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Faith and the Arts 2018 Participant Rego Form

Please fill in your participant details below. Fields marked with an (*) are required. For additional participants, please return and fill in a separate form after you have submitted this registration.



Title

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First Name (*)

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Surname (*)

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Email (*)

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Age (*)

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Address (*)

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Address Line 2

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Town or Suburb (*)

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State (*)

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Postcode (*)

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Mobile (*)

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Dietary Needs: Please list any special diet needs here. We are able to cater for Vegetarian, Gluten Free and Dairy Free Diets so long as they are clearly indicated here. Other diet needs must be negotiated and participants may need to supplement with their own foods.

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Accommodate with: Please write the names of those you would like to be accommodated with (i.e. other family or friends who are also coming). We'll do our best to put you together where possible.

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How did you hear about Faith and the Arts? e.g. Radio / Facebook / Web Search / Eternity News / Friend etc

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Morning Elective Stream 1st Choice: (*)

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Morning Elective Stream 2nd Choice (if 1st Choice unavailable): (*)

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Afternoon Elective Stream 1st Choice (*)

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Afternoon Elective Stream 2nd Choice (if 1st Choice unavailable): (*)

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Flame-worked Glass Session: If you have selected 'Retreat Mode' or 'Mix it Up' as your Afternoon Elective (1st Choice) and would like to be allocated a Flame-worked Glass Session, please choose a preferred afternoon.

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Flame-worked Glass Session 2nd Choice: Please select an alternative afternoon in case your 1st choice is unavailable.

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Airport Pick-up: Do you require a lift from Launceston Airport to Poatina? (We are are happy to provide one - please ensure you provide flight details below, or email ASAP to info@poatinaarts.org.au) (*)



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Arrival Day and Date: Please write the Day and Date you will be arriving (e.g. Sunday 7th Jan)

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Arrival Time: Please provide your scheduled arrival time at Launceston airport (if flying).

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Arrival Flight Number:

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Airport Drop-off: Do you require a lift to Launceston Airport from Poatina? (We are are happy to provide one - please ensure you provide flight details below, or email ASAP to info@poatinaarts.org.au) (*)



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Departure Day and Date: Please write the Day and Date you will be departing (e.g. Sunday 14th Jan)

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Departure Time: Please provide your scheduled departure time at Launceston airport (if flying)

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Departure Flight Number:

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GENERAL TERMS AND CONDITIONS

Faith and the Arts Summer School and Poatina Arts are initiatives of Fusion Australia Ltd.

By registering for this event all attendees agree to allow photographs and video to be taken of them and/or their work which may be used by Poatina Arts for communication and publicity purposes.

By registering for this event all attendees also agree to allow Poatina Arts to add their name and the contact details you have provided to its mailing list for future communication. If you are already subscribed to the Poatina Arts mailing list, your preferences will remain unchanged, however any changes to your contact details will be updated to those you have provided today.

For new subscribers you will be pre-selected for the following preference as follows:
- Faith & the Arts and Artists' Retreat (Christian Events)

Please contact us on info@poatinaarts.org.au if you would also like to select any of the following preferences:
- Workshops and Other Events (Secular Events)
- Schools and Community Groups
- Artist in Residence Program

You may unsubscribe at any time by clicking following the 'unsubscribe' instructions at the bottom of any of our email communications.

This is a drug and alcohol free event.

Do you agree to these General Terms and Conditions? (*)

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Please select your Registration Fee (*)

Please choose your registration fee type.
Add-on Elective Fees apply to some electives - please select any applicable items to match your 1st choices for both Morning and Afternoon elective streams:







Please choose your registration fee type.
Optional Accomodation Upgrade: Budget hostel accomodation is already included in your registration fee. You may select a shared or solo Motel Room or Mountain Cottage (2 bedroom) upgrade here. Please note the shared rates assume that you have a partner, friend(s) or family member(s) who will also register and pay for this upgrade - please record their name(s) below. Prices are per person for the WHOLE week.








Please choose your registration fee type.
Motel/Cottage Partner or Friend(s): Please enter the name(s) of the person(s) you will be sharing your Shared Motel Room or Shared Cottage with (if applicable):

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Sponsor Someone Else (Optional): If you would like to help someone who is struggling to afford FATA, please consider donating here (a tax deductible receipt can be provided on request):







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Click here to submit your registration and finalise payment