Kimberley Leadership Program June 2020 Registration Form

PO Box 238 Hillarys WA 6923 info@outbackin.com.au
2020 Kimberley Leadership Program 28 May - 6 June Registration Form
Experience 10 challenging and rewarding days in the stunning Kimberley region of WA, digging deep and getting out of your comfort zone.

Through personal development coaching and consequence-based team activities, you will gain an understanding of who you are, what has held you back, and how to leverage your strengths to achieve your goals. There's no greater value than a leadership development program that accelerates your self-awareness, expands your network and provides practical and sustainable leadership skills that can be utilised immediately.

Investment: Super Early bird price (by August 31 2019) is $7,000 ex GST.

Early bird price (by December 31 2019) is $7,500 ex GST.

After January 1 2020 investment is $8,500 ex GST.

Nominations close 15 April 2020. There is a $500 non-refundable (but fully transferrable) deposit on booking.

Places are limited to 24.

Inclusions: While on the program, all meals, transport, accommodation, activities; DISC profile assessment; leadership course book and 2 coaching sessions.

Flights to/from Kununurra not included. Investment is fully tax deductible.
PARTICIPANT DETAILS
Your Name *

First Name Last Name
Organisation (if applicable):
Your E-mail *
Your Phone Number *

Area Code Phone Number

Your Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

INVOICING DETAILS
Organisation/Payee *
Is this organisation a Not For Profit? *

Yes No
E-mail *
Phone Number *

Area Code Phone Number

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

My Products *

Kimberley Leadership 2020 non-refundable deposit $ 500.00 AUD

Enter coupon

Total $ 0.00 AUD

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Please upload a head shot of yourself (no more than 10MB)

Browse Files

Cancel of
Should be Empty: