Registration Form

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Registration Form

For the Agenda, please visit http://tinyurl.com/mvt7urx

First Name *

Last Name *

Email *

Phone *

Mobile

Postal Address

Name/Organisation *

Address *

City *

Postcode

Conference and Payment Details

Please register me for: *

Conference Only..................$100+GST

Dinner Only...........................$150+GST

Conference and Dinner......$250+GST

Additional Conference Only Guests - Please list names below:

Additional Dinner Only Guests - Please list names below:

Additional Conference and Dinner Guests - Please list names below:

Special requirements:

Payment: *

I will send a cheque made out to Coastguard Boating Education

Please invoice me / my organisation

Please debit my credit card (Coastguard Boating Education will contact you)

I will pay by bank transfer

If paying by invoice please provide the following:

Name/Organisation

Postal Address (if different from above)

If paying by bank transfer

Please make the payment into the following account:

Account Name: Royal New Zealand Coastguard Boating Education Ltd
Account Number: 03-0275-0506801-00

Please use the following reference "Conference" and your name

Refund Policy

Refunds will only be made prior to 10 days before the Conference date. Requests for refunds should be made to Isabella Hormes by email isabella@boatingeducation.org.nz

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