IPSA 2023 INTERSEX PEER SUPPORT CONFERENCE -- REGISTRATION FORM
This year's conference will be an outwardbound retreat style weekend away together on the outskirts of Canberra the ACT, 30 minutes hours drive from Parliament House.  Free bus transfer will be provided from the CBR Airport and Canberra Civic leaving on Friday 3/11 and returning Sunday 5/11.  Basic dorm-style accommodation and lush catering will be provided.

To register for the Retreat:
1. Complete this registration form and click Submit
2. Click the link on the confirmation page to the booking site to purchase your tickets and optional extras.  Ticket prices for the whole event are on a sliding scale:
  • IPSA Non-member - $300
  • IPSA Member Full - $150
  • IPSA Member Concession - $75
  • IPSA Member Pay what you can - $0 (someone will contact you to confirm )
  • Presenter or performer - $0
  • Single room upgrade - $70.40
  • Sleeping bag hire - $25
3. We will be in contact in October with more information to prepare you for our time together.

Registrations close Tuesday 3rd October 2023
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Email *
Full Name *
Pronouns
Mobile Phone Number *
Are you ... ? *
Required
Are you ...? *
If you are booking for multiple people, who else will be coming?  Please list the ages of any young people.
Do you have any accessibility requirements?
Are you a current IPSA Member?  Retreat tickets for IPSA Members are heavily discounted. Become an IPSA Member here. *
Where are you travelling from? (City/Country) *
Where did you hear about the conference?
Emergency Contact Information - Name: *
Emergency Contact Information - Relationship:
Emergency Contact Information - Phone: *
ATTENDANCE
I will be attending: *
TRAVEL TO VENUE
Bus transfers from Canberra to the retreat venue will be provided.  Every effort will be made to arrive at the pickup/drop off at the stated time but you should be generous when booking your flights to accommodate unexpected delays.  If you miss the bus, you will need to organise your own transport to the venue.

Please nominate your preference:
PICK UP Friday 03/11 *
DROP OFF Sunday 05/11 *
TRAVEL BURSARY
A very small bursary to assist with travel to the retreat from within Australia is available to those members whose attendance would be otherwise prohibited due to financial hardship. Bursaries are only available to those who have a current health care card (Senior/DSP/Newstart) or are currently unwaged.
If you require access to this bursary in order to be able to attend the retreat,  what are the estimated travel cost you are seeking from the bursary? Please add a $ amount and details of your travel arrangements including departure city.
Health Care Card Number and expiry date:
ACCOMMODATION
We are going on camp!  

Accommodation  is at an established activity centre and will be very basic dorm-style, with 4 people per room sharing a bathroom.  Linen, pillows, and towels are provided.  BYO sleeping bags or doona.  Hired sleeping bags can be ordered at time of booking for an additional cost of $25.

The following options are just in case you have specific requirements which we will try to accommodate:
Do you have special accommodation requirements? (select multiple): *
Required
CATERING
All meals will be provided by the venue. There are no stores in the vicinity of the venue.  The bus will make a short stop at a supermarket on the way to the retreat on the Friday if you require any special items.
DIETARY REQUIREMENTS *
Required
CONFERENCE PROGRAM
We are open to suggestions on what activities to hold over the weekend.  There will be plenty of opportunities for social connection.  The venue can facilitate physical activities such as bush-walking or horse riding for us. A counsellor with a speciality in intersex issues will be present throughout the conference.
Is there anything in particular you want to get out of the weekend or to talk with others about?
Would you like to facilitate a session? If so, please provide details of your idea for a session or activity.
Would you be interested in going hiking, abseiling or on the high rope activity at the venue over the weekend?
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DISCLAIMER
As you know, we are a small community group run by peers who are not trained counsellors.  While every care will be taken, by submitting this form you agree to take responsibility for your own person, belongings, health and personal expenses whilst at the conference and release the IPSA and its committee from any liability that could arise.  The IPSA has full Public Liability Insurance coverage.  If you require at any assistance, at any time, please ask for help :)  

*
Required
TICKET BOOKING
After you click submit for this registration form, you will see a link to the ticket booking website.  Complete your registration by booking your ticket and we'll see you at the IPSA Retreat in November!
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