CALOUNDRA FESTIVAL 2014 REGISTRATION FORM SURNAME Name/s Address Phone (H) Mobile Email TOTAL NUMBER ATTENDING: ________ No. _____ No. _____ Ages ___________________________ Teens (high school age) Children’s Church (primary school age) Special Needs – Do you have any special needs we can assist with?__________________________ Volunteers – Is there an area in which you would like to serve during the festival? Activity assistant Children’s Church Choir Usher Bush Dance PowerPoint operator Other______________________________________ Price REGISTRATION FEE Full‐time wage earner (each) – for 6 days Number Totals . . . . .. . . . . . . . . . . . $ 150 $ Concession (single) or (couple each) – for 6 days . . . . . . . . . . . . . . . . $ 95 $ Daily registration (per day) – part‐time attendance . . . . . . . . . . $ 30 $ Cannot afford full cost of registration – donation . . . . . . . . . . . . $ ACTIVITIES Ladies Night – Monday 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25 $ Seniors’ Lunch – Thursday 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18 Young Adults’ – Friday 3 TBA Please indicate your interest and we will contact you TBA TOTAL $ My cheque/money order payable to Caloundra Festival of GCI for $ __________ is enclosed. My completed credit card form for $ __________ is enclosed. I deposited $ __________ into Caloundra Festival of GCI, BSB 064162, account number 10308395, on ____/____/ ____ with the reference of _________________. Photo Release: I hereby give permission to the program organisers to use any photos and/or video footage of all participants registered on this form, in their publications or those of their sponsor, Grace Communion International Ltd. Picture(s) may be used on the website or in other video promotions created by Grace Communion International Ltd. _____________________________________________________________________ ___________________________________ Date Signature Please complete and return this form with payment by FRIDAY, SEPTEMBER 12 to: Caloundra Festival, 35 Malbon Street, Eight Mile Plains, Qld 4113 Register You can now register and pay online at gci.org.au/caloundra2014 Online Office Use Only Chq/MO No CC BSB Account $ $