ThirstyFest 2009 Registration Form



Register for ThirstyFest 09!


Two Easy Ways To Register!


Online Registration:
  1. fill in the form below and you will need to click SUBMIT.
  2. then you will be directed back to this page
  3. click the BLUE icon - CREDIT CARD PAYMENTS and you will go to our secure payment page.

Fax Registration:

  1. Click the ThirstyFest 09 Icon (the black and white one)
  2. you will be asked to download the PDF form - click ok.
  3. print out the form and complete it.
  4. then send the form via fax with payment details to Coastlands FAX 08 8321 9974
  5. or alternatively complete the form and mail with your cheque payable to Coastlands International Christian Centre. PO Box 324, O'Halloran Hill SA 5158.
Click the BLUE Credit Card Payments Box only after you have filled in the Registration form below.

 

click the ThirstyFest icon to download
PDF of registration form


CONSENT DETAILS - the legal stuff

MEDICAL TREATMENT CONSENT: I understand that whilst reasonable care will be taken to ensure the welfare &
protection of my child, I release Thirsty? and their staff and volunteers from any and all liability for any and every injury, damage or loss that may occur to myself or my child(ren) or my/their property. In the case of emergency, I hereby give permission for the First-Aid staff to ensure proper treatment for my child(ren) or myself.

I understand that reasonable effort will be made to contact me before instituting such procedures, however in any event I agree to pay all doctor, ambulance and hospital fees occurred on behalf of my child(ren) and / or myself.

CHILD TRANSPORT CONSENT: I the parent/guardian give permission for my child(ren) to be safely transported to ThirstyFest in Warnambool and to workshops and other Thirsty? or church activities during the event.

CHILD PARACETAMOL CONSENT: I give permission for the First-Aid staff to administer paracetamol to my child(ren)
if deemed necessary by the First-Aid staff.

I INDEMNIFY Thirsty? and their staff and volunteers in respect of all liability incurred in relation to any and every injury, damage & loss
sustained by myself or my child(ren) in relation to the ThirstyFest Event.


ThirstyFest 09 Registration
Attendee 1 (mandatory):  
Attendee 2: 
Attendee 3: 
Attendee 4: 
Attendee 5: 
Attendee 6: 
Attendee 7: 
Email: 
Address (mandatory):  
Contact phone number (mandatory):  
Emergency contact (name and number):  
My church is: 
Yes please - I want a Family Discount for more than 2 registration (2 adults & 2 children - $299): 
I agree to the above listed CONSENT DETAILS (mandatory): 
PHOTO CONSENT: I give permission for Thirsty? to capture my image on video or still photography or the image of my child(ren). Thirsty? reserves the right to use this material for promotional purposes.: 
MAIL OUTS: I am happy to be contacted regarding future Thirsty Events: 
Payment Options (please choose one):  
 
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