Registration Form
A catered supper will be served partway through the evening, with a hot drink and cake available before you head home.  Catering profits go to the Celtic Spirit Pipe Band. 

Cost:

RSCDS members $35 (early bird payment $30, by 1 Aug)

Non-RSCDS members $40 (early bird payment $35, by 1 Aug)

Juniors/Spectators $20 (no early bird rate)

Registrations close 15 October 2023

Refunds: Refund available for sickness or injury, if notified before the event.

Any questions please contact the Rangitikei Region Treasurer at: mhawkes@inspire.net.nz

Privacy Statement: The Tri-Region Centenary Committee is collecting personal information in this form to allow for us to contact you in relation to the Centenary event being run by the Wellington, Rangitikei and Hawkes Bay Regions which you wish to attend.  The information will be held by the Wellington Region and will be accessible to subcommittee members and selected members of the Wellington Region committee.  The information may be disclosed to others outside the subcommittee who are assisting to run the event. The subcommittee will only retain the information collected until one month after the event, and only use it in relation to the event. If you wish to view and request correction, or deletion, of any personal information the subcommittee holds, please contact the Wellington Region Secretary at secretary.rscdswell@gmail.com.

You will receive a confirmation email after you submit your registration form.

You can register for more than one ticket, but we need one person to communicate with. 

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Email *

Name:

 *
Phone Number (in case we need to contact you):  *
Home club (enter Nil if you do not associate with a particular club):
Emergency contact person (name and phone number - in case something happens to any of the registrants at the event): *
How many tickets of which type are you registering for: 
(Early Bird registration is available until 1 August 2023)
 *
0
1
2
3
4
RSCDS Early Bird $30
Non-RSCDS Early Bird $35
RSCDS (after 1 Aug) $35
Non-RSCDS (after 1 Aug) $40
Junior/Spectator $20
Does anyone you are registering for have any dietary requirements  *
0
1
2
3
4
No restrictions
Vegetarian
Gluten free
Dairy free
Payment:

Please pay online, providing your surname and initial in the Particulars, in the Code section insert your home club, and in the Reference section the type and number of tickets paid for, for example “Smith J – Ngaio – nonRSx2” or “Smith J – Glendarroch – RSx4 Junx2”.

Account details:  

Rangitikei Region RSCDS 02-0792-0246622-00 

Please put the date by which you intend to pay below. Note that no tickets will be issued but confirmation will be sent upon receipt of payment.

Intended date of payment:

 *
A copy of your responses will be emailed to the address you provided.
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