The 2010 Healthy Cities Conference - Stamford Plaza Brisbane

 12th & 13th of July.   

 

Registration Form

 

To register please complete the form below with your personal detail and click on the Send Registration button at the bottom of the page.

 

Your details will be kept for use in managing this conference only, unless otherwise advised. 

 
The fields in BLUE are required.
 

Section 1                                                                                                                                              ABN: 88010606694
 

Title

 

           

 First Name
Family Name
Badge Name (only if different from above) 
Organisation (if applicable)
Address Line 1
Address Line 2
Suburb/City 
State       
Postal/ZIP Code
Country    (Required)
Phone     
Fax  
Mobile Phone   
E-Mail Address   please ensure address is spelt/formatted correctly
  Is this your Work Address?
Dietary Requirements
Other Requirements  wheelchair access etc
Send Correspondence E-Mail Fax       Mail     

 

Accompanying Person Information 

You only need to complete this section if you will be purchasing an Accompanying Person Registration (see details in section 2)

 

Title    

  (Mr, Mrs, Ms, Dr, Prof, etc)  

First Name

Surname 

Badge Name (only if different from above) 
Dietary Requirements  
 
Section 2 - Full Registration

Conference Registration Details:
 

Category

Early Rate
(prior to 7th of May 2010)

Standard Rate
(after 7th of May 2010)

Full Registration

$700

$800

Full Student Registration

$550

$600

One Day Registration

$380

$450
Presenter Registration $600 $600
Aust HC Chapter Workshop $50 $85
Workshop 1 - HASSEL $85 $85

Full Registration Includes;

  • Access to the Conference Plenary & Sessions

  • Trade Access

  • Conference Satchel, Handbook & Name Badge

  • Networking Function Attendance

Day Rate (Standard and Early Bird)

  • Conference sessions for nominated day

  • Conference Satchel, Handbook & Name Badge
Registration Type

($AUD)

Section 3 - Partial Registration Information - Day and Workshop Registration

Day registration is available for delegates unable to attend the full conference. Day registration includes:
 access to all conference sessions held on a single day, morning/afternoon teas and lunch for that day, but does not include a conference satchel, or admission to the Networking Functions.

Day Only  

 

Amount ($AUD)

Day Only 

 

 

         
Wednesday Workshops    
 
Section 4 - Social Programme

You can book extra tickets to the Networking Function here.

 

Purchase a ticket here

 

Amount ($AUD)

Purchase another ticket here

 

Amount ($AUD) 

 

Total Registration Due ($AUD)

 

 
Section 5  - Hotel Bookings  - if you do not require accommodation tick this box

Stamford Plaza Brisbane is offering a Conference Delegate Discount of $190 per night (Superior King)

 

  

Mandatory Fields**

 

You can provide a credit card number on the Conference payment gateway as security for the hotel deposit.

The email link to the gateway will be sent to you by email in the next 24 business hours.

  

Hotel**  

 

Arrival Date**

    

Departure Date**

  

Room Type**

  

Arrival Time

    
       

I will be sharing the room with the nominated accompanying person 

 
Special Requirements 

 Hotel Deposit Due  ($AUD)

 

 

Section 6

Please note:

 

You will be sent a tax invoice by email. Please ensure your system can receive email from AST management.  The email will contain payment method details.

 

If you do not receive any correspondence,  email the secretariat .

Cancellations and Amendments


 Registration cancellations and amendments must be sent in writing either by mail, fax or email to AST Management Pty Ltd.  Registration cancellations received at least 31 days prior to the conference will receive a full refund less $125 administration fee.  Registration cancellations received less than 30 days and at least 15 days prior to the conference will receive a 50% refund.  No refunds will be given for registration cancellations received within 14 days of the conference.  As an alternative to cancellation your registration can be transferred to another person at least 15 days prior without receiving any extra cost penalty.  Transfers made 14 days prior and less will incur a $20.00 transfer fee.