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WA Quiz Night | Thursday 5 December 2024

Group Registration Form

Registration contact person

Contact Name

Organisation

Email

Contact phone

My organisation is an AITPM Partner or Sponsor:

Please apply complimentary tickets for this registration, if applicable

Please apply any applicable complimentary tickets and then apply the event discounts for the remainder

Please only apply any event discount, if applicable, not complimentary tickets

Please do not use any of our discounts on this registration

(Not a Partner or Sponsor)

Please confirm that you are authorised by your organisation

I confirm that I am authorised by my organisation to utilise complimentary tickets

Any organiser comments regarding ticket allocation

Attendees

How many delegates are you registering?

If you are registering more than 6 people, please download the following excel spreadsheet, complete the details required for each delegate, and email to registrations@aitpm.com.au

DOWNLOAD EXCEL GROUP REGISTRATION SPREADHSEET FOR 6+ DELEGATES

Otherwise, please complete the details below. If you are registering yourself, please also include your details below.

Delegate 1 First Name

Delegate 1 Last Name

Delegate 1 Email

Delegate 1 State

Dietary Requirements (for in person events only)

Do you require any assistance or assistive devices to access and enjoy our event? (for in person events only)

Delegate 2 First Name

Delegate 2 Last Name

Delegate 2 Email

Delegate 2 State

Dietary Requirements (for in person events only)

Do you require any assistance or assistive devices to access and enjoy our event? (for in person events only)

Delegate 3 First Name

Delegate 3 Last Name

Delegate 3 Email

Delegate 3 State

Dietary Requirements (for in person events only)

Do you require any assistance or assistive devices to access and enjoy our event? (for in person events only)

Delegate 4 First Name

Delegate 4 Last Name

Delegate 4 Email

Delegate 4 State

Dietary Requirements (for in person events only)

Do you require any assistance or assistive devices to access and enjoy our event? (for in person events only)

Delegate 5 First Name

Delegate 5 Last Name

Delegate 5 Email

Delegate 5 State

Dietary Requirements (for in person events only)

Do you require any assistance or assistive devices to access and enjoy our event? (for in person events only)

Delegate 6 First Name

Delegate 6 Last Name

Delegate 6 Email

Delegate 6 State

Dietary Requirements (for in person events only)

Do you require any assistance or assistive devices to access and enjoy our event? (for in person events only)

Privacy & Terms and Conditions

As the main contact and by registering your guests to attend this event, you agree to the terms and conditions listed in the Australian Institute of Traffic Planning and Management’s (AITPM) Privacy Policy and Commerce Policy. By registering, you acknowledge that your registration information may be shared with AITPM Branch volunteers and specific event Partners, for the purpose of providing ongoing event administration and reporting services. Should you have any questions or wish to discuss the terms and conditions, please contact the AITPM Secretariate on aitpm@aitpm.com.au.

Please confirm below to proceed with your registration

I agree with the Terms and Conditions

I agree with the Terms and Conditions

Email address