attending (included in registration fee)

I will not be attending

Conference Dinner - State below the quantity of additional tickets required for accompanying persons:*

Social Program: Wednesday 23 May - Golf - 9 holes (from 2pm)

I will be participating ($70pp)

I will not be participating

Payment Total: Registration Fees + Additional Ticket & Golf Requirements:*

A receipt will be emailed to you upon processing. For further details, contact accounts@superyacht-australia.com. Please charge my:*

Mastercard

Visa

Amount:*

Cardholder's Name:*

Card Number:*

Expiry Date:*

CVV:*