Registration | AHA NSW Africa 2023

Group Registration

PLEASE READ FIRST

You have the option to register more than one (1) per during this registration process. Please enter all the names you wish to register below.

Please complete the following registration in order from the first registrant. You will have the option to add the subsequent persons details later.

Your registration will not be complete until you see the 'Thank You for Registering' page.

Group Members

Group Size

Contact Details

Title

First Name

Last Name

Preferred First Name

Hotel/Business Name

Email Address

Verify Email Address

Work Number

Mobile Number

Address

City/Suburb

State

Postcode

Dietary Requirements

Medical and/or Mobility Requirements

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Relationship

Registration Type

Please note that a payment of 50% per person is required upon booking to secure your place up until 23 December 2022. Full payment is required for registration after this date. All balances including registration, room upgrades and any travel arrangements are due 03 February 2023.

When you finish your registration you will be provided with a payment schedule.

Please select your registration type based on twin share or single supplement below:

Single (Early Bird) FULL

AMOUNT

24,999.00

TOTAL

Single FULL

AMOUNT

25,499.00

TOTAL

Twin Share (Early Bird) FULL

AMOUNT

18,999.00

TOTAL

Twin Share FULL

AMOUNT

19,499.00

TOTAL

Travel

Flight Quote Request

International Travel Request

Please enter your travel request details in the box below. Please advise preferred dates, cities, class of travel and any information that would be useful to create an itinerary for you

Would you like to receive a flight quote from CWT Meetings & Events?

Yes

Please enter any specific travel request details including dates, departure ports, extension requests and booking class.

Flight Request Details

Bed Preference

Please indicate your bedding preference below. This will apply for yourself and if you are registering a second person for the duration of the tour. Please note that not all upgrade options allow for Twin Bedding (2 beds).

What is your bedding preference?

Double (1-Bed)

Twin (2-Beds)

COVID-19

Are you fully vaccinated against COVID-19

Yes

Please indicate which COVID-19 vaccination you have received? (if vaccinated)

COVID Vaccincation

Data Processing Consent

I give consent

Data Processing Consent option required

Summary

Terms and Conditions

Agree

Payment

Thank You

Thank you for registering to attend the 2023 AHA NSW Study Tour to Africa. We will keep in touch with regular updates in the coming weeks.