Correspondence Agenda - Ordinary Council Meeting - 9 July 2013

REGISTRATION FORM
This registration form comprises two pages.
Please complete a separate registration form per delegate and return either by:
Post: 2013 Landcare Conference, PO Box 14, Warwick QLD 4370 or
Email: headwaters@ddrlandcare.org
All enquiries should be directed to
Condamine Headwaters Landcare Group
Contact: Catherine or Angela.
Email: headwaters@ddrlandcare.org or phone: 07 4661 9909
Your details
Name
Organisation
Postal Address
Phone
Mobile
Email
Field trip preferences
Special physical or dietary
requirements
Total amount owing, as per
attached registration page.
1._________________________ 2. _______________________ 3. _______________________
Please tick if a tax invoice is required 1
Payment options
Payment may be made by cheque, or electronic funds transfer. Cheques should be made payable to Condamine Headwaters Landcare
Group and attached to this form. If you’d like us to invoice you, please make a note on this form. If you make a payment through EFT, please
ensure you send us remittance advice and make your payment reference your surname. EFT details are as follows:
Condamine Headwaters Landcare Group Inc – State Conference A/C
Warwick Credit Union
BSB: 817-001, Account: 62294
Privacy statement
Condamine Headwaters Landcare Group is committed to supporting the National Privacy Principles set out in the Privacy Amendment (Private Sector) Act 2000. Condamine
Headwaters Landcare Group will collect and store information you provide in the registration form for the purposes of enabling us to register your attendance at the conference, to
assist with future planning of other events, and to collate and analyse statistical data. Condamine Headwaters Landcare Group will share your information with Landcare
Queensland and may disclose some of the information collected in the registration form to conference sponsors and exhibitors and future conference hosts for marketing purposes.
Condamine Headwaters Landcare Group will not otherwise, without your consent, use or disclose your individual personal information for any purpose. The conference organisers
may produce a delegate listing, for distribution to delegates at the conference. Please tick here __ if you do not wish to be included in this listing.
Cancellation and refund policy
Cancellations made before 1 August 2013 receive a full refund less an administration fee of $30. Cancellations made before 31 August 2013 receive a 70% refund. Cancellations
from 1 September 2013 do not receive a refund unless due to exceptional circumstances, determined by the event manager. Substitutions may be made at any time at no cost.
All approved refunds will be processed post event to be received by Friday, 11 October, 2013.
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