Silver Jubilee Conference REGISTRATION FORM Delegate's Name*Partner's NameCompany / Organisation*MobileEmail* Special Requirements (dietary, mobility or otherwise) for Delegate or partnerDate Arriving* Date Format: DD slash MM slash YYYY Date Departing* Date Format: DD slash MM slash YYYY Arriving Flt NoDeparting Flt NoIs Delegate a Member Yes / No*MemberNon-Member All costs inclusive of GSTArrival Dinner, Monday 21 June Price: $ 77.00 Number of people Arrival Dinner, Monday 21 June Price: $ 97.00 Number of people Nufarm Croplands Agrichemical Morning Tuesday 22 June(No Charge = 4 PDP)Good Yarn Workshop Tuesday 22 June (9.00 -12.00)(Max 20 persons, $5 per person) Price: $ 5.00 Number of people Delegate Registration(Includes all Tuesday 22- Thursday 24 sessions and events)Double Delegate Registration $830.00Single Delegate Registration $520.00Delegate Registration(Includes all Tuesday 22- Thursday 24 sessions and events)Double Delegate Registration $930.00Single Delegate Registration $620.00Please advise numbers attending DUCK and Buried Maori Village Trip OR sheep milking demonstration (included in Registration)Maximum number 112 persons for DUCK/Maori Village Trip. Number attending012Sheep milking demonstration. Number attending012Please indicate if you will be attending the Rothbury Awards Dinner on Thursday evening at the Skyline Restaurant(included in Registration)012Single Day Registration Tuesday 22 June(NOT including Welcome Dinner at Mitai Maori Village) Price: $ 105.00 Number of people Single Day Registration Tuesday 22 June(NOT including Welcome Dinner at Mitai Maori Village) Price: $ 155.00 Number of people Single Day Registration Wednesday 23 June(NOT including field trip & Charity Auction dinner) Price: $ 105.00 Number of people Single Day Registration Wednesday 23 June(NOT including field trip & Charity Auction dinner) Price: $ 155.00 Number of people Single Day Registration Thursday 24 June(NOT including Awards dinner) Price: $ 105.00 Number of people Single Day Registration Thursday 24 June(NOT including Awards dinner) Price: $ 155.00 Number of people Nufarm Croplands Welcome Dinner Tuesday 22 June Price: $ 115.00 Number of people Nufarm Croplands Welcome Dinner Tuesday 22 June Price: $ 165.00 Number of people Field Trip & Charity Auction Dinner Wednesday 23 June Price: $ 105.00 Number of people Field Trip & Charity Auction Dinner Wednesday 23 June Price: $ 155.00 Number of people Rothbury Rural Contractors Awards Dinner Thursday 24 June Price: $ 135.00 Number of people Rothbury Rural Contractors Awards Dinner Thursday 24 June Price: $ 185.00 Number of people Complimentary Registration is provided for: Life Members (not including partner) Trade Exhibitors (one per internal stand) If you qualify for Complimentary Registration tick here󠄀󠄀 and the appropriate adjustments to the invoice will be made. Yes, I'm qualified. St John First Aid Training Courses Friday 25 June (refer to Conference program first)First Aid Refresher Course (6 hours) Current first aid certificate issued date must be after 24 June 2019 Price: $ 100.00 Number of people First Aid Level 1 Course (8 hours) First time attendees or those whose first aid certificate issued before 24 June 2019 Price: $ 125.00 Number of people Total $ 0.00 PaymentPay by Credit CardTo Be invoicedPay by Farmlands CardCredit Card Card Details Cardholder Name CAPTCHA Click here for accommodation at Distinction Hotel, Rotorua Superior Room ($130) Deluxe Room ($150) Hotel Suite ($250)