MATES Kokoda 2019 - Booking Form

MATES Kokoda Trek 2019

Fill out the following form to secure your place. Date: 6 Sep - 15 Sep 2019 | Cost: $5,950
Full Name*

PrefixFirst NameMiddle NameLast Name
Date of Birth

DayMonthYear
Company
Charity*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number

Area CodePhone Number
Mobile Number*
E-mail*
SECURE YOUR POSITION

A $1000 non-refundable registration fee is required to secure your position for this Adventure. Once a deposit is paid, your position is secure and the administrative preparation for your adventure will begin.

If paying by credit card, surcharges apply. Please select what you would like to pay for at this point in addition to the deposit, if relevant.

If paying by EFT, please indicate below and a tax invoice will be emailed to you.

If you are being sponored by an organisation, please indicate below and fill out the fields.
Payment Method*

EFTSponsorship Through OrganisationCredit Card

Credit Card Payment

Registration Fee (Required)$1,000.00AUD

Quantity
Item subtotal:$0.00AUD

Balance of Fees (less deposit)$4,950.00AUD

Quantity

Porter$750.00AUD

Porter Options

Subtotal $0.00AUDTax $0.00AUDTotal $0.00AUD

MATES Kokoda Trek 2019