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Social Registration Form

Name
Nickname
Address
Suburb
Postcode
Phone
Email
 
Club / Uni
 
T-Shirt Size
 
Medicare Card No:
Emergency Contact Name
Emergency Contact Phone
 
Dietary Requirements:
 
Are You Competing?

Days Staying Social
Levy		PrePay
Discount		Total
6 Nights - Mon to Sunday & T-shirt / showbag$270-$25$245
5 Nights - Tues to Sunday & T-shirt / showbag$265-$25$240
4 Nights - Wed to Sunday & T-shirt / showbag$260-$25$235
3 Nights - Thurs to Sunday & T-shirt / showbag$255-$25$230
2 Nights - Fri to Sunday & T-shirt / showbag$225-$25$190
1 Nights - Sat & Sunday & T-shirt / showbag$105-$25$80

Preferred Payment Method
NetBank Transfer
Transfer the total amount payable to the Australian Uni Waterski & Wakeboard Club Championships (AUWWCC) account. Put your NAME in the description/details section.

Account Name: AUWWCC
BSB: 033-050
Account Number: 34-7898
Please fill in the Bank / Receipt Number Below

Deposit at Branch
Arrange alternative payment method with Sam - samual.rickard@gmail.com
Netbank Receipt Number: