| First Name(s) | Surname | ||
| K-CHS Member | Address is required | ||
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Street or POB
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City/Suburb
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State
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Postcode
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| Phone | Mobile | ||
| Enter 'None' if you have no email address | |||
| Note (optional) | |||
| ADULTS | @ $50 ea | ||
| SENIORS | @ $45 ea | ||
| Children | @ $35 ea | ||
| K-CHS Members | @ $42 ea | ||
| Copies of Pansy Book Collect on the day | @ $10 ea (save $2) | ||
| K-CHS is not registered for GST | TOTAL | ||
| *** Only 2 places available *** | |||