Australian Open Registration Form
Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
e-Mail Address (if under 18, e-Mail Address of Guardian) *
Your answer
FISTF Number (if known)
Your answer
Club (if known)
Your answer
Payment
Entry form and payment MUST be received by 4PM, Australian Eastern Standard Time, Wednesday September 14 for entry to be accepted.

REGISTRATION RATES:
Adult : $42.50 AUD
Junior : $27.50 AUD
Additional Function Tickets (each) : $25 AUD

PAYMENT OPTIONS
PLEASE include “(name) – AO ORDER Sep16” as reference

EFT
Zenith Sports and Event Management
WBC - BSB No.: 032-170 / Account No.: 307730

VISA or MASTERCARD
via telephone – 0407008489
(3% surcharge)

CHEQUE
payee – “Zenith Sports and Event Management”
mail to – 3/24 The Crescent, Dee Why NSW 2099

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